Wound Care Product Selection Guide

(Eschar)

(Yellow Fibrinous)

http://www.smtl.co.uk/

http://www.mhcwoundcare.com/education_resources/Wound_Dressing_Selection_Guide.pdf

http://www.worldwidewounds.com/1997/july/Thomas-Guide/Dress-Select.html

Advantages: Especially useful for packing exudating wounds

They do not physically inhibit wound contraction as would gauze

Highly absorbent

Disadvantages:Requires a secondary dressing

Can be too drying if wound has a low volume of exudate

• • Enzymatic debriding agents act on any one or all of these materials: collagen, protein, fibrin, elastin and / or nucleoproteins. Check with each product as to its method of action.
  • Some enzymatic debriders are selective for necrotic tissue while some are not.
  • By loosening the necrotic debris, surgical debridement may be avoided.
  • Tunneling ulcers are particularly suitable for these products as they remove debris which may be difficult to visualize and / or reach.

Advantages: Conformable for easy application and help reduce pain at the wound site

Disadvantages:Moderate to heavily exudating wounds may overwhelm the hydrocolloid dressing, usually within a few days. Break down of the product may produce a residue of varying colors and possible foul odor. This should not be confused with an infectious process.

Method of Use:A suitably sized dressing is selected, applied over the necrotic area and left in place for 3-5 days. It is then removed and the wound examined. This process may be repeated as often as required until debridement is complete.

• Characteristics & Functions
  • Hydrogels consists of insoluble polymers with hydrophilic sites which interact with aqueous solutions absorbing and retaining significant volumes of water.
  • When applied to necrotic tissue, water is transferred directly from the gel to the tissue and thus facilitates rehydration and autolysis.
  • Wound gels are excellent for helping to create or maintain a moist environment.
  • Some hydrogels provide absorption, desloughing and debriding capacities to necrotic and fibrotic tissue.
  • Hydrogel sheets are cross-linked polymer gels in sheet form. Some are available with an adhesive border
• Best Uses
  • Helps provide and maintain a moist wound environment.
  • By increasing moisture content, hydrogels have the ability to help cleans and debride necrotic tissue.
  • For wounds with minimal or no exudate.
  • Hydrogels are particularly useful for cavity wounds, particularly where a degree of undermining is present, and in other situations where the use of hydrocolloid sheets would be inappropriate.
• Advantages
  • Effective in hydrating wound surfaces and liquefying necrotic tissue on the wound surface.
  • Non-adherent and can be removed without trauma to the wound bed.
  • "Soothing" effect promotes patient acceptance
• Disadvantages
  • Not too absorptive, therefore, hydrogels or hydrogel sheets may not be an appropriate choice for moderate to highly exudating wounds.
  • Require secondary dressings.
• Method of use
  • A generous layer of gel is applied to the surface of the wound and covered with a Perforated Plastic Film dressing.
  • If the wound is very dry a more occlusive covering may be used to reduce water vapour loss and prevent the gel from drying out.
  • A semipermeable adhesive film may be used for this purpose.
  • On very dry wounds it is usual to change the dressing at least once per day.

• • They consist of an absorbent fibrous fleece covered with a plastic film containing a series of small holes arranged in a uniform pattern.
  • The plastic film is intended to prevent the dressing adhering to the surface of the wound and the holes are present to allow the passage of exudate through to the absorbent layer.
  • Perforated film absorbent dressings are widely used in the treatment of superficial wounds and are frequently applied in combination with hydrogels or alginates.
  • The ability of these dressings to absorb exudate is limited, and for heavily exuding wounds they are sometimes covered with a second absorbent pad. In these situations the absorbency of the dressing is less important than its low-adherent properties.

• Characteristics & Functions
  • Transparent adhesive films are typically semi-permeable membrane dressings made from a thin sheet of polyurethane coated with a layer of acrylic adhesive.
  • They are waterproof yet permeable to oxygen and water vapor.
  • They help prevent bacterial contamination and maceration.
  • They help maintain a moist wound environment, facilitate cellular migration and promote autolysis of necrotic tissue by trapping moisture at the wound surface
  • Some of the newer films are designed to keep IV sites dry. These films have a higer Moisture Vapor Permeability (MVP) and should not be used for wounds.
• Best use
  • Superficial wounds
  • Wounds with light exudate
  • Wounds on elbows, heels, flat surfaces
  • Covering blisters
  • Retention of primary dressing
• Advantages
  • Transparent films permit evaluation of wound progress without removal of the product
  • They are usually waterproof and gas permeable
  • They help maintain a moist wound environment
  • They are economical
• Disadvantages
  • As an adhesive, transparent films have the potential of causing skin tears if removed improperly
  • They are non-absorptive and will be overwhelmed by moderately exudating wounds
  • They tend to roll up in high friction areas such as the coccyx
  • Some of the newer films are intended for IV sites, and may dry out a wound bed instead of maintaining a moist state
• Method of use
  • A suitably sized dressing is selected, the backing removed and the polyurethane film applied over the wound, taking care not to apply it under tension which could cause damage to the surrounding skin.