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Wound care for nurses
An ideal wound dressing provides protection, maintains moisture, reduces pain, and absorbs exudate. It should not induce pain or itching, be easy to change, allow gaseous exchange, and be inexpensive and readily available. Common types include gauze, tulle, hydrocolloid, hydrogel, alginate, and foam dressings. Vacuum assisted closure (VAC) uses negative pressure to contract the wound and remove exudate, promoting healing through micro and macrostrain. The appropriate dressing depends on the wound characteristics, with dry wounds suited to hydrocolloid or hydrogel and exudating wounds to hydrocolloid or foam.
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Wound care for nurses
- 1. Wound Dressings Dr. JoelArudchelvam Consultant Vascular and Transplant Surgeon
- 2. Wound dressings • Thematerial which is applied to the surface of the wound to cover it is called a dressing. – 1ry – dressing which touches the wound – 2ry – dressing used to cover the primary dressing
- 3. Ideal wound dressing Dressingsare applied to wounds for the following reasons; • To provide a protective cover • To maintain moisture • To reduce pain • To absorb exudates In addition an ideal dressing have the following features; • does not induce pain or itching • easy to change • Allows gaseous exchange • Cheap • Freely available
- 4. Types of WoundDressings • Gauze dressings • Tulle • Hydrocolloid dressings • Hydrogel dressings • Alginate dressings • Foam dressings • Transparent film dressings • Etc.
- 5. Gauze • Cheap • Freelyavailable • Dry • Painful on removing • Damages epithelium
- 6. Tulle • Cheap • Freelyavailable • Easy removal – E.g : Vaseline
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- 8. Hydrocolloid Dressings • Madeup of pectin based material • Absorb exudate • Occlusive – should not be used on infected wounds • Come in various shapes and sizes
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- 10. Hydrogel Dressings • Madeup of primarily water in a polymer to maintain moist wound base • used in dry wounds • Should not be used in exudating wounds
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- 12. Alginate Dressings • Madeup of seaweed • Absorb moderate amounts of drainage • becomes a gel when it comes into contact with wound fluid through Calcium/Sodium ion exchange
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- 14. Foam Dressings • Madeup of polyurethane foam • Absorbs moderate to large amounts of fluid • Available in various sizes and shapes • Some types my macerate peri wound skin if it allows drainage laterally
- 15. Silver Dressings • Antimicrobialto reduce bio burden of wound through slow release of silver ion into the wound • e.g. Acticoat, Biatin Ag, Atruman Ag
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- 18. Vacuum assisted closureVAC • Macrostrain - visible stretch that occurs when negative pressure contracts the foam. – Draws wound edges together – Provides direct and complete wound bed contact – Evenly distributes negative pressure – Removes exudate and infectious materials • Microstrain - micro deformation at the cellular level – Reduces edema – Promotes granulation tissue formation by facilitating cell migration and proliferation
- 19. Vacuum assisted closureVAC • Indications for use – Large wounds – Cavities – Large amount of exudate
- 20. Summary Wound type Dressing DryHydrocolloid, Hydrogel Exudating wound Hydrocolloid, foam Slough Hydrocolloid, hydrogels Dead space / cavity Alginate, foam
- 21. When to changedressings • When there is an indication to change – Soaking – Pain – Need to inspect • Discuss with doctor before changing
- 22. Avoid in chronicwounds • Iodine (Betadine) • Hydrogen peroxide • Other toxic agents
- 23. Avoid • Do nottie gauze bandage tightly around limbs, digits – causes ischaemia • Use – plaster , crepe instead
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