3. Untidy wound
Tidy wound
which heal themselves by
primary intensin
Othervise they undergo
Scars
Contractures
Severe infections
Tidy wound <6hrs..
Primarily closed or
delayed primary closure
after 3-5 days
…untidy wound dealt
with secondary
closure, culture
sensitivty
done, antibitics and
dressing
5. 1.Sloughy wound
• Dead cells accumulated in exudate
Aim:
to liquefy slough and aid its removal
2.Necrotic wound
•Aims:
• to debride and remove eschar
6. 3. Infected wound
•Aims: reduce exudate,
odour and promote
healing
4.Granulating
wound
Aims: support granulation,
protect new tissue, keep moist
11. Need to be compatible with the wound:
May be hydrating or absorptive
Promote/maintain moist, healing environment
Provide insulation
Impermeable to microrganisms
Atraumatic to the wound/periwound area
Cost effective
In conventional terms: dry, or wet
In technical terms we have:
12.
13.
14. Indications:
Superficial and full thickness wounds
Skin grafts, donor sites, burns, skin tears
Under compression for ulcers
Contraindications:
Dry wounds
Examples: Mepilex (Border), Allevyn (Plus
Adhesive), Polymem, Biatain
15. Indications:
Minor injuries (abrasions)
Post-op dressing over sutures
IV sites
Contraindications:
High exudate wounds
Fragile skin
Examples: Tegaderm, Opsite
17. Regranex®
Growth Factor Preparations
PDGF preparation in a
hydrogel
Dermagraft®
Single-Layered Tissue
Human fibroblasts on
matrix meshBilayered Tissue
Apligraf®
Human fibroblasts and
keratinocytes in a
bovine collagen matrix.
20. Indications:
Dry wounds
Wounds with slough wounds
Wounds with eschar
Over tissues and tendons to prevent drying
Contraindications:
High exudate wounds
Examples: Solosite, Woun’ Dress, SkinTegrity
21. Chemically inert, adverse effects rare
Designed to be removed without trauma or pain
Protect friable or newly healed tissue from injury
Less trauma to periwound
Examples: Mepilex, Allevyn Gentle
23. Bacteriocidal:
Silver
Honey
Cadexomer iodine
Bacteriostatic:
Methylene Blue and Gentian Violet
Xeroform
24. Antimicrobial action through (+) silver ion
Effective when in contact with wound fluid
Consider:
Kill rate AND sustained release rate
Testing Methods: Simulated wound fluid, saline
Delivery methods:
foams, gels, alginates, hydrofibers, creams
(SSD - approved for burns, only)
25. Hydrogen peroxide
Acetic acid
Effective against Pseudomonas aeruginosa
Diguanides (Chlorhexidine)
Sodium hypochlorite (Dakin’s)
Not recommended unless suitable are unavailable
Povidone Iodine
26. Usually Type I bovine or avian or type III
porcine collagen
Indications:
Partial & full thickness wounds
Minimal to moderate drainage
Contraindications:
Eschar covered
Full thickness burns
Sensitivity to contents
27. Based on amount of drainage and presence of
infection
Infected wounds need to be monitored daily
Heavily draining wounds may need to be changed 2-3
times a day
As drainage decreases, increase time between dressing
changes
Editor's Notes
When health care providers are seeking the “ideal dressing”, the following questions should be considered:- Does the dressing protect from secondary infection?- Does it provide a moist wound environment?- Does it provide thermal insulation?- Can it be removed without causing trauma to the skin?- Does the dressing remove/absorb drainage and debris?- Is it free from particulates and toxic products?