Wound care dressings and choices for care of wounds in the. Hampton s 2015 selecting wound dressings for optimum healing. The use of a superabsorbent dressing to manage periwound maceration and odor in chronic wounds introduction periwound maceration has been associated with slow healing of wounds. Apply skin prep to the periwound skin and have your wound doctor change the treatment that is being done to the wound. In addition, foam dressings are compatible with enzymatic debridment agents.
A wound dressing must provide a moist environment, remove the excess of exudate, avoid maceration, protect the wound from infection and maintain an adequate exchange of gases. How do you use hydrogel dressings to keep wounds moist without causing maceration. How to select a wound dressing the pharmaceutical journal. How to treat a macerated wound and what does it look like. Five major functions for wounds dressings currently exist. Education of patients, families, caregivers and healthcare providers is the key to a proactive program of prevention and timely, appropriate interventions erwintoth and stenger 2001. Treatments for macerated skin caused by wounds include specific types of bandages and dressings, including. Pdf interventions to avoid maceration of the skin and wound bed. We have come a long way since the 16th century when ambroise pare travelled with the french army as a barbersurgeon. Sodium carboxymethylcellulose, gelatin, pectin, elastomers, and adhesives are bonded to a carrier of semipermeable film or a foam sheet to produce a flat, occlusive, adhesive dressing that forms a gel on the wound surface, promoting moist wound healing. These are sterile gauze pads and bandages that absorb extra moisture. Foam dressings are ultrasoft and highly absorbent thanks to the foam material they are comprised of. Furthermore, as per the professional opinion, it would rather be a commendable idea to avoid using foam dressings in the event of an infectious wound. Because hydrocolloid dressings form a moistureproof barrier they frequently used with incontinent patients as they can keep urine and feces out of the healing wounds.
Either way, drape may prevent maceration that results from moisture from the wound, but will likely not prevent maceration from inappropriate. If there is too little exudate retained in a wound, the dressings will start to adhere to the wound bed, causing pain and damage to the granulation tissue at dressing changes. Wound dressings play a large role in the healing process. Presence of a modern wound dressing protects the fragile tissue from contamination from. Maceration occurs when too much moisture is trapped between the wound and its bandagesometimes the exudate seepage of biological waste from the wound escapes and gets trapped under the bandage, and sometimes the wound itself becomes overly moist. The role of dressings in the treatment of moisturerelated.
Many are able to decrease the amount of fluid pooling under the wound dressing, thus decreasing the risk of skin breakdown. Skin maceration is often associated with improper wound care. Management of wounds with dressings ensure the underlying disease etiology is known or there is an understanding of the disease processes understanding the underlying disease etiology and comorbid conditions helps define dressings and the plan of care be. They are also be used on pressure sores, transplant sites, surgical wounds, ulcers, burns, or injuries that cover a large area of your body 2. Indications and contraindications for foam dressing use.
Wound healing is a dynamic and complex process which requires suitable environment to promote healing process. This type of wound dressing helps to cushion and protect the wound while maintaining a healthy level of moisture. An occlusive dressing has a wax coated covering for the wound that provides air and a watertight seal while a hydro fiber dressing is comparable to sterile gauze pad that helps absorb moisture and promotes fast healing of the condition. Mepilex foam absorbent dressing for treating chronic and. Many have the ability to wick moisture away from the skin, similar to a babys. This is a parallel group, randomized controlled trial to compare the early outcomes of postoperative wounds around the hip and proximal thigh dressed with povidoneiodine soaked gauze dressings. Moisture under occlusive dressings not only increases the. For example, numerous experimental studies in horses have shown that even.
The reinforced alginate fibres in algivon plus release the honey in a slow and sustained manner to maintain the integrity of the dressing. Maceration of the skin around wounds is a common wound care problem. Exudate and maceration in wound care nursing in practice. The product is easily conformable and highly absorbent, to effectively manage wound exudate. There are multiple ways in which to do so, and debridement is perhaps the. Antimicrobials are topical dressings or products used for wounds that are not healing because of infection, or wounds that are at high risk for infection. There are 2 types of dressing used for macerated wounds occlusive and hydro fiber dressings. The white appearance should not in any way be confused with the whitish appearance of new tissue of the healing wound. Wounds on the extremities can be secured with selfadhering dressings, gauze rolls, tubular bandages, or stretch net.
Choosing the correct wound dressing is an important adjunct to the healing of. Wound management involves a comprehensive care plan with consideration of all factors contributing to and affecting the wound and the patient. This is exacerbated by the fact that many affected areas are difficult to dress, for example, those that are adjacent to wounds, in the perianal margin or around. Depending on the amount of exudate, foam dressings have a wear time of one to seven days. These functions are debridement, moisture management, wound protection, infection management, and odor control. Local treatment of moisturerelated skin damage generally involves the use of dressings with significant fluid handling properties to remove excess fluid from the wound and to provide protection to periwound skin. Even when modern dressings are used and sound principles of wound management are followed, wounds of horses, particularly those located at the distal extremity of the limb, heal slowly the reader is referred to chapters 3 and 15 for more information about the healing of wounds on the limbs of horses. There are numerous potential causes of open wounds, and the wounds itself can be in the forms of abrasions, incisions, lacerations, or puncture wounds. They can also show you the best way to put it on and advise you on how. As with many aspects of medicine, the field of wound management has had an interesting journey. Maceration occurs when skin is in contact with moisture for too long. Click on the link when to use wound dressing to view different types of dressings and their use.
Mild solution is the best solution you should use to clean an open wound site. The algivon plus dressings contain 100% manuka honey which makes it an ideal choice for wet wounds, ulcers, and burns. Benbow m 2008 selecting a method for wound debridement. Foam dressings are excellent for wounds which are exuding, whether minimally or. Periwound skin management masd prevention strategies. Other treatments to manage exudate for wounds with heavy exudate, vacuum dressings which use an electronic pump to pull fluid from the wound bed can be used. In addition, the wound will tend to become sloughy or necrotic, as the irrigating effect of the exudate is lost. A macerated wound is an injury accompanied by soft, white, deteriorating skin around the site of the original injury. The advantage of antimicrobial dressings is a longer wear time.
Management of maceration is frequently attempted with the use of absorbent foams, alginates, and hydrogels. Interactive dressings and their role in moist wound management. Inappropriate wound management and dressing selection can also contribute to the problem and lead to. Traditionally wettodry gauze has been used to dress wounds. Sometimes, however, dressings are applied to donate or conserve moisture in order to prevent desiccation and tissue death. If youve ever taken a long bath or spent an afternoon in a swimming pool, youre familiar with what happens to your hands and feet. Highly absorbent dressings and continence pads should be used to draw moisture away from the skin and should be changed frequently. Wound dressings have been used to clean, cover, and protect the wound from the external environment.
To provide best dressings for open wounds, some things need to be considered. To prevent this, skin preparation creams or protective barrier films may aid. Alginate, hydrocellular foam and hydropolymer dressings are all effective in managing wound exudate young, 2000. There is both an art and a science to choosing the correct wound dressing, one that will maintain just the right amount of moisture in the wound bed without allowing the periwound to become macerated. Alternative dressing techniques for small, deep wounds. The role of dressings in the treatment of moisturerelated skin damage. Urgoclean dressings from woundcare is a soft adherent absorbent and soothing dressing ideally used for curing sloughy wounds. Wounds located on the torso will require a dressing that is selfadhering, has an incorporated adhesive border, or is secured with additional tape. A surgical wound of the latter category has a higher incidence of dehiscence or complications.
I am frequently asked for solutions relating to maceration to periwound skin in wounds being treated with negative pressure wound therapy npwt. These products protect the affected area from outside invaders such as bacteria and, ideally, create an environment that will support healthy healing. Types of wound dressings currently used to promote optimal. Hydrogels can only absorb a minimal amount of fluid. Evidencebased practice in wound care and, indeed, all aspects of health policy are part of 21st century medicine. But since they contain high waterglycerin content they are able to donate moisture to dry wounds. Maceration of the skin surrounding a wound may occur if a dressing with a low. Films are not absorptive dressings, and skin surrounding the wound may macerate if. Moistureretentive dressings are used to achieve a moist, but not wet, wound environment. Doctor answers on symptoms, diagnosis, treatment, and more. When applied to the skin or wound, they feel cool and. Antimicrobial dressings for wound contamination antibiotics only for infected wounds not just colonizedcontaminated cultures not generally recommended because all wounds are contaminated if culture indicated, cleanse wound bed with saline, then express drainage from wound bed. There are numerous products to prevent this from happening. The final article in the series is about wound complications and how to deal with them.
Foam wound dressings can be used on infected wounds. Macerated skin around the wound is common in pressure wounds or in wounds that are bandaged too tightly. Hydrocolloids should be used in uninfected bed sores. With the advancement in technology, more than 3000 products have been developed to treat different types of wounds by targeting various aspects of. This article offers some tips on how to select an appropriate dressing how to select a wound dressing will be to facilitate cosmetically acceptable healing in the shortest possible time. Preventing maceration associated with negative pressure wound therapy dressings skin protectant products to prevent periwound maceration.
What types of wound dressing can be used on bed sores. Secondary damage caused in this way will delay healing and. To counteract the purported poisonous effects of gunpowder, the wounds of injured soldiers were scalded with boiling oil. Your guide to foam wound dressings advanced tissue. The skin becomes so soft that it often tends to get injured by simple rubbing or friction. These are nonabsorbent and waxcoated, making them both airtight. As a clinician practicing in the outpatient and home care settings, it was not unusual for patients to have to take a holiday from negative pressure. Hydrogel wound dressings are 80% to 99% waterorglycerinbased wound dressings that are available in sheets, gels, or impregnated gauzes. Dressings to manage wound exudate may include hydrocolloids, foams, hydrofibers, alginates, capillary action dressings and cadexomer iodine. It is not recommended for wounds that are not excessively draining or the ones with eschar. This article describes wound dressings currently available in the uk.
Hydrocolloid dressings have gellike properties and absorb fluids from the wound. These types of dressings are most commonly used for chronic wounds with a slow or stalled healing time. Available in rope dressing designed to cure exuding infected wounds. However, these dressings either lose integrity when saturated. Dressings that create and maintain a moist environment, however, are now considered to provide the optimal conditions for wound healing. Seemingly every week, practice nurses receive flyers advertising new wound dressings.