This document discusses modern wound dressings and care. It provides details on various wound cleansing solutions and their properties. It also describes different types of modern dressing materials like films, hydrogels, alginates, and their functions. Advanced wound care technologies like negative pressure wound therapy, hyperbaric oxygen therapy and photobiomodulation therapy are mentioned. The take home message is that dressing selection depends on wound assessment and characteristics, and multiple dressing materials may be suitable depending on the situation.

1. WOUND
DRESSING
DR. KHADIJAH BINTI NORDIN
UNIT PENJAGAAN LUKA, HEBHK

2. CONTENTS

3. CONTENTS
why modern dressings
dressing solutions
dressing items
wound care advanced technology
wound care AI

4. WHY MODERN DRESSING

5. SIGNIFICANCE MODERN DRESSING

6. HOW TO CHOOSE MODERN
DRESSING

8. WOUND CLEANSING AND SOLUTION
Wound cleansing is a process of removing inflammatory
contaminants from the wound surface which can impede healing
and increase risk of infection using solutions (non-antiseptic and
antiseptic)

9. SOLUTION COMMONLY USED
STERILE WATER NORMAL SALINE

10. STERILE WATER
• HYPOTONIC SOLUTION
• CAN BE KEPT MORE THAN 24
HOURS ONCE OPENED
• BETTER OPTIONS THAN NS
SAME AS JUST USING COLD-
BOILED WATER AT HOME
NORMAL SALINE
• ISOTONIC SOLUTION
• MUST USE WITHIN 24 HOURS
AFTER OPENING
• DISREGARD AFTER 24 HOURS
• IT SUPPORTS THE GROWTH OF
NASOCOMIAL BACTERIA AND
ENHANCES ITS PATHOGENIC
ACTIVITY NOSOCOMIAL
DIFFERENCES

11. SODIUM HYPOCHLORITE
• ITS A SUPER OXIDISED SOLUTION
• CONTAINING SODIUM AND
HYPOCHLORITE IONS
• STERILE AND BROAD SPECTRUM
• ACT BY DESTROYING THE BACTERIAL
CELL WALL
• SOAKING METHOD FOR 1 MINUTE
• ONCE OPEN THE CAP, CAN KEEP FOR 1
MONTH
• EASILY AVAILABLE

12. OCTENIDINE DIHYDROCHLORIDE
• HIGHLY EFFECTIVE FOR MRSA/PSEUDOMONAS/ VIRUS/FUNGAL
• NON TOXIC, NON IRRITANT
• OCTENILIN: FOR WOUND
• OCTENISEPT: FOR WOUND AND MUCUS MEMBRANE
• OCTANISAN: FOR BATHING
• SOAKING METHOD FOR 2 MINUTES
• ONCE OPEN THE CAP, CAN KEEP FOR 2 MONTHS
• BIT PRICY

13. POLYHEXAMETHYLENE BIGUANIDE (PHMB)
• POLYHEXANIDE:
• HIGHLY POTENT ANTIMICROBIAL AGENT
• BINDS TO BACTERIA’S OUTER LAYER WALL
CAUSING IT TO DISINTEGRATE AND LYSIS
• BIGUANIDES:
• SURFACTANT THAT BREAKS BIOFILM WALL
• FOR CHRONIC & EPITHELISING WOUND
• SOAK 5 MIN
• FOR CHRONIC & GRANULATING WOUND
• SOAK 10 MINS
• FOR CHRONIC & INFECTED WOUND
• SOAK 15 MINS

14. POVIDONE IODINE 10%
• HIGHLY POTENT,
• CAN EVEN KILL THE GOOD CELLS
• NOT TO BE USE ON HYPERTHYROID PATIENTS
• CAN CAUSE SKIN IRRITATION
• EASY TO FIND

15. ACETIC ACID 3% - 5%
• ACIDITIC PROPERTIES HELPS IN KILLING BACTERIA
• USE DILUTED ACETIC ACID (3%-5%)
• GOOD FOR PSEUDOMONAS
• CASES STUDY SHOWED APPLICATION 2 TO 12 TIMES
ON A WOUND WILL SHOWS IT BENEFICIAL EFFECT.

16. HYDROGEN PEROXIDE
• NOT FOR CLEAN WOUND
• USE DILUTED HYDROGEN PEROXIDE ON AN
INFECTED WOUND
• MIGHT CAUSE BURNING AND STINGING
SENSATION PAIN
• HAVE SLIGHT HEMOSTATIC PROPERTIES

17. OTHERS
CHLORHEXIDINE
NOT EFFECTIVE AGAINST
MYCOBACTERIUM/VIRUS/FUNGAL
EUSOL
AS WOUND DISINFECTANT
GENTIAN VIOLET
ANTISEPTIC DYE SOLUTION FOR
FUNGAL INFECTION

18. MODERN DRESSING
MATERIAL

19. Tullea
• fabric impregnated with:
• soft paraffin oil
• balsam of Peru
• olive oil
• prevents its sticking to wounds,
• it needs to be used in combination
with another absorbent dressing.
• Cheap
• Freely available
• E.g : Jelonet, bactigrass

20. Film
• Propose
• Protect against
contamination and friction
• Maintain moist surface
• Prevent evaporation
• Facilitate assessment
• Advantage:
• Transparent
• Bacterial barrier
• Waterproof
• Breathable

21. Hydrogel
• Made up of water in a
polymer to maintain
• moisture
• used in dry wounds
• Should not be used in
exudating wounds
• Propose:
• Rehydrate debride and
deslough the wound
• Promote moist healing
• Cavity filling
• Soften the necrotic
tissues

22. Hydrocolloid
Dressings
• slowly absorb fluids, leading to a change
in the physical state of the dressing &
the formation of gel covering the
wound.
• they are called interactive dressings
• Provide moist wound environment
• Promote the formation of granulation
tissue
• Provide PAIN RELIEF by covering nerve
endings with both gel and exudate.
• Constituents are methylcellulose,
pectin, gelatin, and polyisobutylene.
• Available with border or without border

23. Alginate
• Made up of seaweed
• Absorb moderate amounts of
drainage
• becomes a gel when it comes into
contact with wound fluid through
Calcium/Sodium ion exchange
• Can be used for haemostatic
properties
• biodegradable

24. CMC DRESSING
(Carboxymethyl Cellulose)
• Manage heavy exuding wound
• The hydofibre will become gel like layer
that can be easily removed
• Maintains a moist healing environment
• Longer wear time
• Comfortable and non-traumatic upon
removal
• Reduce risk of maceration
• Can be used on infected wound
• Not helpful in dried wound
• Need secondary dressing

25. Silver
impregnated
dressing
• No known resistance
• Locally acting
• Antimicrobial to reduce bio
burden of the wound
through the slow release of
silver ion into the wound
• e.g. Acticoat, Biatin Ag,
Atruman Ag

26. Charcoal impregnated
dressing
• Odor absorbent and reduce
odor
• Need for secondary dressing
• the active charcoal layer
absorbs bacteria and locally
released toxins, as well as
volatile amines and fatty acids
responsible for wound odor

27. Collagen dressing
• Function
• enhanced tissue granulation and
epithelisation wound
Advantage
• closed faster
• Disadvantage
• not for very dry wounds
• not infected wounds

28. Iodine based
dressing
• Function
• antibacterial properties
• maintain moist wound bed
• Advantage
• break biofilm
• can last up to 3 days (brown
colour turns white)
• Disadvantage
• not for hyperthyroid patients

29. Honey
• Function
• antimicrobial debride/desloughing
(protease enzymes)
• anti-inflammatory
• Advantage
• promote granulation
• has enzymatic debridement
properties (protease enzymes)
• can reduce scarring tissue and
pain
• Disadvantage
• desirable effect upon daily usage

30. Polymem
• Function
• same as foam
• contains a surfactant that helps
with bactericidal effect
• Advantage
• can contour according to the
wound bed
• contains glycerin, making it not
stick hard on the wound bed
• can absorb exudate
• prevent vertical transmission to
skin
• Disadvantage
• not for too heavy exudative wound

31. PARRASIT IN WOUND THERAPY
• Maggots
• release proteolytic enzymes to
deslough tissues
• not for tunneling wounds,
eschar/necrotic tissue and wound
with exposed organs
• Leeches
• provide neovascularization tissue

32. SKIN BARRIER
• Function:
• protective skin barrier
• protect peri-wound region
• can also serve as prevention
of pressure injury and
treatment of stage 1 Pressure
Injury
• calmoseptine: incontinence-
associated dermatitis

33. MODERN WOUND CARE
ADVANCED TECHNOLOGY

34. HYPERBARIC
OXYGEN CHAMBER
THERAPY
NEGATIVE
PRESSURE WOUND
THERAPY
LASER THERAPY
PHOTOBIOMODULATION THERAPY
TOPICAL OXYGEN THERAPY
MICROCURRENT DEVICE THERAPY
Ultrasound
Healing
Therapy

35. NEGATIVE PRESSURE
WOUND THERAPY
Use it to absorb exudate,
increase tissue granulation by
microdeformation, wound
contraction by macro-
deformation, and
approximation of wound
edges.

36. HYPERBARIC OXYGEN CHAMBER
THERAPY
Giving 100% oxygen
concentration to the
whole body system to
promote tissue growth
and angiogenesis

37. TOPICAL OXYGEN THERAPY
Giving oxygen
concentration directly to
the wound for 24 hours
to promote tissue growth
and angiogenesis

38. • Used low-energy ultrasound waves
• No direct contact is ever made with
the wound.
• treatment takes only two and a half
minutes
• Able to kill more than 80 percent of
bacteria on the surface,
• stimulating the cells within and below
the wound bed
• to accelerate the normal healing
process.
Ultrasound Therapy

39. LOW LIGHT LASER
THERAPY
Can help to reduce pain,
accelerate tissue repair,
heal wounds, and
improve nerve function
and vascular activity

40. PHOTOBIOMODULATION
THERAPY

41. MICROCURRENT DEVICE THERAPY
Use as part of pain
relief therapy for
patients with acute
and chronic pain
whenever they have
to do dressing

42. WOUND CARE AI

43. NATROX IQ

45. KroniKare

46. SUMMARY:
FROM
REMOVAL
TO
RE-APPLICATION
Wound
Thin exudate Basic solution
Highly exudate
(high bacterial
activity)
Adequate time
Superoxidise
solution
Not enough time PHMB
Dry Debridement
This is the moment when you remove secondary dressing from patient.
Describe exudate consistency and characteristic.
Decide which solutions best for cleansing.

47. SUMMARY:
FROM
REMOVAL
TO
RE-APPLICATION
Tissue
Viable
Proceed with
normal cleansing
Hydrogel (autolytic
debridement)
Non-viable
Slough
Hydrogel with
protease
(enzymatic
debridement)
Necrotic Patch Sharp debridement
After removal of secondary dressing, examine wound bed and decides tissue
management
Decides which primary dressing best for wound bed management or
debridement.

48. SUMMARY:
FROM
REMOVAL
TO
RE-APPLICATION
Moisture
Dry Hydrocolloid
Moist
Serous/Thin Absorbent
Exudate/Thick Maintenance
Examine wound bed moisture balance and decide which secondary dressing
best to maintain moist wound bed.
Decision making must include 5As and consideration to patients interest
and local resources.

49. TAKE HOME MESSAGE
• DRESSING MATERIALS USAGE IS OPERATOR-DEPENDENT AND DEPENDS ON
YOUR WOUND ASSESSMENT AT THAT TIME
• ALL MATERIALS CAN BE USED BUT MUST JUSTIFY WHY THE NEEDS OF IT
• DO LIMIT YOURSELF TO JUST ONE TYPE OF DRESSING ONLY