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TYPES OF DRESSING

Wound Care Training Module

Wound Care Training Module - National Wound Care Committee

Wound Care Training Module

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  1. Dressing Purpose
  2. Dressing Categories

Content

Wound Care Training Module - National Wound Care Committee

Content

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DRESSING PURPOSE

      • Protect wound from trauma and microbial contamination
      • Reduce pain
      • Maintain temperature & moisture of wound
      • Absorb drainage & debride the wound
      • Control & prevent haemorrhage (pressure dressing)
      • Provide psychological comfort

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      • Ideal /optimum dressing:

        • Remove excess exudates
        • Waterproof
        • Maintain moist wound healing environment
        • Trauma protection
        • Allows gaseous exchange if appropriate
        • Non adherent
        • Provide barrier to pathogens
        • Safe & easy to use
        • Provide thermal insulation

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DRESSING CATEGORIES

  1. Conventional / Inert
  2. Gauze –soaked with normal saline / antiseptic
  3. Gamgee as secondary dressing

  1. Modern / Advanced / Active Dressings

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Modern / Advanced / Active Dressings

DRESSINGS

PURPOSE

ADVANTAGES

DISADVANTAGES

PRACTICAL USAGE

  1. Film

Protect against contamination and friction

Maintain moist surface

Prevent evaporation

Facilitate assessment

Adherent

Transparent with measurement grid

Bacterial barrier

Waterproof

Breathable

Fluid collection

Possibility of stripping away newly formed epithelium on removal

Apply the film over the site making sure there is no air under it

To remove the film, stretch the film and pull slowly from the edges

Frequency of dressing change: 2-5 days depending on the wound

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DRESSINGS

PURPOSE

ADVANTAGES

DISADVANTAGES

PRACTICAL USAGE

  1. Hydrogel

Rehydrate , debride and deslough the wound

Promote moist healing

Cavity filling

Comfortable

Provide moist environment and reduce pain

Rehydrate eschar

Desloughing agent

Promotes granulation

Need secondary dressing

Maceration of the skin around the wound

Apply the hydrogel on the wound bed as a primary dressing

Frequency of dressing change:

2-3 days

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DRESSINGS

PURPOSE

ADVANTAGES

DISADVANTAGES

PRACTICAL USAGE

  1. Hydro-colloid

Provide moist environment

Absorb exudates

Bacterial barrier

Cleans and debrides by autolysis

Easy to use

Cost effective

Promotes granulation tissue

Effective for low to moderate exuding wounds

Waterproof

Unpleasant odour

Forms a yellow liquid gel

Difficult to use in cavities

Maceration of skin around wound

Apply the adhesive side onto the wound without touching the wound bed

A yellow liquid is seen after the dressing is left in situ which needs to be cleansed

Frequency of dressing change:

2 to 5 days

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DRESSINGS

PURPOSE

ADVANTAGES

DISADVANTAGES

PRACTICAL USAGE

  1. Calcium Alginate

Absorb wound exudates and maintain moisture

Economical and easy to apply

Biodegradable

Haemostatic properties

Not helpful for dry wounds

Need secondary dressing

Available in sheet or rope form

Effective to stop bleeding

The residue of the biodegradable product has to be washed off during the cleansing process

Frequency of dressing change:

2 to 5 days

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DRESSINGS

PURPOSE

ADVANTAGES

DISADVANTAGES

PRACTICAL USAGE

  1. Foams

Absorbent

Cushioning

Conforms to body contours

Designed for cavity wounds

Highly absorbent

Provides protection

Bacterial and waterproof

Can adhere to wounds if exudate dries out

Foam dressing is used as a secondary dressing or as cavity fillers.

Frequency of dressing change:

2 to 3 days or longer if for offloading

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DRESSINGS

PURPOSE

ADVANTAGES

DISADVANTAGES

PRACTICAL USAGE

  1. Hydrofibre

Manage heavy exuding wounds

Maintains moist healing environment

Longer wear time

Comfortable and non traumatic upon removal

Reduce risk of maceration

Can be use on infected wounds

Not helpful for dry wounds

Needs secondary dressings

The hydrofibre will become gel- like layer which can be easily removed

Frequency of dressing change:

2 to 5 days

  1. Charcoal

Odour absorbent

Reduces odour

Needs secondary dressing

Frequency of dressing change:

2 days

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DRESSINGS

PURPOSE

ADVANTAGES

DISADVANTAGES

PRACTICAL USAGE

  1. Silver

To reduce bacterial bioburden in infected wounds

Locally acting

No known resistance

Bactericidal

Some silver dressings do discolour the wound

Place the dressing with the side with silver facing the wound bed

Frequency of dressing change:

2 to 3 days

  1. Multi-function dressing (Polymeric membrane dressing )

To manage moisture imbalance (from dry to moderate)

Antiseptic property

Has surfactant which helps to cleanse the wound when it is applied

Offloading property

Not for heavily exudative wounds

Frequency of dressing change:

2 to 5 days

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DRESSINGS

PURPOSE

ADVANTAGES

DISADVANTAGES

PRACTICAL USAGE

  1. Composite dressing (combination of 2 or more dressing materials)

According to components of the materials

Multifunction

Same as individual components listed above

Frequency of dressing change: 2 to 5 days

  1. Other advanced dressings

Not widely used – some may be used in specialised center

e.g Collagen, matrix and regenerative dressings, cultured epidermis, growth factors , stem cells.

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TAKE HOME MESSAGES

  • Know your dressing material well and use it judiciously.
  • All wounds need to be cleansed thoroughly before applying any types of dressing materials.

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REFERENCES

  • Harikrishna K.R.Nair. Compendium of Wound Care Dressings in Malaysia. Edition 1 (2012) 
  • Harikrishna K.R.Nair. Compendium of Wound Care Dressings in Malaysia. Edition 2 (2013)
  • Harikrishna K.R.Nair. Compendium of Wound Care Dressings in Malaysia. Edition 3 (2014)

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THANK YOU

Wound Care Training Module - National Wound Care Committee