WOUND TREATMENT - Idi Cabang Tangerangidicabangtangerang.org/upload/20200216103708-Dr. Andiati...

WOUND TREATMENTPIT V. IDI CABANG TANGERANG

Minggu,16 Februari 2020

Andiati Silviana

INTRODUCTORY

Wound and wound type

Concept of wound management

Wound dressing

WOUND

Physical injury to the body consisting of a laceration or breaking of the skin or mucous membrane

Opening made in a skin or a membrane of the body incidental to a surgical procedure

Hemostasis -- vasoconstriction + coagulation

Inflammation Proliferative phase Remodeling phase

Lost of the linear progression between the sequential phases of an acute wound

Often caused by ischemia, pressure, infection

venous ulcer, diabetic ulcer, pressure ulcer, arterial ulcer

Definition

Acute

Chronic

WOUND MANAGEMENT

Elimination of extrinsic factors triggering the development of the wound (e.g. pressure)

General Guideline

Treatment of the underlying disease (e.g. venous insufficiency, diabetes)

Creation of optimal physiological wound healing conditions (moist wound healing)

After healing is completed: protection of new, fragile skin

DISADVANTAGES Scab formation -- create physical barrier because the

epidermal cells cannot move through the formed scab Air exposure -- reduces surface temperature of the wound

causing peripheral vasoconstriction Wound packing with dry gauze --impair healing Covering the wound with dry dressing -- may traumatize the

surface of the wound on removal

Allow wounds to heal under moist conditions

WOUND MANAGEMENT

wounds with tissue cavity should be packed with dry gauze and covered with a dry dressing

ADVANTAGES Prevention of scab formation -- epidermal cells are able to move

rapidly over the surface of the dermis through the exudate which collects at the wound/dressing interface

Hydrating environment --the application of a totally occlusive or semi-permeable dressing to the wound can also prevent secondary damages as a result of dehydration

Presence of exudate -- provide assistance with the autolytic debridement of wounds, carries a number of Growth factor essential to the healing of wounds, protects granulation and encourages epithelialization of wounds

Easy to remove, moist, atraumatic

attached to the wound, painful, tissue damage

TRADITIONA

LMODERN

WOUND DRESSING

EXUDED WOUND DRY WOUND

MOISTWOUND

MOIST WOUND HEALING CONCEPT

Absorbent dressing Antimicrobial dressing Calcium alginate Foam dressing

Hydrogel Antimicrobial dressing with

hydrogel Ointment dressing

Hydrocolloid Transparent dressing

Hydrocolloid• promote healing by creating and controlling moist

wound environment• Forms gel upon absorbing exudate to provide a moist

healing environment.• Dry to moderately exudating wounds• shallow wounds• granulating and epithelizing phase

MOIST WOUND

HYDROCOLLOID Low to moderate exudate, donor sites, granulating

wounds

When placed on a wound, the polymers combine with the exudate and form a soft,moist gel-like mass

Encourage autolysis to aid the removal of slough

Benefit:

Flexible and waterproof

Provide a physical barrier

Form a gel with exudate

Aid in debriding

Need no secondary dressing

Wound care module. Australia: Australian Government Department

of Veteran’s Affairs. P.1-29

FILM DRESSINGS For superficial, clean wounds with no to low

exudate and post-operative dressing over suture to reduce sub-tissue tension

Should not be used for infected wounds

Thin, polyurethane membrane coated with a layer of acrylic adhesive and:

Waterproof

Gas permeable

Flexible and transparent

Protect from shear, friction, chemicals, microbes

Wound care module. Australia: Australian Government Department

of Veteran’s Affairs. P.1-29

EXUDED WOUND Absorbent dressing Antimicrobial dressing Calcium alginate Foam dressing

ALGINATE

Used on donor sites, bleeding sites, exudating leg ulcers and cavities

Benefits:

Highly absorbent

Form a gel with exudate

Create moist interface

Easily removed

Haemostatic

Wound care module. Australia: Australian Government Department

of Veteran’s Affairs. P.1-29

HYDROFIBRE DRESSINGS

Have some of the properties of alginates in that they are a fiber rope or dressing that forms a firm gel in contact with fluid

They: Composed of a synthetic fibrous mat

Form a firm gel in contact with exudate

Highly absorbent

Have no lateral wicking

Wound care module. Australia: Australian Government Department

of Veteran’s Affairs. P.1-29

FOAM Soft, open-celled

hydrophobic/hydrophilic non-adherent dressings, single or multiple layered

Used for moderately to heavily exudating wounds including ulcers, donor sites, minor burns, or secondary dressings after hydrogel

Can be placed in cavity or gaping surgical wounds

and non-residual

Wound care module. Australia: Australian Government Department

of Veteran’s Affairs. P.1-29

Benefits : Allow the passage of exucate

through non-adherent surface Absorbent and maintain a

moist environment Cushioning , non adherent,

and non-residual

DRY WOUNDS

HYDROGEL

Used to help re-hydrate sloughy wounds and necrotic tissue to aid in the autolytic debridement of wounds

Also used in the management of burns

Wound care module. Australia: Australian Government Department

of Veteran’s Affairs. P.1-29

Thank you