Dr. Clare Fenwick, 2010

Dr.
Clare Fenwick, 2010

Aim of wound dressings
 Heal, prevent infection and manage exudate
 Protect wound and surrounding tissue
 Reduce pain and minimise client distress
 Maintain wound temperature
 Manage potential or actual haemorrhage
 Manage wound odour
 Immobilise an injury
Dr. Clare Fenwick, 2010

Product selection
 Wound aetiology
 Wound location
 Wound exudate
 Product life span
 Cost factors
 Availability

Wound Bed Preparation
 Cleansing techniques
 Debridement
 Sharp
 Surgical
 Mechanical
 Enzymatic
 Autolytic
 Biodebridement (maggots)

Sharp Debridement
Clare Fenwick Griffith University Gold

Coast 2010
Sharp Debridement

Coast 2010
Surgical debridement using waterjet hydrosurgery
Intra-operative
Pre-operative Clare Fenwick Griffith University Gold
Coast 2010
Mechanical debridement
Coast 2010
Enzymatic Debridement

Coast 2010
Autolytic Debridement

Coast 2010
Biodebridement

Coast 2010
Cleansing techniques
 Clean versus sterile technique
 Normal saline and tap water are OK
 Hand washing is essential to reduce infection
 Dirty hand & clean hand
 Wound field concept

Clean and dirty hand
Dressing
Equipment
clean dirty

Wound Field concept
Dressing
Equipment

Dressing & Exudate
None – Low Films

Hydrogels
Low – Mod Hydrocolloid
Mod – Heavy Alginates

Hydrofibre
Foams
Wound products
 Inert non stick dressings
 Film dressings
 Foam dressings
 Hydrogel dressings
 Hydrocolloid dressings
 Alginate dressings
 Hydrofibre dressings
 Zinc dressings
 Nanocrystalline Silver dressings
 Cadexomer Iodine
 Vacum assisted closure
 Manuka Honey

Inert non stick dressings
Primary
 Gauze dressing
Protective low absorption dressing
 Paraffin tulle dressings (Jelonet®,
Bactigras®)
Application:
Clean wound base
 Non-paraffin, non-tulle, woven products,
Place shiny side of dressing to wound.
May(eg Adaptic®,
require soaking if Inadine®)
exudate strikethrough has
occurred.
 Non stick dressings (eg Melolin®,
Cutilin®)
Contraindications/Possible Side effects:
 Combine
Harsh debridement of the wound bed if exudate dries
Limited use as a primary dressing
Dries out the woundClare
bed Fenwick Griffith University Gold
Coast 2010
Film dressings
Primary and secondary dressing
Product names include
Low exudating wounds, protective dressing.
 Opsite Flexigrid®
Application:
 Opsite
Clean Post-Op®
wound base
Prepare periwound area with a protective barrier wipe.
 Tegaderm®
Apply adhesive side to wound and remove outer layer.
Adhesive strongest in first 24 hours, can remain for 7 days.
 Polyskin®
Observe for maceration, remove if this occurs.
Contraindications/ Possible Side effects:

Do not apply to infected wounds or if allergic to tapes
If not removed correctly can be traumatic to the wound bed .
NB Green sided Opsite is for wounds, orange sided Opsite is
for vascular access devices
Coast 2010
Film dressings Film Dressing

Product names include
Low exudating wounds, protective dressing.
 Opsite Flexigrid®
Application:
 Opsite
Clean Post-Op®
wound base
Prepare periwound area with a protective barrier wipe.
 Tegaderm®
Apply adhesive side to wound and remove outer layer.
Adhesive strongest in first 24 hours, can remain for 7 days.
 Polyskin®
Observe for maceration, remove if this occurs.

Do not apply to infected wounds or if allergic to tapes
If not removed correctly can be traumatic to the wound bed .
NB Green sided Opsite is for wounds, orange sided Opsite is
for vascular access devices
Coast 2010
Foam dressings
Product names
Light/mod/highly available
exudating wounds, protective dressing, cavity
wounds
 Allevyn®
Application:
 Allevyn Adhesive®
Clean wound base
 Allevyn
Read packagedCavity®
for insertion side (patterned or shiny side up)
Sheet foam left insitu up to 7 days (24 hours if infected)
 Cavi-Care®
Cavity foams left insitu up to 14 days (daily washing of foam
if infected)

Avoid covering with occlusive dressings.
Avoid wounds dressed with
Clare antibacterial
Fenwick solutions.
Griffith University Gold
Coast 2010
Foam dressings
Product names
Light/mod/highly available
exudating wounds, protective dressing, cavity
wounds
 Allevyn®
Application:
 Allevyn Adhesive®
Clean wound base
 Allevyn
Read packagedCavity®
for insertion side (patterned or shiny side up)
Sheet foam left insitu up to 7 days (24 hours if infected)
 Cavi-Care®
Cavity foams left insitu up to 14 days (daily washing of foam
if infected)
Foam Dressing
Avoid covering with occlusive dressings.
Avoid wounds dressed with
Clare antibacterial
Fenwick solutions.
Griffith University Gold
Coast 2010
Hydrogel dressings
Primary dressing
Product names available
Sloughy or necrotic wounds requiring chemical debridement.
Lightly exudating wounds, hydrate dry wounds. .
 Solugel®
Application:
 Intra
Clean wound site®
base Gel
Coat wound base with at least 5 mm gel.
 Solosite®
Apply Gel
sheet directly to wound base.
Can remain insitu up to 3 days
 Clear-Site®
Requires a secondary dressing
 Duoderm® Gel
 Aquaflo®
Remove if patient complains of burning or discomfort.
Can cause maceration if too much is applied.
Don’t use on highly exudating wounds
Clare Fenwick or blind
Griffith University Gold sinuses
Coast 2010
Hydrogel dressings
Hydrogel Dressing
Primary dressing
Sloughy or necrotic wounds requiring chemical debridement.
Lightly exudating wounds, hydrate dry wounds. .
 Solugel®
Application:
 Intra
Clean wound site®
base Gel
Coat wound base with at least 5 mm gel.
 Solosite®
Apply Gel
sheet directly to wound base.
Can remain insitu up to 3 days
 Clear-Site®
Requires a secondary dressing
 Duoderm® Gel
 Aquaflo®
Remove if patient complains of burning or discomfort.
Can cause maceration if too much is applied.
Don’t use on highly exudating wounds
Clare Fenwick or blind
Griffith University Gold sinuses
Coast 2010
Hydrocolloid dressings
Product
Sloughy names
wounds available
requiring autolytic debridement, low/moderate
exudating
 Duodermwounds.
Extra Thin®
 Duoderm CGF®
Application:
 Duoderm® Paste
Clean wound base, wipe periwound with barrier wipe
 Comfeel
Warm productPlus Transparent®
in hands to activate adhesive
Place adhesive
 Comfeel side to
Plus® wound.Dressing
Contour
Leave at least 2 cm border around wound.
CanComfeel Plus® Pressure Relieving Dressing

be left insitu up to 7 days, dependant on exudate level.
 Comfeel®
Dressing becomesPaste
opaque when due for change
 Comfeel® Powder
Do not apply to infected
Clarewounds
Fenwick Griffithor
Coast 2010
if client
University Gold is allergic.
Remove if patient complains of discomfort.

Hydrocolloid dressings
Hydrocolloid
Primary andDressing
secondary dressing
Product
Sloughy names
wounds available
requiring autolytic debridement, low/moderate
exudating
 Duodermwounds.
Extra Thin®
 Duoderm CGF®
Application:
 Duoderm® Paste
Clean wound base, wipe periwound with barrier wipe
 Comfeel
Warm productPlus Transparent®
in hands to activate adhesive
Place adhesive
 Comfeel side to
Plus® wound.Dressing
Contour
Leave at least 2 cm border around wound.
CanComfeel Plus® Pressure Relieving Dressing

be left insitu up to 7 days, dependant on exudate level.
 Comfeel®
Dressing becomesPaste
opaque when due for change
 Comfeel® Powder
Do not apply to infected
Clarewounds
Fenwick Griffithor
Coast 2010
if client
University Gold is allergic.
Remove if patient complains of discomfort.

Alginate dressings
Primary dressing
Medium to heavy exudating, bleeding, sloughy or infected wounds.
 Kaltostat®
Application:
 Algoderm®
Clean wound base
Lightly pack or line the wound, product swells with exudate.
 Sorbsan®
Avoid pre-moistening the product.
Discontinue use if the dressing remains dry.
 Curasorb®
Can be left insitu up to 4 days, dependant on exudate level.
Requires a secondary dressing, do not use an occlusive dressing
 Kaltocarb®
Do not use on dry wounds as it dehydrates the wound bed
Coast 2010
Alginate dressings
Primary dressing
Medium to heavy exudating, bleeding, sloughy or infected wounds.
 Kaltostat®
Application:
 Algoderm®
Clean wound base
Lightly pack or line the wound, product swells with exudate.
 Sorbsan®
Avoid pre-moistening the product.
Discontinue use if the dressing remains dry.
 Curasorb®
Requires a secondary dressing, do notCalcium
use an occlusive
Alginatedressing
 Kaltocarb®
Dressing
Do not use on dry wounds as it dehydrates the wound bed
Coast 2010
Hydrofibre dressings
Primary dressing:
Medium to heavy exudating or infected wounds
 Aquacel
Application:
Clean wound base
Line the wound base with product
Cover with a secondary dressing.

Heavily infected wounds require Hydrofibre impregnated with
Silver.
Do not use in people allergic to hydrocolloids
Coast 2010
Hydrofibre dressings
Hydrofibre Dressing

Primary dressing:
Medium to heavy exudating or infected wounds
 Aquacel
Application:
Clean wound base
Line the wound base with product

Heavily infected wounds require Hydrofibre impregnated with
Silver.
Do not use in people allergic to hydrocolloids
Coast 2010
Nanocrystalline Silver dressings
Primary dressing:
Product
Infected names
wounds available
(150 pathogens including MRSA and VRE),
burns, donor and recipient sites.
 Acticoat®
Application:
 Aquacel
Clean wound base
Ag®
 Actisorb
Moisten product plus® (charcoal)
with sterile water, daily if not enough exudate
Cut to wound size and shape, apply blue side down

Do not use on people going for a Magnetic Resonance Imaging
Do not use in people allergic
Clare Fenwickto silver
Griffith
Coast 2010
University Gold
Nanocrystalline Silver dressings
Primary dressing:
Product
Infected names
wounds available
(150 pathogens including MRSA and VRE),
burns, donor and recipient sites.
 Acticoat®
Application:
 Aquacel
Clean wound base
Ag®
 Actisorb
Moisten product plus® (charcoal)
with sterile water, daily if not enough exudate
Cut to wound size and shape, apply blue side down
Can be left insitu
Nanocrystalline up toDressings
Silver 7 days, dependant on exudate level.

Do not use on people going for a Magnetic Resonance Imaging
Do not use in people allergic
Clare Fenwickto silver
Griffith
Coast 2010
University Gold
Zinc dressings
Product
Primary names available
dressing
Sloughy wounds, epithelialising wounds and to protect limbs
 Steripaste®
at risk of skin tears or degloving.
 Viscopaste®
Application:
 Flexidress®
Cut length as required, usually 3-4 times the size of the wound
Fold to make a patch and place over wound.
 Gelocast®
Requires a secondary dressing.
Can be left insitu up to 7 days.

Allergy to zinc
Coast 2010
Zinc dressings
Product
Primary names available
dressing
Sloughy wounds, epithelialising wounds and to protect limbs
 Steripaste®
at risk of skin tears or degloving.
 Viscopaste®
Application:
 Flexidress®
Cut length as required, usually 3-4 times the size of the wound
Fold to make a patch and place over wound.
 Gelocast®
Requires a secondary dressing.
Can be Paste
Zinc left insitu up to 7 days.
Dressings

Allergy to zinc
Coast 2010
Other Dressings
 Wound Honey
 Cadexomer Iodine
 Vacum assisted closure (VAC) (see
lecture)

References
 Carville, K. (2005). Wound Care Manual.
Western Australia: Silver Chain Foundation.
 Ellis, T. (2002). Wound bed preparation- a
wound management imperative. Woundcare
Network(10), 1-4.
 Myers, B. A. (2008). Wound Management
Principles and Practice (2nd ed). New Jersey:
Prentice Hall.

Dr. Clare Fenwick, 2010

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Dr.

Clare Fenwick, 2010