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Omer hashm
H.O
Sugical
wound

Traumatic
wound

Untidy
Tidy
(incisional)

(penetrating,
lacerating.
Degloving)
Untidy wound

Tidy wound
which heal themselves by
primary intensin
Othervise they undergo
 Scars
 Contractures
 Severe ...
Size, dep
th &
location

Lab tests:

HISTORY
examination

WOUND
ASSESMENT

WOUND
BED

SURROUNDING
skin
1.Sloughy wound

• Dead cells accumulated in exudate

Aim:
to liquefy slough and aid its removal

2.Necrotic wound

•Aims:...
3. Infected wound

•Aims: reduce exudate,

odour and promote
healing

4.Granulating
wound

 Aims: support granulation,

p...
 PRIORITIES

-Correct Etiology
-Provide Systemic Support
-Use appropriate therapy
• GOAL

-Healing
-Maintenance
Traditional dressings:

Modern Moist Wound Dressings:

• Gauze, lint and fiber
products
• Hydrocolloids

•
•
•
•
•
•
•

Fo...
Autolytic
Fillers

Hydrating

Primary
Non-adhesive
Active

Absorbing
Secondary
Enzymatic
Need to be compatible with the wound:
 May be hydrating or absorptive
 Promote/maintain moist, healing environment
 Pro...
 Indications:
 Superficial and full thickness wounds
 Skin grafts, donor sites, burns, skin tears
 Under compression f...
 Indications:
 Minor injuries (abrasions)
 Post-op dressing over sutures
 IV sites

 Contraindications:
 High exudat...
 Indications:
 Highly exuding wounds
 Infected wounds (change daily)

 Contraindications:
 Dry wounds or wound with e...
Regranex®
Growth Factor Preparations

PDGF preparation in a
hydrogel
Dermagraft®
Single-Layered Tissue

Human fibroblast...
Processed Tissue
 Primatrix®

 Oasis®

Acellular collagen dermis (fetal
bovine origin)

Acellular bovine graft
(Bovine S...
 Indications:
 Dry wounds
 Wounds with slough wounds
 Wounds with eschar
 Over tissues and tendons to prevent drying
...
 Chemically inert, adverse effects rare
 Designed to be removed without trauma or pain
 Protect friable or newly healed...
 Enzymatic

Viridine-strptokinase
 biological

maggots
 Bacteriocidal:
 Silver
 Honey
 Cadexomer iodine
 Bacteriostatic:
 Methylene Blue and Gentian Violet
 Xeroform
 Antimicrobial action through (+) silver ion

 Effective when in contact with wound fluid
 Consider:
 Kill rate AND su...
 Hydrogen peroxide
 Acetic acid
 Effective against Pseudomonas aeruginosa

 Diguanides (Chlorhexidine)
 Sodium hypoch...
Usually Type I bovine or avian or type III
porcine collagen
Indications:



Partial & full thickness wounds
Minimal to m...
Based on amount of drainage and presence of
infection
 Infected wounds need to be monitored daily
 Heavily draining woun...
Wound management & dressings
Wound management & dressings
Wound management & dressings
Wound management & dressings
Wound management & dressings
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Wound management & dressings

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wound management, dressings type, dirty and clean wounds, presents plan to manage different types of wounds and options of available dressings.

Published in: Health & Medicine, Business
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  • When health care providers are seeking the “ideal dressing”, the following questions should be considered:- Does the dressing protect from secondary infection?- Does it provide a moist wound environment?- Does it provide thermal insulation?- Can it be removed without causing trauma to the skin?- Does the dressing remove/absorb drainage and debris?- Is it free from particulates and toxic products?
  • Transcript of "Wound management & dressings"

    1. 1. Omer hashm H.O
    2. 2. Sugical wound Traumatic wound Untidy Tidy (incisional) (penetrating, lacerating. Degloving)
    3. 3. Untidy wound Tidy wound which heal themselves by primary intensin Othervise they undergo  Scars  Contractures  Severe infections Tidy wound <6hrs.. Primarily closed or delayed primary closure after 3-5 days …untidy wound dealt with secondary closure, culture sensitivty done, antibitics and dressing
    4. 4. Size, dep th & location Lab tests: HISTORY examination WOUND ASSESMENT WOUND BED SURROUNDING skin
    5. 5. 1.Sloughy wound • Dead cells accumulated in exudate Aim: to liquefy slough and aid its removal 2.Necrotic wound •Aims: • to debride and remove eschar
    6. 6. 3. Infected wound •Aims: reduce exudate, odour and promote healing 4.Granulating wound  Aims: support granulation, protect new tissue, keep moist
    7. 7.  PRIORITIES -Correct Etiology -Provide Systemic Support -Use appropriate therapy • GOAL -Healing -Maintenance
    8. 8. Traditional dressings: Modern Moist Wound Dressings: • Gauze, lint and fiber products • Hydrocolloids • • • • • • • Foams Films Alginates/Hydrofibers Collagen Hydrogels Topical Antimicrobials Silicone Look how far we’ve come!!!
    9. 9. Autolytic Fillers Hydrating Primary Non-adhesive Active Absorbing Secondary Enzymatic
    10. 10. Need to be compatible with the wound:  May be hydrating or absorptive  Promote/maintain moist, healing environment  Provide insulation  Impermeable to microrganisms  Atraumatic to the wound/periwound area  Cost effective  In conventional terms: dry, or wet  In technical terms we have:
    11. 11.  Indications:  Superficial and full thickness wounds  Skin grafts, donor sites, burns, skin tears  Under compression for ulcers  Contraindications:  Dry wounds  Examples: Mepilex (Border), Allevyn (Plus Adhesive), Polymem, Biatain
    12. 12.  Indications:  Minor injuries (abrasions)  Post-op dressing over sutures  IV sites  Contraindications:  High exudate wounds  Fragile skin  Examples: Tegaderm, Opsite
    13. 13.  Indications:  Highly exuding wounds  Infected wounds (change daily)  Contraindications:  Dry wounds or wound with eschar  Aquacel, Melgisorb, Seasorb, Kaltostat
    14. 14. Regranex® Growth Factor Preparations  PDGF preparation in a hydrogel Dermagraft® Single-Layered Tissue  Human fibroblasts on matrix meshBilayered Tissue  Apligraf® Human fibroblasts and keratinocytes in a bovine collagen matrix.
    15. 15. Processed Tissue  Primatrix®  Oasis® Acellular collagen dermis (fetal bovine origin) Acellular bovine graft (Bovine Small Intestinal Submucosa)
    16. 16.  Indications:  Dry wounds  Wounds with slough wounds  Wounds with eschar  Over tissues and tendons to prevent drying  Contraindications:  High exudate wounds  Examples: Solosite, Woun’ Dress, SkinTegrity
    17. 17.  Chemically inert, adverse effects rare  Designed to be removed without trauma or pain  Protect friable or newly healed tissue from injury  Less trauma to periwound  Examples: Mepilex, Allevyn Gentle
    18. 18.  Enzymatic Viridine-strptokinase  biological maggots
    19. 19.  Bacteriocidal:  Silver  Honey  Cadexomer iodine  Bacteriostatic:  Methylene Blue and Gentian Violet  Xeroform
    20. 20.  Antimicrobial action through (+) silver ion  Effective when in contact with wound fluid  Consider:  Kill rate AND sustained release rate  Testing Methods: Simulated wound fluid, saline  Delivery methods: foams, gels, alginates, hydrofibers, creams  (SSD - approved for burns, only)
    21. 21.  Hydrogen peroxide  Acetic acid  Effective against Pseudomonas aeruginosa  Diguanides (Chlorhexidine)  Sodium hypochlorite (Dakin’s)  Not recommended unless suitable are unavailable  Povidone Iodine
    22. 22. Usually Type I bovine or avian or type III porcine collagen Indications:   Partial & full thickness wounds Minimal to moderate drainage  Contraindications:    Eschar covered Full thickness burns Sensitivity to contents
    23. 23. Based on amount of drainage and presence of infection  Infected wounds need to be monitored daily  Heavily draining wounds may need to be changed 2-3 times a day  As drainage decreases, increase time between dressing changes
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