Which Product Do I Use? · • Suprasorb X + PHMB • SSD cream . A wound formulary can assist with...
Transcript of Which Product Do I Use? · • Suprasorb X + PHMB • SSD cream . A wound formulary can assist with...
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Which Product Do I Use?
Karen Huxtable
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There are so many to choose
from!
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So how do we choose?
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We need to know:
• How dressings function
• What the ideal wound environment is
• The healability of the wound
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Dressings’ main role is to
manage moisture
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Dressings will:
• Soak up moisture
• Strain/filter moisture
• Retain moisture
• Add moisture
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Dressings that soak up moisture
are for wet wounds
• Foams
• Alginates
• Hydrofibres
• Gelling fibres
• Vertically wicking
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Mesh dressings strain or filter
moisture – moist/wet wounds
• Mesh dressings
• Cuticerin
• Adaptic
• Atrauman
• Silicone mesh dressings
• Mepitel
• Silflex
• Duratouch
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Dressings that retain moisture are
for moist wounds
• Hydrocolloids
• Comfeel
• Duoderm
• Films
• Tegaderm
• Op-Site
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Hydrogels add moisture to dry
wounds
• Hydrogels
• Solosite
• Intrasite
• Aquaflo
• Curafil
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Some dressings may also kill
bacteria:
• Silver
• Iodine
• Honey
• PHMB
• AND either add,
retain, absorb or filter
moisture
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Antimicrobial dressings also modulate
moisture
Absorb moisture
• Aquacel Ag
• Iodosorb
• Medihoney
• Acticoat
• Kendall AMD Foam
• Kerlix AMD Gauze
• Mepilex Ag
Filter moisture
• Actilite
• Atrauman Ag
• Acticoat Flex
• Inadine
Add moisture
• Prontosan Gel
• Suprasorb X + PHMB
• SSD cream
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A wound formulary can assist
with product choice
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Moist Wound Healing: why should
tissue be moist?
• Maintains viable tissue – prevents cell
dessication
• Reduces pain
• Breaks down slough & necrotic tissue
• Cleans the wound
• Promotes epithelial migration
• Facilitates a pain-free, atraumatic dressing
removal
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The ideal wound environment
that favours healing
• Warm
• Moist
• Slightly acidic
• Free from debris
(slough and necrotic
tissue)
• Free from disease (low
bacterial levels)
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Wound bed preparation
• Epithelial cells need
moisture and a clean
wound bed before they
will migrate across a
wound
• Dressings are used to
alter or maintain the
environment
depending on what is
required
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The wound environment will
direct dressing choice
• Primary or secondary intention?
• Flat or cavity?
• Dry, moist or wet?
• Clean, polluted or infected?
• Big or small?
• Difficult site?
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Primary & secondary intention
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Cavity wounds
• Fill the dead space
• “fluff” not stuff
• Alginates
• Hydrofibres (aquacel)
• Gelling fibres
(durafibre)
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Dry wounds are dead wounds
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Moist = viable, dry = dead
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Hydrogels will hydrate, debride
and restore viability in dry
(healable) wounds
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Polluted rivers breed disease
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So do polluted wounds
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Wet wounds can cause skin
maceration & excoriation
• Wet wounds with
slough and bacteria
need absorbent
antimicrobial
dressings and
frequent dressing
changes
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Understand healability
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Poor healability
• Dry intact necrotic
toes and heel wounds
should be kept dry
• This is to prevent
bacteria entering the
wound and increasing
risk of limb-
threatening infection
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Fungating wounds
• Atraumatic
• Antimicrobial
• Gel if dry
• Vertically wicking and
absorbent if wet
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How do you know it was the
“right” dressing?
• Comfortable insitu
• Easy to remove
• Didn’t traumatise the wound or skin
• Provided moist environment
• Prevented maceration
• Reduced odour/bacteria/sloughy tissue
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In summary:
• Learn how dressings function
• Assess the healability of the wound
• Use the right dressing function to achieve
the ideal wound environment to promote
healing and/or quality of life
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Nurturing - it’s in your hands.