Wound Care Protocol

Presented by:

Dr. M. Paul

Primary Care Provider – Wound Care Protocol

Principles of wound bed

preparation

• Debridement

• Moisture balance

• Bacterial balance

5 Tips for the Clinician• Assess patient and patient’s wound with each dressing change.

• Keep dressing as thin as possible in the plantar surface.

• If packing, wick it. Remember, “Fluff. Don’t stuff”.

• Temperature of affected limb is important. It may indicate infection, inflammation and/or

decreased vascular supply.

• Listen to the patient and/or his circle of care.

Adapted by Sibbald, Goodman, Woo et al. Special Considerations in Wound Bed Prep. 2011: An Update Advances in Skin & Wound Care Sept. 2011.

Clinical Pathways

• Diabetic foot ulcer

• Surgical wounds

• Pressure ulcers

• Venous stasis ulcers

• Chronic maintenance wounds

• Infected surgical wounds

• Pilondial sinus / incision and drainage

• Trauma wound

• Atypical wounds

• Burns

Superficial granulating wound

Products

Minimum exudate Moderate to severe exudate

hydrogels

hydrocolloids

Hydrofibers

Calcium

alginates

foams

Cavity wound

Products

Minimum exudate Moderate to Severe

exudate

PHMB

Hydrofiber, calcium alginate

and foam

Burns

• Nanocrystalline silver

• Hydrofiber with silver

• Flamazine

• Polysporin to face

Chronic wounds

Inadine and

Iodosorb

Silver productsPHMB

Infected wounds

HOST

BACTERIA

STAGES OF INFECTION

Contaminated

Host in control

Colonized

Established bacterial

population, host control

bacterial balance

Critically Colonized

Established bacterial

population, wound not

progressing, bacterial

imbalance, no signs of infection

Infected

Bacteria in control

TREAT

WITH:

Topical

Antimicrobials

Systemic

Antibiotics

Adapted by P. Coutts from D. Keast and P. Bowler

Products

• Antimicrobial dressings

– Silver

– Iodine

– PHMB

• Acetic acid

Hydrofera blue

Intertrigo

Venous stasis ulcers

Compression bandages

Dressings:

• calcium alginate with AG

• hydrofiber with silver

• PHMB

• Iodine dressing

Necrotic wounds

• Autolytic debridement

• Autolytic debridement contraindicated

in ischemic wounds

• Inadine or Iodosorb

• Betadine solution painted on

Use of NPWT and

Disposable Negative Pressure

VAC

PICO

QUANTUM

Medical Professionals:

The first people you see after saying:

“Hold my beer and watch this”.