1) The document discusses various wound care products and their uses. It describes phases of wound healing and fundamentals of wound care. 2) It provides details on different dressing types including hydrocolloids, calcium alginates, hydrogels, foams, silver products, collagen dressings, film dressings, and bioengineered skin substitutes. 3) The document advises that the appropriate product depends on factors like the wound's needs to promote healing, practical considerations, and the patient's situation.

2. TOPICAL WOUND CARE
WHAT TO PICK?

4. PHASES OF WOUND HEALING
1) Inflammatory (0 – 4 days). Vasoconstriction, clot
formation and hemostasis.
2) Proliferative (2-3 days to 30 days). Fibroblasts lay
framework for ECM and new granulation.
Angiogenesis connects new granulation and
epithelialization progresses across wound base.
3) Remodeling (3 weeks to 2 years). Completion of
wound contraction with crosslinking of collagen and
reduction in scar size. Tensile strength ultimately
becomes appro. 80% of original.

5. WOUND CARE FUNDAMENTALS
 Maintain moist wound environment
 Remove eschar, debris and necrotic tissue from
wound bed
 Control exudate
 Prevent trauma and further wounding
 Identify and treat infection
 Manage edema
 “Back to basics”

6. MOIST WOUND CARE
 Moist wound environment facilitates healing
 Wounds that are too wet or too dry cannot
progress through normal phases of healing
 Products to absorb and dry if too wet
 Products to maintain and add moisture if too dry
 Should be a part of essentially every wound care
regimen
 No air drying or soaking!

7. HYDROCOLLOIDS

8. HYDROCOLLOIDS
 Impermeable to bacteria
 Facilitates autolytic debridement
 Self adhesive
 As exudate is absorbed, forms a colloidal gel
 Not for use in heavily exudating wounds
 Common uses are pressure ulcers, burns
 Ex: Duoderm, Tegaderm, Replicare, Restore

10. CALCIUM ALGINATES

11. CALCIUM ALGINATES
 Use in exudating wounds
 Absorbs drainage and turns it into gel
 Fills dead space
 Prevents wound base from being too wet but yet
prevents drying
 Commonly used in exudating cavity and tunnel
wounds as well as venous insufficiency ulcers
 Secure with secondary dressing

13. HYDROGELS

14. HYDROGELS
 Soothing and pain reducing
 Rehydrates wound and maintains moist
environment
 Prevents dressing adherence
 Can fill small voids or dead spaces
 Comes in gels and sheets
 Requires secondary dressing
 Can cause peri-wound maceration

16. FOAMS

17. FOAMS
 Highly Absorptive
 Non-adherent
 Conformable
 Protects wound and peri-wound from trauma
 Thermal insulation
 Common uses are pressure (decubitus) ulcers
 Can use under compression for venous ulcers

19. SILVER PRODUCTS

20. SILVER PRODUCTS
 Documented antimicrobial activity thru history
 Effective against MRSA and VRE
 Available in a wide variety of dressing substrates
 Products containing silver that also absorb
drainage, ie, silver alginates, tend to perform the
best
 Common uses are CVI and diabetic ulcers

22. COMBINATIONS
22

23. COLLAGEN DRESSINGS
 Stimulate and recruit cells for healing
 Provide gridwork or matrix for new tissue
 Available as synthetic or bioengineered
 Common uses are in well granulated wounds.
Not of value over eschar or slough

25. COLLAGEN DRESSINGS

26. FILM DRESSINGS
 Semi-permeable
 Waterproof (also retain moisture)
 Transparent for visualization
 Can tear fragile skin
 Not for infected or exudating wounds
 Common uses are lacerations, skin tears and IV
sites.

28. BIOENGINEERED SKIN
SUBSTITUTES
 Useful for relatively shallow, well granulated
wounds
 Surface area; small to large wounds
 Speeds up wound closure remarkably
 Grafts must be offloaded and carefully protected

29. 29

31. GAUZE
 Wet to dry leads to non-selective mechanical
debridement
 Stimulates F.B. reaction frequently
 Good bacterial growth medium. 7.1% infection
rate vs 1.3% for hydrocolloid dressing
 Readily permeable to gas and bacteria
 Lots of good evidence that we should not use
anymore as a primary dressing
 Effective and economical as secondary or cover
dressing

33. Betadine
Peroxide
Dakins
Neosporin
N.S Gauze
Air

34. Soaking
Air Drying

35. PRODUCT SELECTION
 1) What does the wound need?
 2) Does the product accomplish that
 3) Does it need more than one product?
 4) What is available (Insurance?)
 5) What is practical
 6) What can the patient/caregivers apply
 7) What can the patient afford?
 8) Is it cytotoxic

36. THANK YOU !
QUESTIONS ???