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Wound Care (continued)

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. PharmacyToday A part of your everyday Page 174 HEALTHCARE HANDBOOK 2017-2018 Common Disorders

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