2017 HCHB_digital

Wound Care (continued)
Wound type Management Dressings Dressing features
Surgical wounds
Puncture wounds
eg, splinters or
nail puncture
Household
burns
Skin tears
Skin ulcers
• For surgical wounds, keep wound edges
together and follow surgeon's instructions
for wound care.
• For small puncture wounds clean the
wound with saline, tap water, or a lowtoxicity
antiseptic cleansing solution, and
apply an antiseptic. Refer to a doctor more
serious puncture wounds, or if it has been
more than five years since a person's last
tetanus shot.
• If a protective dressing is needed, use an
island adhesive dressing and change daily.
• Remove heat source from the patient.
• Immediately cool the area for up to 20
minutes with cool running water from a
tap or shower. In the absence of water, any
cool clean fluid can be used.
• Remove any affected clothing if it is wet
with hot liquid or affected by a chemical
splash. Remove tight rings or jewellery
from the injured area before swelling
occurs. Do not try to remove fabric stuck
to skin.
• Call 111 for patients with serious burns or
refer them to their doctor.
• After cooling the area for 20 minutes,
remove any non-viable tissue and apply
an antiseptic if the burn has compromised
the skin integrity. Apply a sterile dressing.
Improved outcome results have been
reported for sustained-release silver
dressings and honey dressings.
• Skin tears often occur in fragile skin of the
elderly. Salvage the skin flap if possible.
Keep the flap moist and stop any bleeding
by using impregnated gauze. Realign the
skin using wound closure strips.
• Cover skin tear with a moist, healing
wound dressing.
• Skin ulcers should be correctly diagnosed
by a doctor before commencing treatment.
• Provide a moist healing environment.
• Use dressings which absorb exudate from
the wound.
• Dressings keep the wound at body
temperature – optimum for new skin
growth.
• Wound closure strips eg, Elastoplast,
Steristrip, Nexcare Butterfly/Steri-strip
Closures
• Wound pad non-stick dressings eg,
Elastoplast, Melolin, Telfa
• Film dressing eg, Elastoplast, Opsite,
Tegaderm
• Dressings impregnated with honey
eg, Manuka Health Wound Dressings,
ApiNate dressing
• Island dressings eg, Elastoplast, Opsite
Post-Op, Nexcare, Telfa, Tegaderm with
pad.
• Silver dressings eg, Acticoat, Allevyn
Ag
• Dressings impregnated with honey
eg, Manuka Health Wound Dressings,
ApiNate dressing
• Hydrocolloid dressings eg, Elastoplast
• Island dressings eg, Elastoplast, Opsite
Post-Op, Nexcare, Telfa, Tegaderm with
pad.
• Silver dressings eg, Acticoat, Allevyn
Ag
• Impregnated gauze eg, Jelonet
• Wound closure strips eg, Elastoplast,
Steristrip, Nexcare Butterfly/Steri-strip
Closures
• Film dressing eg, Elastoplast, Opsite,
Tegaderm
• Follow doctor's advice regarding choice
of wound dressing. Dressings are usually
occlusive as ulcers heal better in a moist
environment. Honey dressings may be
helpful.
• Hydrocolloid/Hydroactive dressings
eg, Elastoplast, Allevyn and Duoderm
• Dressings impregnated with honey
eg, Manuka Health Wound Dressings,
ApiNate dressing
• Wound closure strips hold wound edges together,
are flexible, help reduce scarring and have
hypoallergenic adhesive.
• Non-stick wound pad dressings absorb fluid but
won’t stick to the wound.
• Film dressings are water and bacteria-proof moist
dressings, which do not absorb exudate.
• Self-adhesive island dressings have two types:
– non-waterproof, with non-adherent wound pad,
which absorbs wound exudate without sticking
to the wound.
– waterproof and bacteria-proof dressings which
are covered by a special film. This waterproofs
and protects the wound against bacteria.
The transparent film allows the wound to be
monitored.
• Island dressings – see above.
• Hydrocolloid dressings are highly absorbent,
binding exudate and preventing skin maceration
and breakdown.
• Dressings impregnated with honey help absorb fluid
exudate, keep the wound moist, will not stick to
the wound and have antibacterial properties. Cover
with waterproof dressing, or if moderate to heavy
exudate use a dry dressing with tape and bandage.
Caution: Diabetics may need to monitor blood
sugars (refer to pharmacist).
• Impregnated gauze keeps the area moist.
• Wound closure strips hold wound edges together,
are flexible, help reduce scarring and have
hypoallergenic adhesive.
• Film dressings are water and bacteria-proof moist
dressings, which do not absorb exudate.
• Hydrocolloid dressings are highly absorbent,
binding exudate and preventing skin maceration
and breakdown
• Dressings impregnated with honey help absorb fluid
exudate, keep the wound moist, will not stick to
the wound and have antibacterial properties. Cover
with waterproof dressing, or if moderate to heavy
exudate use a dry dressing with tape and bandage.
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Page 174 HEALTHCARE HANDBOOK 2017-2018 Common Disorders