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Dry Wound - Add Moisture
To promote moist wound healing there must be some moisture in the wound bed. [15]
- Sibbald, R.G., Elliott, J.A., and Ayello, E.A. (2015). Optimizing the moisture management tightrope with wound bed preparation 2015©. Adv in Skin & Wound Care. 28(10), 466-76.
Fragile Skin Around a Wound
Protect at risk skin by applying a protective barrier between the skin and the source of irritation. Note: In some situations ostomy barrier products may be used for protection around tubes and fisulae.
Heavily colonized wound
Colonization of bacteria in a wound indicates that bacteria are multiplying in the wound and causing tissue damage and signs of infection in the wound. The tissue response can range from mild to severe with limb or life threatening changes. Traditional signs of infection may include redness, warmth, swelling, fever, increased drainage, and foul odor. [14]Antimicrobial dressing - Ionic silver dressings, powered by Hydrofiber® Technology, absorb wound fluid and kill bacteria in the dressing to help decrease bacteria in the wound bed. [16]
14. Gupta, S., Andersen, C., Black, J., et al. (2107). Management of chronic wounds: diagnosis, preparation, treatment, and follow-up. Wounds. 29(9 suppl), S19-S36.
16. Bowler, P., Jones, S., Towers, V., et al. (2010). Dressing conformability and silver-containing wound dressings. Wounds UK. 6(2), 14-20.
Heavily Draining Wound - Exudate Management
Absorbent dressings used in the management of fluid loss from a wound. Some dressings are also used to fill dead space or a cavity type wound. Other dressings are used as a cover for an absorbent filler dressing. [14]
- Gupta, S., Andersen, C., Black, J., et al. (2107). Management of chronic wounds: diagnosis, preparation, treatment, and follow-up. Wounds. 29(9 suppl), S19-S36.
Malodorous wound
The management of malodorous wounds.
Moist Wound – Maintain Moisture
Maintain Moisture Use a moisture retentive dressing that will maintain moisture in the wound. [15]
- Sibbald, R.G., Elliott, J.A., and Ayello, E.A. (2015). Optimizing the moisture management tightrope with wound bed preparation 2015©. Adv in Skin & Wound Care. 28(10), 466-76.
Necrotic Tissue - Debridement
Debridement Removal of non-viable tissue that would otherwise impair the healing of a wound. Eschar is a type of necrotic tissue. Slough is the byproduct of wound inflammation and can harbor bacteria. Both tissue types need to be removed from the wound to promote healing. [13]
Note: One exception is that dry stable eschar on the lower extremity should not be debrided.
Autolytic debridement is promoted by maintaining a constantly moist wound bed condition to help liquefy and remove non-viable tissue in a selective, safe, comfortable way. [14]
Note: One exception is that dry stable eschar on the lower extremity should not be debrided.
Autolytic debridement is promoted by maintaining a constantly moist wound bed condition to help liquefy and remove non-viable tissue in a selective, safe, comfortable way. [14]
- Black, J., Baharestani, M., Black, S., et al. (2010). An overview of tissue types in pressure ulcers: a consensus panel recommendation. O-WM 56(4), 28-44.
- Gupta, S., Andersen, C., Black, J., et al. (2107). Management of chronic wounds: diagnosis, preparation, treatment, and follow-up. Wounds. 29(9 suppl), S19-S36.
Venous insufficiency
A leg ulcer is a breakdown in tissue on the leg or foot resulting from alterations in the arterial or venous vessels in the lower leg or both. Venous leg ulcers are the most common type of lower extremity ulcer and are the result of poor venous return to the heart resulting in sustained venous hypertension causing swelling and tissue damage in the lower leg. [14] Compression - Wound management with compression therapy is very important for managing venous wounds. [14]Note: Sometimes patients exhibit both mixed arterial and venous disease so evaluation of the leg must be done prior to the use of compression in order to rule out any signs of arterial disease. [14]
- Gupta, S., Andersen, C., Black, J., et al. (2107). Management of chronic wounds: diagnosis, preparation, treatment, and follow-up. Wounds. 29(9 suppl), S19-S36.
Compression
Exudate Management