Upload
others
View
4
Download
0
Embed Size (px)
Citation preview
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