prepared by: ms lee mee ling (srn, son) wounds & type of dressing materials

PREPARED BY:MS LEE MEE LING

(SRN, SON)

WOUNDS & TYPE OF DRESSING MATERIALS

LEARNING OBJECTIVES

At the end of this session, the students are able to:

1. Define what wound is.2. Recognize different types of wound based

on their descriptions and characteristics shown.

3. Describe process of wound healing.4. Identify commonly used dressing

materials used for wound dressing.

DEFINITION OF WOUNDAny physical injury involving a break in the

skin ortissues, usually caused by an act or accident

rather than by a disease.

TYPES OF WOUND

NO.

TERMS DESCRIPTIONS / CHARACTERISTICS

1. Intentional wound

Occur during therapy eg. during operation or venipuncture or treatment.

2. Unintentional wound

Caused by accidental conditions eg. cuts or falls.

3. Closed wound

Traumatized tissues without a break in the skin eg. bruises.

4. Open wound

Traumatized tissues with skin break or mucous membrane surface is broken.

CONT’

Open wound

Intentional wound Unintentional wound

Close wound

CONT’NO. TERMS DESCRIPTIONS /

CHARACTERISTICS

5. Contusion wound

Closed wound; skin appears bruised from damaged blood vessels. Caused by blow from a blunt instrument.

6. Incision wound

Open wound; deep or swallow. Caused by sharp instrument eg. knife or scalpel.

7. Abrasion wound

Open wound involving the skin. Caused by surface scrape, either unintentional eg. scraped knee from a fall or intentional eg. dermal abrasion to remove birthmarks.

CONT’

Contusion wound Incision wound

Abrasion wound


CHARACTERISTICS

8. Puncture wound

Open wound. Caused by penetration of the skin and often the underlying tissues by a sharp instrument; either intentional or unintentional.

9. Laceration wound

Open wound; edges are often jagged. Caused by tissues torn apart, often from accidents eg. machinery.

10. Penetrating wound

Open wound. Caused by penetration of the skin and the underlying tissues, usually unintentional eg. from a bullet or metal fragments.

CONT’

Punctured wound Laceration wound

Penetrating wound


CHARACTERISTICS

11. Clean wound Uninfected wound in which minimal inflammation is encountered and the respiratory, alimentary, genital and urinal tracts are not entered. Wound granulation present.

12. Contaminated wound

Include open, fresh, accidental wounds and surgical wounds involving a major break in sterile technique or a large amount of spillage from the gastrointestinal tract. Contaminated wounds show evidence of inflammation.

13. Dirty / Infected wound

Include wounds containing dead tissues and wounds with evidence of a clinical infection eg. presence of purulent discharge or maggots.

CONT’

Clean wound Contaminated wound

Dirty/Infected wound

PROCESS OF WOUND HEALING

WOUNDS HEAL IN 3 PHASES:1. Inflammation phase - is when blood clots

form, bacteria are attacked to prevent infection, and

key biochemical cells gather

at the site of the wound, causing it to swell. - inflammation begins almost immediately

after injury, peaking at 3-5

days.

CONT’

2. Proliferation phase - when these key cells

multiply at the wound site to make new tissue and blood vessels.

- open wounds generally heal from the bottom

up, as cells multiply to fill in the wound with new tissue.

CONT’

3. Remodeling phase - where the wound is

healed and the initial scar tissue is gradually restructured.

TYPES OF DRESSING MATERIALS

An appropriate dressing materials should provide these functions to enhance wound healing:

1. Provide mechanical and bacterial protection.2. Maintain a moist environment at the wound or

dressing interface.3. Allow gaseous and fluid exchange.4. Remain nonadherent to the wound.5. Safe in use - nontoxic, nonsensitizing and

nonallergic (both to the patient and the medical personnel).

6. Well acceptable to the patient eg. providing pain relief and not influencing movement.

CONT’7. Highly absorbable (for exuding wounds).8. Absorb wound odor.9. Sterile.10. Easy to use (can be applied by medical

personnel or the patient).11. Require infrequent changing (if

necessary).12. Available in a suitable range of forms and

sizes.13. Cost effective and covered by health

insurance systems.

CONT’DRESSSINGMATERIAL

DESCRIPTION PURPOSE EXAMPLES

Transparent adhesive films/wound barriers

Adhesive plastic, semipermeable, non-absorbent dressings allow exchange of oxygen between the atmosphere and wound bed. They are impermeable to bacteria and water.

To provide protection against contamination and friction; to maintain a clean moist surface that facilitates cellular migration; to provide insulation by preventing fluid evaporation; and to facilitate wound assessment.

Op-Site, Tegaderm


DESCRIPTION

PURPOSE EXAMPLES

Impregnated nonadherent dressings

Woven or nonwoven cotton or sunthetic materials are impregnated with petrolatum,saline, zinc-saline, antimicrobials or other agents, Require secondary dressings to secure them in place, retain moisture and provide wound protection.

To cover, soothe and protect partial and full thickness wounds without exudates.

Jelonet, Bactigras



Hydocolloids Waterproof adhesive wafers, pastes or powders. Wafers designed to be worn for up to 7 days, consist of two layers. The inner adhesive layer has particles that absorb exudates and form a hydrated gel over the wound; the outer film provides a seal.

To absorb exudates; to produce a moist environment that facilitates healing but does not cause maceration of surrounding skin; to protect the wound from bacterial contamination, foreign debris and urine or feces; and to prevent shearing.

Duoderm


DESCRIPTION

PURPOSE EXAMPLES

Hydrogels Glyserin or water-based nonadhesive jellylike sheets, granules or gels are oxygen permeable, unless covered by a plastic film. May require secondary occlusive dressing.

To liquiefy necrotic tissue or slough, rehydrate the wound bed and fill in dead space.

Aquasorb


DESCRIPTION

PURPOSE EXAMPLES

Polyurethane foams

Nonadherent hydrocolloid dressings; these need to have their edges taped down or sealed. Require secondary dressings to obtain an occlusive environment. Surrounding skin must be protected to prevent maceration.

To absorb light to moderate amounts of exudates; to debride wounds.

Lyofoam, Allevyn



Exudate absorbers (alginates)

Nonadherent dressings of powder, beads or granules, ropes, sheets or paste conform to the wound surface and absorb up to 20 times their weight in exudates; require a secondary dressing.

To provide a moist wound surface by interacting with exudates to form a gelatinous mass; to absorb exudates; to eliminate dead space or pack wounds and to support debridement.

Kaltostat

DRESSING MATERIALS - construction and design

THANK YOU&

HAPPY LEARNING

prepared by: ms lee mee ling (srn, son) wounds & type of dressing materials

Documents