2. Prepared By
MD. Golam Kibria
Lecturer(Wet Processing)
Northern University Bangladesh
B.Sc, M.Sc (Textile Engineering, BUTEX)
Email: kibria.but@gmail.com
3. Content
• Introduction
• What is wound?
• Classification of wounds
• Mechanism of injury
• Purpose of wound dressing
• Dressing selection
• Types of dressing
• Properties of an ideal dressing
• Properties and functions of wound care products
• How to change dressing?
• Conclusion
4. Introduction
The purpose of this presentation is to provide a guide on commonly
available wound dressing products. Wound dressings are designed to
help healing by optimizing the local wound. The dressing in contact
with the wound bed is known as the primary dressing. If a dressing is
required to absorb leakage or to secure a primary dressing, it may be
referred to as the secondary dressing. With the advancement in
technology, currently, different types of wound dressing materials are
available for all types of wounds. But the selection of a material for a
particular wound is important to achieve faster healing.
5. What is wound?
• A wound is defined as a
disruption in the continuity
of the epithelial lining of the
skin or mucosa resulting
from physical or thermal
damage. According to the
duration and nature of
healing process, the wound
is categorized as acute and
chronic.
It can be mild, severe, or
even lethal.
Wound edge Wound
corner
Surface of
the wound
Base of the wound
Cross section of a simple wound
Skin surface
Subcutaneus tissue
Superficial fascia
Muscle layer
Base of the wound
Wound edge
Surface of
the wound
Wound
cavity
6. Classification of wounds
1. Based on the origin
I. Mechanical
1. Abraded wound (vulnus abrasum)
2. Puncured wound (v. punctum)
3. Incised wound (v. scissum)
4. Cut wound (v. caesum)
5. Crush wound (v. contusum)
6. Torn wound (v. lacerum)
7. Bite wound (v. morsum)
8. Shot wound (v. sclopetarium)
II. Chemical
1. Acid
2. Base
III. Wounds caused by radiation
IV. Wounds caused by thermal forces
1. Burning
2. Freezing
V. Special
2. According to the bacterial contamination
• Clean wound
• Clean-contaminated wound
• Contaminated wound
• Heavily contaminated wound
2. Depending on the depth of injury
• Superficial
• Partial thickness
• Full thickness
• Deep wound
7. Mechanism of Injury
Wounds are caused by three different types of forces-
• Shear: Result from sharp objects
• Low energy
• Minimal cell damage
• Result in straight edges, little contamination
• Heals with a good result
• Compressive: Result from blunt objects impacting the skin at a right angle
• Results in stellate or complex laceration
• Ragged or shredded edges
• More prone to infection
• Tensile: Result from blunt objects impacting the skin at an oblique angle
• Results in triangular wound
• Sometimes produces a flap
• More prone to infection
8. Purpose of wound dressing
- To promote wound healing by primary intention .
- To prevent infection .
- To assess the healing process.
- To protect the wound from mechanical trauma .
- To absorb drainage.
- To prevent contamination from bodily discharge.
9. Dressing selection
• Dressing selection should be
simple and promote moist
wound healing ( Winter 1962).
• Avoid complex combinations of
dressings which may be
expensive and ineffective.
• Ensure that they are safe and
research based.
• Wounds need to be reassessed
and dressing selection changed
accordingly.
The selection of wound dressing is
based on:
• Condition of wound bed
• Exudate
• Presence of infection
10. Types of dressings
Dry - to – dry :
Used primarily for wounds
closing by primary intention.
Layer of wide mesh cotton
gauze lies next to the wound
surface , second layer of dry
absorbent cotton to protect
the wound
Wet – to – dry :
These are particularly useful for
untidy or infected wounds that
must be debrided and closed by
secondary intention
Layer of wide mesh cotton gauze
saturated with saline next to
wound surface ,second layer of
moist absorbent with same
solution to debride the wound
11. Types of dressings
Wet –to – wet :
Used in clean open wounds.
Layer of wide mesh gauze
saturated with antibacterial
solution next to the wound
surface, second layer of
absorbent material saturated
with the same solution to dilutes
viscous exudates .
Wet – to-damp :
Variation of wet to dry dressing
12. Properties of an ideal dressing
• Bacteria proof
• Allows gaseous exchange
• Manages exudate
• Non-adherent
• Fibre and toxin free
• Hypoallergenic
• Maintain haemostasis and optimum temperature.
• Acceptability to patient
• Cost effective.
13. Properties and functions of wound care
products
Alginates
• Some alginates have haemostatic
properties due to release of
calcium ions.
• Promotes debridement of slough.
• Highly absorbent and
biodegradable can absorb 20 times
own weight. Made from brown
seaweed.
• Suitable for wet or cavity wounds.
14. Film dressings
•Impermeable to fluids and
bacteria
•Promote moist wound healing.
•Permeable to air and water
vapour.
•Non absorbent
•Can be used as primary and
secondary dressing
•Remove by lifting corner and
stretching horizontally.
15. Foams
• Available as either polyurethane or
silicone.
• Adhesive and non adhesive
variables –adhesives may cause
skin reactions.
• Moderate or low exudate this
varies according to MVTR (ability to
transmit water vapour to outer
surface).
• Can be used as primary or
secondary dressing.
• Adhesive versions can cause
contact dermatitis
16. Hydrocolloids
• One of the first “modern dressings”
• Provides moist wound healing and
promotes debridement and
formation of healthy granulation
tissue.
• Occlusive and waterproof
• Low to medium exudate wounds-
limited absorption capacity.
• Caution if used on infected
wounds.
• May have slight odour on removal
17. Hydrofibre
•This is not an alginate although
perfoms in a similar way.
•Is made from the same
composition as hydrocolloids.
•Absorbs wound fluid and
transforms into soft gel.
•Highly absorbent
•Promotes debridement.
•Absorbs and locks in bacteria
and exudate.
18. Hydrogels
• Contain high water content up to 96%)
• Excellent biocompatibility (also occur
in contact lenses and ECG gel)
• Starch compounds ( Carboxy methyl
cellulose) are integrated to provide gel
forming properties.
• Promotes debridement of eschar and
slough.
• Hydrogel sheets may reduce pain.
• Caution if used on infected wounds.
• Requires secondary dressing
19. Wound contact layers
•Non adherent dressings for
lightly exuding granulating
wounds
•Prevents trauma to wound bed.
•NA Ultra-knitted viscose fabric.
•Atruaman – impregnated with
triglycerides.
•Mepitel – soft silicone contact
layer for delicate skin
20. Absorbent dressings
•For highly exuding wounds.
•Some may bind bacteria into
dressing to control infection and
bacteria load.
21. Antimicrobials
Inadine and cadexomer iodine
•Inadine –10% povidone-iodine
•Cadexamor iodine – released from starch when
in contact with wound exudate
•Caution in thyroid patients iodine sensitivity,
renal problems
Silver
•Aqucel AG -1.2%
•Acticoat – nano crystalline silver – rapid
bacteria kill due to high concetration of
elemental silver
•Actisorb silver – with charcoal for odour
22. PHMB (Polyhexamethylene
biguanide)
•Wound cleanser- Surfactant
•Debriding hydro gel
•Contains betadine which penetrates and
removes bacteria
Honey
•Algivon
•Non –adherent alginate impregnated with
medical grade Manuka honey
•Facilitates debridement
•Inhibits bacterial growth
•Reduces odour.
23. How to change dressing
1- Explain procedure to the client .
2- wash hands.
3- provide for client privacy .
4- Remove binder and tape
5- Remove and dispose of soiled dressing .
6- Setup sterile supplies .
7- Irrigate the wound :
8- Clean the wound .
9- Apply dressing to the drain site and incision.
24. Conclusion
Currently more than 3000 types of dressings are available in the market
making the physician to address all aspects of wound care. But still
there is no superior product that heals chronic wounds like venous leg
ulcers, diabetic wound and pressure ulcers which often fail to achieve
complete healing. Hence developing a dressing material that addresses
the major interfering factors of normal healing process will help
patients and wound care practitioners largely.
