wound dressing for chronic wound
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wound dressing for chronic wound
- 1. Dressings for Chronic wounds Dr. Joel Arudchelvam Consultant Vascular and Transplant Surgeon
- 2. Dressings for Chronic wounds • Definition of chronic wound / dressing • Types of dressings • Summary of use of various dressings • When to change • What not to do
- 3. Chronic ( non healing ) ulcer / wound • Wounds / ulcers not showing signs of healing after 6 weeks.
- 4. Wound dressings • The material which is applied to the surface of the wound to cover • – 1ry – dressing which touches the wound – 2ry – dressing used to cover the primary dressing
- 5. Ideal wound dressing Dressings are applied to wounds for • To provide a protective cover • To maintain moisture • To absorb exudates In addition an ideal dressing • Does not induce pain or itching • Easy to change • Allows gaseous exchange • Cheap • Freely available
- 6. Types of Wound Dressings • Gauze • Tulle • Hydrocolloid • Hydrogel • Alginate • Foam • Transparent film • Etc.
- 7. Gauze • Cheap • Freely available • Dry • Painful on removing • Damages epithelium
- 8. Tulle • Cheap • Freely available • Easy removal – E.g : Vaseline
- 9. Hydrocolloid Dressings • Made up of pectin based material • Absorb exudate • Come in various shapes and sizes
- 10. Hydrogel Dressings • Made up of water in a polymer • Used in dry wounds
- 11. Alginate Dressings • Made from seaweed • Absorb moderate amounts of drainage • becomes a gel when it comes into contact with wound fluid
- 12. Foam Dressings • Made up of polyurethane foam • Absorbs large amounts of fluid • Available in various sizes and shapes
- 13. Silver Dressings • Reduce bio burden - through slow release of silver ion into the wound • e.g. Acticoat, Biatin Ag, Atruman Ag
- 14. Vacuum Assisted Closure VAC
- 15. Vacuum Assisted Closure VAC • Mechanisms of action – Macro strain – Micro strain • Macrostrain - visible contraction which occurs when negative pressure is applied. – Draws wound edges together – Provides direct and complete wound bed contact – Removes exudate
- 16. Vacuum Assisted Closure VAC • Microstrain - micro deformation at the cellular level – Reduces edema – Promotes granulation tissue formation by facilitating cell migration and proliferation
- 17. • Indications for use – Large wounds – Cavities – Large amount of exudate Vacuum Assisted Closure VAC
- 18. Summary Wound with slough , dead tissue – needs wound toilet. Wound type Dressing Dry Hydrocolloid, Hydrogel Exudating wound Hydrocolloid, foam Dead space / cavity Alginate, foam, VAC Gauze, tulle and gel Most wounds
- 19. When to change dressings • When there is an indication to change – Soaking / smelling – Need to inspect – pain , swelling , fever, ect. • Discuss with doctor before changing
- 20. Avoid in chronic wounds • Iodine (Betadine) • Hydrogen peroxide • Other toxic agents
- 21. Avoid • Do not tie gauze bandage tightly around limbs, digits – causes ischaemia • Use – plaster , crepe instead
- 22. Thank You