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dressings
WOCN program
| Question | Answer |
|---|---|
| identify three wound management principles | control or eliminate etiology, provide systemic support to reduce existing and potential cofactors, maintain physiologic local wound environment |
| most wound dressings are occlusive dressings: true or false? | false-most wound dressings are not occlusive |
| Is foam dressinsg indicated for pressure distribution or cushioning of the pressure wound site? | no-foam dressings do not distribute pressure |
| identify a dressing that absorbs minimal exudate and is low profile | low profile hydrocolloid |
| how often should an amorphous hydrogel be changed? | daily |
| identify two non-adherent dressings | mepitel, hydrogel sheet, contact layer |
| what is indicated for superficial wound with minimal exudate | thin colloid, thin foam |
| how far should hydrocolloid dressing extend onto the intact periwound base? | 2.5 cm |
| list the disadvantages of gauze dressing | doesn't provide protection, more frequent changes necessary, can be painful to remove, lower healing rates |
| honey and silver dressings are examples of what type of dressing | antimicrobials |
| can a contact layer dressing be a primary OR secondary dressing? | no-a contact layer can only be a primary dressing |
| what would a wound with large amount of exudate be best managed with? | alginate or hydrofiber |
| list 4 criteria for recommending a wound care product | amount of exudate, size of wound, including depth, location of wound, etiology, presence of infection or not |
| identify five generic wound care product categories with indications and contraindications of use | transparent film, hydrocolloid, alginate, antimicrobial, foam, hydrogel |
| Give examples Control or Eliminate Causative factors | offload pressure, reduce friction/shear, protect from moisture, compression to improve venous return, prevent trauma to insensate foot |
| relate moist wound healing theory to wound dressing characteristics | wound must be kept moist but not overly saturated, either needs donation of moisture or control of exudate |
| what are the objectives of a physiologic wound environment | prevent/manage infection, cleanse wound, remove nonviable tissue, maintain appr. level of moisture, eliminate dead space, control odor, eliminate or reduce pain, protect wound and periwound |
| give examples of providing systemic support to reduce existing and potential cofactors | optimize nutrition, adequate hydration, reduce edema, control BGL's, promote blood flow (cold, pain, nicotine, caffeine) |
| What is a primary dressing | a therapeutic or protective covering applied directly to the wound bed to meet the needs of the wound |
| what is a secondary dressing | provides a therapeutic or protective function and is used to increase the ability to adequately meet the wound needs and/or secure the primary dressing |
| elaborate on prevent and manage infection | cover wound with dressings impermeable to bacteria to protect from outside contaminants, infection control precautions, wound cleansing and debridement, antimicrobial if indicated, wound culture if needed |
| explain a method of wound cleansing | normal saline with 4-15 psi to remove debris without harming healthy tissue |
| explain "maintain appropriate level of moisture" | dressing with high moisture vapor transmission rate will allow moisture to escape and evaporate to manage minimally exudative wound, moderate to heavy draining wound require absorptive dsgs, select topical dressings that maintain moist wound |
| eliminate dead space | hydrating or absorbent-impregnated gauze for large deep wounds, ensure packing material is in contact with wound edges and can be easily removed |
| explain interventions to control odor | topical metronidazole, appropriate dgs change frequency, charcoal dressings, debridement and antimicrobials as needed |
| how can dressings eliminate or minimize pain | choose semi-occlusive dressings, non-adherent dressings, dressings that require fewer changes, |
| explain interventions to protect periwound skin | skin barriers (liquid, ointments, wafers), appropriate interval for dressing changes |
| what are the key features of a physiologic wound environment | adequate moisture level, temperature control, pH regulation, control of bacterial burden |
| explain contact layer | protects wound bed from direct contact with other agents and dressings, porous to allow exudate to pass or medication to absorb into wound conforms to wound shape |
| explain collagen dressing | may enhance deposition of collagen fibers, chemoattractant to granulocytes an fibroblasts, bioresorbable, hemostatic properties, decreases MMP's |
| what is promogran | collagen and cellulose matrix, inactivates MMP's is sacrificial protein so that growth factors are spared |
| name benefits of foam dressings | have been shown to reduce shear, absorbant, can be primary or secondary dog, antimicrobial foam can reduce epibole |
| hydrocolloid | elastomeric, adhesive, and gelling agents, is absortive, healing rates similar to alginates , should extend 2.5cm onto periwound skin, is occlusive, waterproof |
| how does honey work | promotes autolysis by pulling lymph fluid into wound, is antimicrobial, produces H2O2, activates MMP's |
| define senescence | inability of cells to respond to growth factor-wound not progressing, |
| what is the difference between occlusive and moisture retentive dressings | moisture retentive is permeable to vapors so it allows vapors to dissipate. Occlusive is not permeable so vapors do not dissipate |
| explain TIME | Tissue (viable or not) Infection or inflammation, Moisture imbalance Edge of wound (undermining, non advancing) |
| what is sorbact | a contact layer dressing coated with DACC, which is hydrophobic. Bacteria are attracted to it, are irreversibly bound to it upon contact, cannot replicate or release endotoxins, removes bacteria when dsg is removed |
| describe cadexomer iodine | can penetrate biofilm absorbs exudate and particulate matter from surface of granulating wounds, as dressing becomes moist iodine is released |
| what is PHMB | a biocide that is more appropriate for prophylaxis found in various dessings (Kendall AMD foam for ex. ) |
| describe hydrophera blue | methylene blue-genetian violet, can be contact layer or filler, can reduce hypergranulation, promote flattening of slightly rolled edges can be used with enxyme therapy- collagenase |
| describe hydrofiber | similar to alginate but made of different fiber. Highly absorbent |
| can absorptive dressing be covered with transparent film as a cover dressing | yes |
| uses for transparent dressing | protection of intact skin, cover dressing |
| what is mvtr | moisture vapor transmission rate. The lower the number the less moisture evaporates from the dressing, the higher the number the more evaporation occurs |
| what is collagenase | Santyl, enzymes that break the peptide bonds in collagen promoting debridement |
| describe hypergranulation | exact cause unknown but over hydration is thought to be a cause, also suture, foreign body, unstabilized tube, occlusive dsg |
| treatment of hyper granulation | stabilize tube, remove foreign object, topical steroid, absorbant dsg, remove occlusive dsg, antimicrobial dog, collagen dog with MMP inhibitors, apply consistent local pressure, debridement/cauterization |
| polymeric membrane | can reduce epibole |
Created by:
Beth Perry
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