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Hyberbaric Oxygen for burns
increase oxygen, used in combo with debridement..all nonviable tissue must be removed - not used when pseudomonas present
Wet - to - dry gauze dressing
Indications: moist necrotic wounds (not with eschar) Contraindications: clean wound Procedure: damp sterile 4x4 to wound, remove when dry Disadvantage: painful, not specfic, costly
Indications: lean ound gentle, necrotic wound, vigorous Contraindications: allergic to certain irrigant Procedure: flush wound to debride loose necrotic tissue Disadvantage: Messy, chance of maceration
Enzymatic / Chemical
Indications: All necrotic wounds Contraindications: Infection, gangrene, dry eschar Procedure: topical agent Disadvantages: slow 3 - 30 days, clean wound bed
Surgical Sharps to remove nonviable tissue
Indications: Necrotic wounds (best if moist) Contraindications: untrained, dry gangrene, ischemic or clean/healing wounds
Indications: all necrotic wounds (best if dry) Contraindications: Dry gangrene or ischemic wounds Procedure: Apply dressing to retain moisture and let RBC liquefy and help remove eschar and slough Disadvantages: takes time
Dry wound dressing
Gels / hydrogels, moistened alginate with transparent film, hydrogel with hydrocolloid
Silver sufadiazine, Mafenide acetate, silver nitrate, Bacitracin / polsporis, Nitrofurazone, Gentamucin, Collagenase
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