Wound Dressings (PTA)
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| Hydrocolloids | anchored to intact skin surrounding wound
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| Hydrocolloids: INDICATIONS | Partial & full-thickness wounds; Granular OR Necrotic wounds
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| Hydrocolloids: + ADVANTAGES | Moist environment---Autolytic debridement---Protection from microbes---Moderate absorption---No 2° dressing needed---Waterproof surface
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| Hydrocolloids: - DISADVANTAGES | Traumatizes surrounding intact skin when removed---Rolls in areas of excessive friction---Cannot be used on infected wounds
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| Hydrogels: INDICATIONS | Superficial & Partial-thickness wounds (e.g. abrasions, blisters, pressure ulcers) that have minimal drainage
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| Hydrogels: +ADVANTAGES | Moist environment---Autolytic debridement---Reduces pressure & pain---can be used as Coupling agent for US---Minimally adheres to wound
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| Hydrogels: - DISADVANTAGES | Dressings can dehydrate---Not used if lots of drainage present---Requires 2° dressing
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| Foam Dressings | hydrophilic @ wound contact surface (exudate absorbed) & hydrophobic on outer surface
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| Foam Dressing:INDICATIONS | Protection for partial & full-thickness wounds with varying levels of exudate; can be used as 2° dressings over amorphous hydrogels
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| Foam Dressing: +ADVANTAGES | Moist environment---Adhesive & Non-adhesive available---Prophylactic protection & cushioning---Autolytic debridement---Moderate absorption
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| Foam Dressing: -DISADVANTAGES | Roll in areas of excessive friction---Removal of adhesive form may traumatize periwound---Wound inspection difficult (NOT transparent)
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| Transparent Film | permeable to vapor & O2, but impermeable to bacteria and H20
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| Transparent Film: INDICATIONS | Superficial wounds (scalds, abrasions, lacerations) or Partial-thickness wounds with minimal drainage
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| Transparent Film: +ADVANTAGES | Moist environment---Autolytic debridement---Visualization---Resistant to shearing & friction---Cost-effective
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| Transparent Film: -DISADVANTAGES | Periwound maceration (too much exudate)---Adhesive removal may traumatize periwound---NOT used on infected wounds
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| Gauze: INDICATIONS | Infected & Non-infected---Wet-to-wet, Wet-to-moist, or Wet-to-dry debridement
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| Gauze: +ADVANTAGES | Readily available & Cost effective---Used alone or in combo. with other dressings---Can modify # of layers (accommodate changing wound status)---Infected or uninfected wounds
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| Gauze: -DISADVANTAGES | Adheres to wound bed---Highly permeable (requires frequent changing)---Increased infection rate
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| Alginates | interaction of Calcium ions in the dressing & Sodium ions in the wound exudate; highly permeable & non-occlusive
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| Alginates: INDICATIONS | Partial & full-thickness wounds such as pressure wounds OR venous insufficiency ulcers; infected wounds (lots of exudate)
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| Alginates: +ADVANTAGES | High absorptive capacity---Autolytic debridement---Protection from microbes---Infected or uninfected wounds---Non-adhering to wound
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| Alginates: -DISADVANTAGES | May need frequent changing (depending on exudate)---Requires 2° dressing---Cannot be used on wounds with exposed tendon, joint capsule, or bone
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| Occlusion | ability of a dressing to transmit moisture, vapor, or gases from the wound bed to the atmosphere; impermeable
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| Most Occlusive Dressings-->Non-Occlusive Dressings (in order) | 1) hydrocolloids 2) hydrogels 3) semi-permeable foam 4) semi-permeable film 5) impregnated gauze 6) alginates 7) traditional gauze
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| Most Moisture Retentive-->Least Moisture Retentive (in order) | 1) alginates 2) semi-permeable foam 3) hydrocolloids 4) hydrogels 5) semi-permeable films
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| Types of Selective Debridement | Sharp, Enzymatic, Autolytic
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| Types of Non-Selective Debridement | Wet-to-dry dressings, Wound irrigation, Hydrotherapy
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