Archive for the ‘Dressings’ Category

From Transparent Dressings to Hydrogels, Wound Care Dressings You Use Every Day

Monday, February 1st, 2021
wound care dressings

As wound care professionals, wound care dressings are an important tool.

Keeping up to date on the types of wound care dressings available to treat patients in our care is our duty.

Wound care dressings come in various shapes, sizes and have indications for their use.

Professionals who treat wounds must remain aware of the types of wound care dressings they can use, as well as their contraindications. Here’s a list.

Transparent Film Dressings

Transparent wound care dressings are thin, transparent sheets of polyurethane coated with an adhesive and are available in a variety of shapes and sizes. They are semi-permeable, allowing the one-way passage of oxygen and moisture vapor, but are waterproof and impermeable to bacteria.

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Learn When You Should Apply a Hydrogel Dressing to a Wound

Wednesday, September 30th, 2020
hydrogel dressings

As wound care clinicians, you must be aware of the different types of wound care dressings, such as hydrogel dressings.

A hydrogel dressing — also known as hydrated polymer dressings — consist of 90% water in a gel base that regulate fluid exchange from the wound surface.

It absorbs small amounts of fluid and donating moisture to the wound bed.

These dressings are available in sheets, amorphous gels, or impregnated gauze and packing strips.

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Explore When to Use a Collagen Wound Dressing on Your Patients

Wednesday, September 9th, 2020
collagen wound dressing

As wound care certified (WCC) clinicians, you should be aware of the types of dressings available to treat patients in your care.

Wound care dressings come in various shapes, sizes and have indications for their use, including collagen wound dressings.

Let’s explore which types of dressings are focused on collagen.

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Antimicrobial Products: Read Labels and Do Your Own Research

Wednesday, March 18th, 2020
antimicrobial products

The wound care industry has been inundated with antimicrobial products for years. 

Companies with good intentions try to improve outcomes and move away from antiquated antiseptics, such as Betadine, Dakins and acetic acid, that are not actually approved for use in wounds.

But some products are cytotoxic and lack any solid evidence that they are antimicrobial.

Instead, companies are offering modern products with little or no cytotoxicity available in multiple forms, such as cleansers and dressings. The challenge facing you in this barrage of products is knowing whether they are actually antimicrobial in the wound. 

This blog will arm you with proper ways to analyze these antimicrobial products and increase knowledge about them.

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Your Essential Guide to Wound Packing Dead Space

Wednesday, February 19th, 2020
wound packing

Let’s face it, there is nothing fun, exciting or sexy about this topic.

Wound packing is just a necessary part of performing good wound care treatments in the event your patient has notable depth in their wound. 

However, there is a purpose and a proper way to pack a wound with the goal of promoting healing in the most effective and efficient manner.

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What’s All the Fuss about Wound Dressing Change Frequency?

Wednesday, December 4th, 2019
A clinician maintains a patient's wound dressing change frequency.

Let’s take a one question wound care quiz.

What is more important for wound dressing change frequency?

  1. Expert application of a dressing
  2. Frequency of the dressing change

The correct answer is the frequency. Now let’s talk about why.

I do not want to take away from the importance of properly applying dressings because that certainly has its own merits. But when it comes down to it, the frequency wins hands down. 

As we teach in class, wound healing is a dynamic process. As the wound progresses through the phases of healing, all kinds of cellular activity is happening.

From the neutrophils and macrophages to the growth factors and fibroblasts, each phase has a job to do for the wound to move to the next phase and ultimately close.

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Wet-to-Dry Dressings: Why Not?

Friday, February 10th, 2017

What should wound care professionals do when a physician orders wet-to-dry dressings? Be prepared and know the facts.

Wet-to-Dry Dressings: Why Not?

Pictured: Trauma caused by wet-to-dry dressing.

 

Those of us in wound care know that wet-to-dry dressings are considered substandard care. Some physicians, however, commonly order wet-to-dry dressings for patients, often leaving clinicians in a tricky situation. Do you feel conflicted as to how you should respond? It can be intimidating, but with a little preparation, it doesn’t have to be. By knowing the facts about wet-to-dry dressings, as well as effective and cost-efficient alternatives, you can handle such situations with confidence. Not sure where to start? We’re here to help.

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Maceration and Hydrogels? Just Say Whoa

Thursday, July 21st, 2016

How do you use hydrogel dressings to keep wounds moist without causing maceration? Very carefully.  

 

Maceration and Hydrogels? Just Say Whoa

 

If you’ve ever taken a long bath or spent an afternoon in a swimming pool, you’re familiar with what happens to your hands and feet: they become soft, white, and wrinkled up like prunes. This is a classic case of maceration, which occurs when skin tissue is exposed to excessive moisture over a period of time.

As clinicians, we regularly treat patients with wounds (which need to be kept moist) that are surrounded by tissue that needs to be kept dry. So knowing how to properly treat the wound without causing maceration makes all the difference in the healing process.
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Warm Wound Healing? It’s All About Foam Dressings

Thursday, February 4th, 2016

Keeping a wound warm is an important part of wound care treatment, and foam dressing does the trick because it effectively maintains optimum temperatures and promotes healing. 

Foam for Warm Wound Healing

 

For wound care clinicians – and anyone else who ever treats wounds – it’s important to know that moist wounds heal faster. However, moisture on any surface (including wounds) will begin evaporating when exposed to air, and at a quicker rate as the surface cools. So the challenge of healing wounds effectively is to keep a wound moist and warm. Fortunately, foam dressings maintain optimum healing conditions, and help our patients heal faster.

Why warm is better

As wound tissues lose moisture, a cooling effect occurs in the wound. Because cells and enzymes function optimally at normal body temperature, a drop of just 2 °C is sufficient enough to negatively affect the biological healing process.

In fact, when a wound dressing is changed, it can take a wound base temperature up to four hours before it returns to normal. This is an important factor to consider when anticipating healing times, as well as when prepping your patient for a dressing change. Additionally, when tissue cooling occurs, it can lead to a higher risk of infection due to vasoconstriction, and hemoglobin’s increased need for oxygen. This, in turn, decreases the amount of oxygen available for neutrophils, which fight infection.

So how does this all tie in to dressings? By using the right type of dressings – and applying them properly – you can create an optimum environment for wound healing. The dressing that keeps the wound bed the warmest is foam.

Foam Dressing

Semipermeable polyurethane foam dressing is nonadherent and nonlinting. It has a hydrophobic or waterproof outer layer, and provides a moist wound environment. Other characteristics of foam dressing include:

  • It is permeable to water vapor, but blocks the entry of bacteria and contaminants
  • It can be purchased in various thicknesses, with or without adhesive border
  • It is available in pads, sheets, and cavity dressings

Consider using foam as primary or secondary dressing for partial- and full-thickness wounds, with minimal to heavy drainage. In addition, foam dressing:

  • Works well for granulating and epithelializing wounds
  • Provides insulation to keep wounds warm
  • As secondary dressing for wounds with packing
  • Can be used to absorb drainage around tubes
  • Helpful for hypergranulation tissue along with compression

The advantages to using foam dressing on wounds are that it:

  • Provides moist wound healing
  • Doesn’t adhere to the wound
  • Provides cushioning
  • Is easy to apply and remove
  • Can be used with infected wounds
  • Provides a bacterial barrier
  • Is effective with hypergranulation
  • Can be used under compression
  • Can be cut to accommodate tubes

The disadvantages to using foam dressing on wounds include:

  • It could be expensive if exudate requires daily dressing changes
  • Wound beds may desiccate if there is no exudate from the wound
  • A secondary dressing might be required
  • If it becomes saturated, it can lead to maceration of the periwound
  • It is contraindicated for use with third-degree burns, dry eschar, and sinus tracts

What do you think?

Knowing that moist and warm wounds heal faster obviously makes using the right dressings (and applying them properly) crucial to effective wound care. Do you regularly use foam dressings, and have you noticed a difference in healing time? And have you learned any special application techniques that help keep wounds at an optimum body temperature? We’d love to hear about your experiences – please leave your comments below.

Wound Care Education Institute® provides online and onsite courses in the fields of Skin, Wound, Diabetic and Ostomy Management. Health care professionals who meet the eligibility requirements may sit for the prestigious WCC®, DWC® and OMS national board certification examinations through the National Alliance of Wound Care and Ostomy® (NAWCO®). For more information see wcei.net.

Wet-to-Dry Dressings: Here We Go Again

Thursday, October 15th, 2015

Wet-to-Dry dressingsIn the modern world of wound care, we’ve seen drastic improvements in treatment options over the years. So it’s always a surprise when we hear that there are still orders being submitted these days for outdated practices. In this case, we’re talking about those dreaded wet-to-dry dressings.

Why is this still happening – even though the disadvantages to this approach are well-documented? Could it simply be due to a lack of education? Or maybe it’s due to the unavailability of other wound care products that have been shown to yield much better (and safer) outcomes. Whatever the reason, we’re here to double-down on this: no more wet-to-dry dressings.

What are Wet-to-Dry Dressings?

Wet-to-dry is a form of mechanical debridement, and is substandard for wound care.  Here’s how it works:

  • A moist saline gauze is placed onto the wound bed.
  • The dressing is allowed to dry and adhere to the tissue in the wound bed.
  • Once the gauze is dry, the clinician forcefully removes the gauze.
  • Any dead tissue that has adhered to the dry gauze will then be removed from wound bed.
  • These steps are to be repeated every 4 to 6 hours.

 A Reality Check

Although this is technically the way wet-to-dry dressings are applied, most often clinicians will modify it by moistening the gauze prior to removal. This is so that it won’t stick to the wound bed and cause bleeding and trauma, or remove healthy tissue along with it.  The problem is that, while well-intentioned, the moistening of the gauze before removal, which spares the patient pain, defeats the original purpose (mechanical debridement). In addition, the prescribing clinician’s orders are not being followed.

To further complicate matters, some professionals with prescriptive authority write for this dressing but do not understand it is for debridement.  For example, a Physician’s Assistant once explained that he thought this type of dressing meant that the wound bed would be kept moist and covered with a dry secondary dressing.  So in many cases, we have wet-to-dry orders being written by someone who doesn’t understand what they’re ordering, and we have clinicians implementing these orders incorrectly.

The 2014 International Pressure Ulcer Guidelines clearly state that wet-to-dry dressings can be painful and may remove healthy tissue.  It also states that they are being used less frequently. In fact, research shows that this procedure is associated with slower healing rates and are costly in professional time due to the need for frequent wound dressing changes.

We Have Solutions

So, what is the answer to this ongoing problem for wound care practitioners? It’s all about education, and everyone can help by:

  1. Sharing information. Proper educational resources and information regarding this issue need to be shared with not only nursing staff, but also with those who write the orders.
  2. Making a plan. Talk to your medical director and plan a short educational program to present alternatives for those with prescriptive authority.
  3. Asking for change. Ask for a facility policy change from your medical director that states wet-to-dry dressing orders are no longer acceptable.
  4. Talking about it. Keep the discussion going and enlist help from all levels of the organization.
  5. Learning from others. There are plenty of success stories out there from facilities that have planned for and implemented change involving key stake holders. Know that changes can be made, and don’t get discouraged if it doesn’t happen quickly. Remember, your patients are counting on you.

What do you think?

Do you work in a facility that has eliminated wet-to-dry dressings?  How did this change in policy take place, and do you have tips for others who are dealing with this problem? We would love to hear about your experiences having to do with this topic. Please leave your comments below.