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Home | Principles of Surgery

Dressings

Optimum environment for wound healing

  1. Moist
  2. Free from infection, with minimal slough
  3. Free of chemicals and foreign bodies
  4. Optimum temperature
  5. Minimal number of dressing changes
  6. Correct pH

Different dressings are appropriate for different stages of the wound healing

Good wound management necessitates flexible approach to election and use of dressings

 

Requirements from a dressing

  1. Wound
    • Protection from infection and trauma
    • Debrides, both mechanically and chemically
    • Absorbent and removes excess exudate, whilst keeping wound moist
    • Maintains temperature and gaseous exchange
  2. Patient
    • Comfortable and cosmetically acceptable
    • Stimulates healing
  3. Healthcare provider
    • Inexpensive
    • Easy to change

Type Description  Brand names  Indications 
Hydrocolloids Available as pastes, granules, wafers
Mixture of carboxymehtylcellulose, pectins, gelatins, elastomers
Forms gel on contact with wound secretions, absorbing secretions
Granuflex Wet sloughly wounds 
Hydrofibre Consists of carboxymethylcellulose spun into fibre
Forms gel on contact with wound secretions, which absorbs secretions
Aquacel Heavily exudating wounds 
Hydrogels  Insoluble polymers, water and propylene glycol
Absorbs large volumes of exudates and effective at desloughly/debriding
  Desloughing/debriding 
Semipermeable film dressings Clear polyurethane film coated adhesive    Not suitable if excessive exudate 
Alignates Derived from seaweed
Absorbs secretions to form gel to optimise moist wound healing
Kaltostat, sorbsan   
Foam dressings Consists of polyurethane / silicone foam
Very absorbant
  Flat / cavity wounds  
Antimicrobial dressings  Little evidence for benefit     
Artificial and living skin equivalents Can facilitate cell proliferation, production of extracellular matrix
Epidermal components - Vivoderm
Dermal components - Dermagram
Composite grafts (epidermal / dermal components)
   
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