advdressing.pptx

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Page 8
D
r
e
s
s
i
n
gmaterial:g
a
u
z
e
Moderateabsorbtion
Nonadhesive
Lighthydration
Superficialwounds
&
lightexudingwounds
th
ThorneC,ChungK
,GosainA
,GurtnerG,MehraraB
,RubinP
,SpearS.Grabba
n
dSmith’splasticsurgery
.7edition.Philadelphia;2014

Page 9
D
r
e
s
s
i
n
gmaterial:T
u
l
l
e
s
L
o
wabsorbtion
Nonadhesive
Shallowwounds
&
lightexudingwounds

Page 10
D
r
e
s
s
i
n
gmaterial:film
Nonabsorbing
Fullyadhesive
Slowhydration
 Superficialwounds&
lightexudingwounds
th
ThorneC,ChungK
,GosainA
,GurtnerG,MehraraB
,RubinP
,SpearS.Grabba
n

Page 11
H
y
d
r
o
g
e
ls
h
e
e
t
s
L
o
wabsorption
Nonadhesive
oradhesiveborder
Moderatehydration
 Superficialwounds&
lightexudingwounds,
painfulwounds
th
ThorneC,ChungK
,GosainA
,GurtnerG,MehraraB
,RubinP
,SpearS.GrabbandSmith’splasticsurgery.7edition.Philadelphia;2014

Page 12
A
m
o
r
p
h
o
u
s
h
y
d
r
o
g
e
l
Low-moderateabsorption
Nonadhesive
Quickhydration
 Infectedwound
Superficialtodeepwounds
lighttomoderate
exudingwounds
th
ThorneC,ChungK
,GosainA
,GurtnerG,MehraraB
,RubinP
,SpearS.Grabba
n

Page 13
H
y
d
r
o
c
o
l
l
o
i
d
s
Low-moderateabsorption
Fullyadhesive
Moderatehydration
Superficialwounds
lighttomoderateexudingwounds
Promotecellmigration
W
ounddebridementbyautolytic
th
ThorneC,ChungK
,GosainA
,GurtnerG,MehraraB
,RubinP

Page 14
F
o
a
m
s
Highabsorption
Fulltononadhesive
Nothydration
Superficialtodeepwounds
Moderatlytoheavily
exudingwounds
th
ThorneC,ChungK
,GosainA
,GurtnerG,MehraraB
,RubinP
,SpearS.Grabba
n

Page 15
A
l
g
i
n
a
t
e
s
Highabsorption
Nonadhesive
Nothydration
Superficialordeepwounds
Moderatlytoheavily
exudingwounds
th
ThorneC,ChungK
,GosainA
,GurtnerG,MehraraB
,RubinP

Page 16
C
o
l
l
a
g
e
n
s
 Moderatetohigh
absorption
Nonadhesive
Nothydration
 Superficialordeepwound
lighttomoderatly
exudingwounds
th
ThorneC,ChungK
,GosainA
,GurtnerG,MehraraB
,RubinP
,SpearS.Grabba
n

Page 17
Silver-impregnatedd
r
e
s
s
i
n
g
s
Colonization,infectedwound
 Broadspectrumofbactericidal
activitywithlowtoxicto
human
 Gauze,hydrocolloid,alginates,
foams,creamsandgels
th
ThorneC,ChungK
,GosainA
,GurtnerG,MehraraB
,RubinP

Page 18
D
e
r
m
a
lc
o
l
l
a
g
e
nr
e
p
l
a
c
e
m
e
n
t
Superficialandmoderate-depthpartialthicknessburns
Increasedspeedofhealing
DecreasedPain
Increaserateofepithelialization

Page 19
Nephew&
Smith

Page 20
N
e
g
a
t
i
v
ep
r
e
s
s
u
r
ew
o
u
n
d
t
h
e
r
a
p
y
NegosantiL,PintoV
,SgarzaniR.Clinicalevidencespersonalexperiencesrecentapplications.W
orldJDermatol.2012October2;1(3):13-23.

Page 21
N
e
g
a
t
i
v
ep
r
e
s
s
u
r
ew
o
u
n
d
t
h
e
r
a
p
y
KirbyM.Negativepressurewoundtherapy.Br
.J.OfDiabetesandV
ascularMedicine.2007;7(5):230-234.

Page 22
 Intermittentorcontinuoussubatmospheric
pressuretoawoundat50-175m
m
H
g
 Moistwoundhealingenvironment
 Removaloffluidsandinfectiousmaterials
 Decreasedbacterialcolonization
 Enhancedformationofgranulationtissue
N
e
g
a
t
i
v
ep
r
e
s
s
u
r
ew
o
u
n
d
t
h
e
r
a
p
y
.J.OfDiabetesandV

Page 23
N
e
g
a
t
i
v
ep
r
e
s
s
u
r
ew
o
u
n
d
t
h
e
r
a
p
y
A
d
v
a
n
t
a
g
e D
i
s
a
d
v
a
n
t
a
g
e
Reductionofedema Timeconsuming
Rapidcelldivision Expensive
Increaseinlocalbloodflow Laborintensive
Reductioninbacterialevelsand
Removalofharmfulproteases
Notalwayseffective
.J.OfDiabetesandV

Page 24
N
e
g
a
t
i
v
ep
r
e
s
s
u
r
ew
o
u
n
d
t
h
e
r
a
p
y
Indication Contraindication
Lymphaticleaks
Venousstasiswounds
Woundswithfistulae
Sternalwound
Orthopedicswounds
Abdominalwounds
Chronicopenwounds(diabeticulcers
andstages3and4pressureulcers)
Acuteandtraumaticwounds
 Necrotictissue
 Malignantwound
 Ischemicwounds
 Activebleeding,exposedlargevessel
 Infectedwound
th
ThorneC,ChungK
,GosainA
,GurtnerG,MehraraB
,RubinP

Page 25
DiniV
,MitevaM,RomanelliP
,BertoneM,RomanelliM.Evaluationofvenouslegulcersbeforeandafternegativepressurewoundtherapy.W
ounds.2011;23(9):257–266

Page 26
TuncelU,TuranA
,BayraktarA
,
A
ydinU,ErkorkmazU.Clinicalexperiencewiththeuseofgauze-basednegativepressurewoundtherapy.W
ounds:2012;24(8):227–233.

Page 27
C
h
r
o
n
i
cw
o
u
n
d
s
Definition
woundsthathavefailedtoproceedthrough
theorderlyprocessthatproducessatisfactory
anatomicandfunctionalintegrity.
Themajorityofwoundsthathavenothealedin
3monthsareconsideredchronic.

Page 28
Maintainingamoistwoundenvironmenteg.hydrocolloids.
Highabsorptionmaterial
Compressiontherapy
th
ThorneC,ChungK
,GosainA
,GurtnerG,MehraraB
,RubinP
V
e
n
o
u
s
s
t
a
s
i
su
l
c
e
r
s

Page 29
V
e
n
o
u
s
s
t
a
s
i
su
l
c
e
r
s
Compressiondressing

Page 30
Moistdressing
th
ThorneC,ChungK
,GosainA
,GurtnerG,MehraraB
,RubinP
Arterialu
l
c
e
r
s

Page 31
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
Arterialu
l
c
e
r
s

Page 32
P
r
e
s
s
u
r
eu
l
c
e
r
s

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