Dressing Solutions

Question 1

Name the primary dressings that are NOT anti-microbial

Answer 1

Tulle Gras
Calcium Alginate
Hydrofibre 
Hydrogel
Hydrocolloid

Question 2

What primary dressings would you use on an infected wound?

Answer 2

Iodine (PVP and cadexomer)
Silver
Hypertonic Sodium Chloride
Honey
Chlorhexadine
PHMB

Question 3

What is an example of a low absorbency secondary dressing?

Answer 3

Melolin

Island dressing

Question 4

What is an example of a moderate absorbency secondary dressing?

Answer 4

Combine

Question 5

What is an example of a high absorbency secondary dressing?

Answer 5

Foam

Question 6

What is an example of a super absorbency secondary dressing?

Answer 6

Zetuvit (+)

Question 7

What is an example of a tertiary dressing?

Answer 7

Tape (micropore)
Bandage (self adhesive)
Fixamul

Question 8

What 10 factors inhibit healing?

Answer 8

1. Ageing process
2. Co-morbidities (diabetes)
3. Nutritional status
4. BMI Extremes
5. Medication
6. Allergies
7. Mobility & Activity
8. Radiotherapy & Chemotherapy
9. Psychosocial factors
10. Psychological state

Question 9

What are the 13 parameters of wound assessment?

Answer 9

1. Type of wound
2. Aetiology
3. Mode of healing
4. Duration of wound
5. Location
6. Dimension (L W D)
7. Clinical appearance
8. Wound edges
9. Exudate
10. Odour
11. Surrounding skin
12. Pain
13. Allergies

Question 10

What products have debriding properties?

Answer 10

Honey
Hydrogel
Hydrocolloid
Hypertonic Sodium Chloride 
PHMB (prontosan)
Cadexomer Iodine

Question 11

Name 6 modes of healing

Answer 11

1. Primary intention
2. Secondary intention
3. Delayed primary intention
4. Skin grafts
5. Flaps
6. Bioengineered tissue

Question 12

Five signs of infection

Answer 12

1. Redness (erythema)
2. Swelling (oedema)
3. Pain
4. Exudate
5. Heat

Question 13

What two products have anti-inflammatory properties?

Answer 13

1. Silver

2. Iodine

Question 14

What two products have haemostatic properties?

Answer 14

1. Calcium Alginate

2. Honey

Question 15

What product can NOT be used on a bleeding wound?

Answer 15

Hypertonic Sodium Chloride

Question 16

What is the trade name for chlorhexadine impregnated tulle gras?

Answer 16

Bactigrass

Question 17

What effect does NSAID have on wound healing?

Answer 17

Suppresses the inflammatory phase of healing by blocking prostaglandin synthesis

Question 18

What effect does cytotoxic agents have on wound healing?

Answer 18

Affects rapidly replicating cells primarily epithelialising cells

Question 19

What effect does corticosteroids have on wound healing?

Answer 19

• Suppress macrophages and collagen production
• impairs angiogenesis and epithelisation
• inhibit wound contraction
• lowers immune response
• increase susceptibility to infection

Question 20

What effect does immunosuppressive drugs have on wound healing?

Answer 20

Reduce white cell activity resulting in impaired debris clearance

Question 21

What effect does antibiotics have on wound healing?

Answer 21

• penicillin releases peniciliamine, preventing collagen cross-linking
• doxycycline reduces matrix metalloproteases and retard collagen degradation

Question 22

What effect does nicotine have on wound healing?

Answer 22

• Reduces neutrophils, collagen, connective tissue synthesis, macrophage function, epithelialisation and vitamin C stores
• 6x increased risk of wound infection and dehiscence

Question 23

What is the criteria for standard aseptic technique?

Answer 23

• Simple
• Less then 20 min in duration
• Involves small key parts and sites
• Minimal number of key parts

Question 24

What is the criteria for surgical aseptic technique?

Answer 24

• Complex
• Longer then 20 min
• Large open key site
• Large/numerous key parts

Question 25

Define primary intention mode of healing

Answer 25

Wound edges held in close apposition by either sutures, staples, adhesive taps or tissue glue.

Question 26

Define delayed primary intention as a mode of healing

Answer 26

Infected wound that requires intensive cleaning prior to primary closure 3-7days

Question 27

Define secondary intention as a mode of wound healing

Answer 27

Spontaneous wound healing occurs by an obvious process of granulation, contraction and epithelisation that results in scarring

Question 28

Define what the 4 types of exudate indicate

Answer 28

- Serous: clear straw coloured - Haemoserous: slight blood stained serious fluid - Sanguineous: frank or heavily blood stained fluid - Purulent: containing pus

Question 29

What do rolled wound edges indicate?

Answer 29

Inhibit healing & epithelisation of sinus tracks or malignant changes

Question 30

What do raised wound edges indicate?

Answer 30

Hypergrannulation or malignancy

Question 31

What aspects of surroundings skin need to be assessed?

Answer 31

``` Cellulitis Oedema Induration Eczema Maceration Foreign bodies Contact dermatitis ```

Question 32

What does pain indicate?

Answer 32

``` Disease process Trauma Surgery Infection Foreign bodies Poor dressing choice or products ```

Question 33

What effect can infection have on a wound?

Answer 33

Dehiscence Evisceration Haemorrhage Sepsis

Question 34

What are 6 other signs of infection?

Answer 34

New, increased and altered pain Delayed healing Friable, bright red Hypergrannulation tissue Pocketing or irregular deposition of granulation tissue Bridging tissue Increased or altered exudate