This document is a PowerPoint presentation about wound dressings. It discusses different types of wound dressings including primary and secondary dressings, classifications of dressings into 7 categories like films and hydrogels. It provides details on specific dressing materials like gauze, tulles and film. It also covers topics like chronic wounds, venous stasis ulcers, arterial ulcers, pressure ulcers, diabetic wounds and negative pressure wound therapy.

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Advanced dressing
Thidanai Khameiad 5thyear medical student

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Wound dressing
ThorneC,Chung K,GosainA,GurtnerG,MehraraB,Rubin P,SpearS.GrabbandSmith’splasticsurgery.7th edition. Philadelphia; 2014

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Wound dressing
Primarydressingisplaceddirectlyonthewoundandmay
provideabsorptionoffluidsandpreventdesiccation,infection,
andadhesionofasecondarydressing.
Secondarydressingisonethatisplacedontheprimary
dressingforfurtherprotection,absorption,compression,and
occlusion

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Classiication
Woundcaredressingdividedinto7class
Film
Composites
Hydrogel
Hydrocolloid
Alginates
Foam
Absorbtivedressing
ThorneC,ChungK,GosainA,GurtnerG,MehraraB,RubinP,SpearS.GrabbandSmith’splasticsurgery.7th edition.Philadelphia;2014

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เก่งกาจ วินัยโกศล. AdvancedWoundDressing. ภาควิชาศัลยศาสตร ์คณะแพทยศาสตร ์มหาวิทยาลัยขอนแก่น. SrinagarindMedJ2013;28

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Page 7เก่งกาจ วินัยโกศล. AdvancedWoundDressing. SrinagarindMedJ2013;28

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Dressing material: gauze
Moderateabsorbtion
Nonadhesive
Lighthydration
Superficialwounds
&lightexudingwounds
ThorneC,ChungK,GosainA,GurtnerG,MehraraB,RubinP,SpearS.GrabbandSmith’splasticsurgery.7th edition.Philadelphia;2014

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Dressing material: Tulles
Lowabsorbtion
Nonadhesive
Shallowwounds
&lightexudingwounds

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Dressing material: film
Nonabsorbing
Fullyadhesive
Slowhydration
Superficialwounds&
lightexudingwounds
ThorneC,ChungK,GosainA,GurtnerG,MehraraB,RubinP,SpearS.GrabbandSmith’splasticsurgery.7th edition.Philadelphia;2014

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Hydrogel sheets
Lowabsorption
Nonadhesive
oradhesiveborder
Moderatehydration
Superficialwounds&
lightexudingwounds,
painfulwounds
ThorneC,ChungK,GosainA,GurtnerG,MehraraB,RubinP,SpearS.GrabbandSmith’splasticsurgery.7th edition.Philadelphia;2014

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Amorphous hydrogel
Low-moderate absorption
Nonadhesive
Quickhydration
Infected wound
Superficialtodeepwounds
lighttomoderate
exudingwounds
ThorneC,ChungK,GosainA,GurtnerG,MehraraB,RubinP,SpearS.GrabbandSmith’splasticsurgery.7th edition.Philadelphia;2014

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Hydrocolloids
Low-moderate absorption
Fullyadhesive
Moderatehydration
Superficialwounds
lighttomoderateexudingwounds
Promotecellmigration
Wounddebridementbyautolytic
ThorneC,ChungK,GosainA,GurtnerG,MehraraB,RubinP,SpearS.GrabbandSmith’splasticsurgery.7th edition.Philadelphia;2014

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Foams
High absorption
Fulltononadhesive
Nothydration
Superficialtodeepwounds
Moderatlytoheavily
exudingwounds
ThorneC,ChungK,GosainA,GurtnerG,MehraraB,RubinP,SpearS.GrabbandSmith’splasticsurgery.7th edition.Philadelphia;2014

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Alginates
High absorption
Nonadhesive
Nothydration
Superficialordeepwounds
Moderatlytoheavily
exudingwounds
ThorneC,ChungK,GosainA,GurtnerG,MehraraB,RubinP,SpearS.GrabbandSmith’splasticsurgery.7th edition.Philadelphia;2014

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Collagens
Moderatetohigh
absorption
Nonadhesive
Nothydration
Superficialordeepwound
lighttomoderatly
exudingwounds
ThorneC,ChungK,GosainA,GurtnerG,MehraraB,RubinP,SpearS.GrabbandSmith’splasticsurgery.7th edition.Philadelphia;2014

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Silver-impregnated dressings
Colonization,infectedwound
Broadspectrumofbactericidal
activitywithlowtoxicto
human
Gauze,hydrocolloid,alginates,
foams,creamsandgels
ThorneC,ChungK,GosainA,GurtnerG,MehraraB,RubinP,SpearS.GrabbandSmith’splasticsurgery.7th edition.Philadelphia;2014

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Dermal collagen replacement
Superficialandmoderate-depthpartialthicknessburns
Increasedspeedofhealing
DecreasedPain
Increaserateofepithelialization

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Page 19Nephew&Smith

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Negative pressure wound therapy
NegosantiL,PintoV,SgarzaniR.Clinicalevidencespersonalexperiencesrecentapplications.WorldJDermatol.2012October2;1(3):13-23.

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Negative pressure wound therapy
KirbyM.Negativepressurewoundtherapy.Br.J.OfDiabetesandVascularMedicine.2007;7(5):230-234.

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 Intermittentorcontinuoussubatmospheric
pressuretoawoundat50-175mmHg
 Moistwoundhealingenvironment
 Removaloffluidsandinfectiousmaterials
 Decreasedbacterialcolonization
 Enhancedformationofgranulationtissue
Negative pressure wound therapy
KirbyM.Negativepressurewoundtherapy.Br.J.OfDiabetesandVascularMedicine.2007;7(5):230-234.

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Negative pressure wound therapy
Advantage Disadvantage
Reductionofedema
Rapidcelldivision
Increaseinlocalbloodflow
Reductioninbacterialevelsand
Removalofharmfulproteases
Timeconsuming
Expensive
Laborintensive
Notalwayseffective
KirbyM.Negativepressurewoundtherapy.Br.J.OfDiabetesandVascularMedicine.2007;7(5):230-234.

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Negative pressure wound therapy
Indication Contraindication
Lymphaticleaks
Venousstasiswounds
Woundswithfistulae
Sternalwound
Orthopedicswounds
Abdominalwounds
Chronicopenwounds(diabeticulcers
andstages3and4pressureulcers)
Acuteandtraumaticwounds
 Necrotictissue
 Malignant wound
 Ischemicwounds
 Activebleeding,exposedlargevessel
 Infectedwound
ThorneC,ChungK,GosainA,GurtnerG,MehraraB,RubinP,SpearS.GrabbandSmith’splasticsurgery.7th edition.Philadelphia;2014

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DiniV,MitevaM,RomanelliP,BertoneM,RomanelliM.Evaluationofvenouslegulcersbeforeandafternegativepressurewoundtherapy. Wounds.2011;23(9):257–266

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TuncelU,TuranA,BayraktarA,AydinU,ErkorkmazU.Clinicalexperiencewiththeuseofgauze-basednegativepressurewoundtherapy.Wounds:2012;24(8):227–233.

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Chronic wounds
Definition
woundsthathavefailedtoproceedthrough
theorderlyprocessthatproducessatisfactory
anatomicandfunctionalintegrity.
Themajorityofwoundsthathavenothealedin
3monthsareconsideredchronic.

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Maintainingamoistwoundenvironmenteg.hydrocolloids.
Highabsorption material
Compression therapy
ThorneC,ChungK,GosainA,GurtnerG,MehraraB,RubinP,SpearS.GrabbandSmith’splasticsurgery.7th edition.Philadelphia;2014
Venous stasis ulcers

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Venous stasis ulcers
Compressiondressing

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Moistdressing
ThorneC,ChungK,GosainA,GurtnerG,MehraraB,RubinP,SpearS.GrabbandSmith’splasticsurgery.7th edition.Philadelphia;2014
Arterial ulcers

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Wound Material
Intact skin Film, thin hydrocolloid,
offloading footwear
Minimal exudate Film, hydrocolloid,
thin foam
Moderate exudate Hydrocolloid, foam,
calcium alginate
Heavy exudate Foam, calcium alginate
Infection wound antimicrobial dressing
Arterial ulcers

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Pressure ulcers

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Pressure ulcers
ชนิดแผลกดทับ ลักษณะการทาแผล ตัวอย่างวัสดุ
Grade II ขึ้นไป ในแผลชื้นพอเหมาะ
รอบแผลแห้ง
ลอกออกง่าย
Occlusive dressing
Non adhesive
แผลตื้น, exudate น้อย ในแผลชื้นพอเหมาะ
รอบแผลแห้ง
ลอกออกง่าย
Film, hydrocolloid
exudate ปานกลาง-มาก วัสดุที่ดูดซับ exudte ได้ดี Foam, alginate
แผลแห้ง มี eschar ต้องการความชื้นมากขึ้น
เพื่อให้เกิด autolytic
debridement
Hydrogel
แผลเป็ นโพรงและหลุมลึก วัสดุที่เข้าถึงก้นแผล Calcium alginate
แผลติดเชื้อ ยาฆ่าเชื้อ Sustained silver releasing
Gauze impregnated with
antimicrobial agent
พรพรหม เมืองแมน, อภิรักษ์ ช่วงสุวนิช, อภิชัย อังสพัทธ์, จอมจักร จันทรสกุล. Wound care 2014. พิมพ์ครั้งที่ 1. ชมรมแพทย์อุบัติเหตุไฟไหม้น้าร ้อนลวกแห่งประเทศไทย
ร่วมกับชมรมสมานแผลแห่งประเทศไทย. กรุงเทพมหานคร; 2014.

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Diabetic wounds
Wound Material
Minimal exudate Hydrocolloid
Moderate exudate Hydrofiber
Heavy exudate Foam
Infection wound Gauze impregnated with
antimicrobial agent
พรพรหม เมืองแมน, อภิรักษ์ ช่วงสุวนิช, อภิชัย อังสพัทธ์, จอมจักร จันทรสกุล. Wound care 2014. พิมพ์ครั้งที่ 1. ชมรมแพทย์อุบัติเหตุไฟไหม้น้าร ้อนลวกแห่งประเทศไทย
ร่วมกับชมรมสมานแผลแห่งประเทศไทย. กรุงเทพมหานคร; 2014.

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Dermal living replacement
Dermagraft® isasterile,cryopreserved,humanfibroblast–deriveddermalsubstitute
generatedbythecultureofneonataldermalfibroblastsontoabioabsorbable
polyglactinmeshscaffold.

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