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Principles of Surgery
- Acute Limb Ischaemia
- Anastamosis
- Blood transfusion
- Brainstem death
- Burns
- Chemotherapy
- Clinical Trials / Medical statistics
- Diathermy
- Drains
- Dressings
- Fracture healing
- Gunshot wounds / Blast Injury
- Informed Consent
- Intensive Care (ITU)
- Nerve Injury
- Operating list order
- Paediatrics
- Palliative care
- Patient safety in theatre
- Radiotherapy
- Screening
- Sterilisation & disinfection
- Stoma
- Surgical Audit
- Sutures / Needles
- Symptom based
- Theatre design
- Tourniquet
- Transplantation
- Wound healing
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Dressings
Optimum environment for wound healing
- Moist
- Free from infection, with minimal slough
- Free of chemicals and foreign bodies
- Optimum temperature
- Minimal number of dressing changes
- 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
- 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
- Patient
- Comfortable and cosmetically acceptable
- Stimulates healing
- 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) |