39 terms

Wound Care Dressings

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Melgisorb plus
Calcium alginate.
Good for moderately draining wounds.
Can stay in place for 7 days.
Melgisorb AG
Calcium alginate
Good for moderately draining wounds.
Aquacel Extra
Hydrofiber
Woven texture that helps keep the material together which is helpful when packing into wounds.
Can stay in place for 7 days.
Aquacel AG
Hydrofiber with silver
Woven texture that helps keep the material together which is helpful when packing into wounds.
Helps reduce bacterial colonization for wounds that may have an infectious appearance.
Can stay in place for 3 days.
Hydrofera blue classic
Bacteriostatic dressing
Absorptive foam made with methylene blue and Gentain Violet to prevent surface bacteria and fungus from living on wound bed.
Helps "push down" hyper granulation tissues.
May remain in place for 3-5 days.
Needs to be moistened and cut to size of the wound bed prior to application.
May be placed over collagens or hydrogels; even non-adherent contact lays such as adaptive, adaptive touch and cutimed sorb act.
Also comes in a rope; great for tunnels and packing wounds.
Hydrofera blue ready
Bacteriostatic dressing.
Absorptive foam made with methylene blue and Gentain Violet to prevent surface bacteria and fungus from living on wound bed.
Helps "push down" hyper granulation tissues.
May remain in place for 7 days.
Does not need to be moistened and does need to cut to size of wound bed prior to application.
May be placed over collagens or hydrogels; even non-adherent contact layers such as adaptic, adaptive touch and cutimed sorbact.
May fenestrate to allow extra drainage to flow towards secondary dressing - for high draining wounds it has been helpful to place aquacel or drawtex over the top of the hydrofera blue ready to help wick away the moisture.
Drawtex
Used for heavily draining wounds.
Should be cut to size of wound as it can cause maceration if touching the periwound.
Should be changed every 3-5 days if wound is draining significantly, but may remain in place for 7 days.
Often times will use this as a secondary to absorb additional drainage.
Adaptic
Vaseline impregnated gauze.
Can be placed under absorbent dressing to help prevent painful dressing removal. Should be changed every 3-5 days.
Adaptic touch
Silicone adhering wound contact layer.
Used to help hold biologics/skin grafts in place.
Can be placed under absorbent dressing to prevent painful dressing removal.
Can stay in place for 7 days.
Cutimed sorbact
Bacteria binding mesh
Allows drainage to go through and into secondary dressing.
Can be placed over collagens and hydrogel.
Endoform
Fenestrated collagen, made form ovine (sheep)
Seems to work better for wounds that drain significantly.
Needs to be moistened with saline when applied to the wound bed.
Promogran
Helps to add moisture to wound beds with a drier appearance.
Needs to be moistened with saline when applied to the wound bed.
Double layer used when leaving in place for 7 days; single when being changed over the week.
Prisma Ag
Collagen with silver
Used when wound bed appearances to infected or colonized with bacteria.
Needs to be moister with saline with applied to the wound bed.
Double layer used when leaving in place for 7 days; single when being changed over the week. Typically if using this product, one is conceded about infection, therefore the dressing should be changed more frequently, avoiding a weekly dressing if possible.
Duoderm
Hydrocolloid
Provides protection to the skin, acting as another layer of skin.
Absorbs a small amount of drainage - this drainage can serve as an autolytic debridement that is not painful for the patient.
Mepilex foam
Helps absorb drainage.
Have found it helpful to fenestrate foam for highly exudating wounds and place a aquacel or drawtex behind the foam to wick away drainage.
Can be used to provide offloading (mepilex foam ring - (doughnut) to the periwound)
Providing padding for sensitive or boney areas
Mepilex border
Silicone adhesive - tolerated well by patients with adhesive allergies
Boarder lite: only indicate to stay on wound for 3-5 days.
Regular boarders: indicate to say in place for one week.
Do not recommend this type of dressing for the foot.
Patients should not shower with this dressing on.
Tegaderm foam adhesive
Sticks on well and conforms to patient.
May stay in place for 7 days.
Works best when skin is prepared with skin prep prior to application.
Water resistant - patient can shower with this dressing on as long as they do not soak/submerse in water.
ABD, Kerlix, Kling, Coban
Help to hold dressings in place.
Not water proof
Helpful for those who are sensitive to adhesive.
Silicone tape (blue)
Helpful for patients with sensitive skin but does not stick well.
Medipore tape
Sticks great but can be painful with removal and irritating to those with sensitive skin.
Steristrips
Helpful when trying to keep dressings in place underneath secondary dressing (especially those on the feet)/
Hydrogel/Carasyn
Helps to hydrate and keeps wounds moist.
Provides some debridement
May be changed daily, but may stay in place for 7 days.
Cheaper alternative to Santyl
Santyl
Enzymatic deb rider that assisted in removing dead/necrotic tissue from wound beds.
Needs to be changed daily as the enzymes are only active for 24 hours - if unable to change daily, the santyl is basically hydrogel after 24 hours and may be left on the wound but will not provide the same effects as if changed daily.
This may be very cost prohibitive for patients make sure patients are aware of this prior to discharge and have backup plan in place hydrogel.
Apply nickel thick and cover with a saline moistened gauze to activate the enzymes.
Do not use with dressings that contain silver or iodine as they inactivate the santyl - also do not use with cutimed sorb act.
Silvadene
Often used with burns. Contains antibacterial and analgesic properties.
Typically applied 1-2 times a day.
Zinc oxide
Used as a skin barrier.
Helpful to help prevent maceration when applied to the periwound.
Hydrocortisone/Triamcinolone
Helps reduce redness and itching. Should not be used long term.
Lidocaine ointment
Used to help reduce pain.
Mupirocin, Gentamycin, bacitracin
Antibacterial ointments
Should be changed daily.
Clotrimazole
Antifungal
Iodosorb
Contains iodine which helps combact infection
Provides some absorption
Can be left in place for 7 days.
Can be expensive for patient's to purchase.
Formula 2
Great emollient
Used a great deal to moisturize and protect skin within the clinic.
Can be purchased by patients online.
Regranex
Prescription gel that must be ordered for patient and needs to be kept refrigerated.
Platelet derived growth factor.
Used for diabetic foot ulcers.
Daily application - left in place 12 hours when washed off and left off for 12 hours (then repeated daily)
Compression wraps
Ensure an ABI between 0.8-1.2 prior to applying any type of compression)
Unna boot
Zinc impregnated gauze
- Wrapped in a spiral fashion, starting at foot and working up leg to just below the knee. Covered with a cob an layer. Works best for patients who are ambulatory. Helps reduce redness and irritation. Changed in two days after initial application, then weekly.
Calamine unna boot
Calamine impregnated gauze.
Wrapped in a spiral fashion, starting at foot and working up leg to just below the knee. Covered with a cob an layer. Works best for patients who are ambulatory. Helps reduce itching. Changed in two days after initial application, then weekly.
Coban 2 - Two layer compression wrap
First layer is foam, and then second is a coban layer.
Spiral fashion application starting at foot, working up to just below the knee.
Change in two days after initial application, then weekly.
Profore Lite - Three layer compression wrap
Same as the pro fore, minus the 3rd compressive layer.
Tend to be difficult to secure and keep in place. More comfortable for patients due to less pressure than the pro fore.
Changed in two days after initial application then weekly.
Profore
Four layer compression
Some patient's feel that this wrap is more comfortable than the cob an 2 due to the cotton contact layer.
Changed in two days after initial application then weekly.
Typically this wrap is used after patient has trailed the cob an 2 and tolerated it as this one proves significantly more compression.
TCC
Used for offloading foot ulcers.
Cannot be used for infected wounds.
Changed in two days after initial application then weekly.
ABI's need to be obtained prior to application
Patient needs to be instructed to use back boot when walking to prevent breaking of the cast.
May be beneficial to rider a PT evaluation for gait when initiating this treatment.
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