2 We will dose your Gentamycin We will dose your Vancomycin We will dose your Heparin We will dose your Warfarin We will do your wound care
4 Animal models show that wounds, including chronic wounds, heal in four phases. Some combine first two. Phases: Hemostasis Inflammation Proliferation or Granulation Remodeling or Maturation
5 Hemostasis (within minutes) Vasoconstriction, platelets, ADP, thrombin, fibrin and stable hemostatic plug. Inflammation (- 4 days post-injury) Erythema, neutophils, phagocytosis, macrophages, chemotactic and growth factors
6 Proliferation, Granulation, Contraction (day four to 21) pebbled red tissue in wound base, fibroblasts, collagen, pericytes, angiogenesis, epithelialization. Maturation (up to 2 years) tensile strength, fibroblasts.
8 Platelets seal damaged blood vessels, which themselves initially constrict but ultimately relax. Platelets secrete vasoconstrictive substances but prime role is to form stable clot. ADP, from damaged tissues, causes platelet aggregation and adherence to exposed collagen. Other secretions stimulate intrinsic clotting cascade through production of thrombin, in turn forming fibrin from fibrinogen. Fibrin mesh strengthens platelet aggregate into stable hemostatic plug. Platelets also secrete platelet-derived growth factor, initiating subsequent steps.
9 Erythema, swelling and warmth often associated with pain up to 4 days post injury. Leaking blood vessels release plasma and PMN s into surrounding tissue. Neutrophils phagocytize debris and microorganisms and provide first line of defense against infection, aided by local mast cells. Fibrin degradation products attract macrophages to phagocytize bacteria and provide a second line of defense. Also secrete variety of chemotactic and growth factors, fibroblast growth factor, epidermal growth factor, transforming growth factor beta and interleukin-1 which direct next stage.
10 Day four to 21, characterized by pebbled red tissue in wound base. Replacement of dermal tissues and subdermal tissues in deeper wounds and wound contraction. Fibroblasts secrete collagen framework on which further dermal regeneration occurs - specialized fibroblasts are responsible for wound contraction.
11 Pericytes regenerate outer layers of capillaries and the endothelial cells which produce the lining, angiogenesis. Keratinocytes are responsible for epithelialization. In final stage of epithelializtion, contracture occurs as keratinocytes differentiate to form protective outer layer or stratum corneum.
12 Process involves remodeling dermal tissues to produce greater tensile strength. Principle cell involved is the fibroblast. Can take up to 2 years and explains why apparently healed wounds can break down dramatically and quickly if attention is not paid to initial causative factors
13 In 1962, Winter described improved wound healing under moist conditions. Only more widely recognized and applied in clinical practice in last decade.
14 Decreased dehydration and cell death - repair requires neutrophils, macrophages, fibroblasts and pericytes that cannot function in dry environment. Increased angiogenesis - requires moist environment but also occurs towards regions of low oxygen tension such that occlusive dressings may act as stimulus. Enhanced autolytic debridement - neutrophil life is enhanced and proteolytic enzymes are carried to wound bed allowing for painless debridement. Increased re-epithelialization - cells must spread over wound surface from edges and have supply of blood and nutrients. Dry crusted wounds reduce this supply and provide barrier to migration thus slowing rates of epithelialization.
15 Bacterial barrier and decreased infection rates - occlusive dressings with good edge seals can provide barrier to microorganisms migration into wound. Wounds covered with occlusive dressings have lower rates of infection than gauze dressings. Decreased pain - moist wound bed insulates and protects nerve endings reducing pain and requires fewer uncomfortable dressing changes. Decreased costs - occlusive dressings have higher per unit cost than conventional gauze, but reduced dressing changes and increased healing rates may be cost effective in long term.
16 Removes excess exudate and toxins High humidity at the dressing wound interface Allows for gaseous exchange Provides thermal insulation Protects against secondary infection Free from particulate and toxic components No trauma with removal
17 Prospective, blinded, randomized trials - None Systematic reviews - None Consensus - Limited Apparently, evidence not necessary to establish a 'Center of Excellence'
22 chemical mixture - one substance dispersed evenly throughout another. Dispersed particles are only suspended in the mixture, unlike a solution, where they are completely dissolved within. Colloidal system consists of dispersed (or internal) phase and a continuous phase (or dispersion medium). Milk (liquid butterfat globules dispersed within a water-based fluid), is a colloid.
23 colloid system in which the colloid particles are dispersed in water. Depending on the quantity of water available, it can exist in different states, e.g., gel or sol (liquid). Many are derived from natural sources. Agar-agar is extracted from seaweed, gelatin is produced by hydrolysis of bovine and fish proteins, and pectin is extracted from citrus peel and apple pomace.
24 Hydrocolloid-based medical dressings are occlusive and do not allow water, oxygen, or bacteria into the wound. This may facilitate angiogenesis and granulation. Hydrocolloids also lower ph of the wound surface inhibiting bacterial growth.
25 solid, jelly-like material with properties ranging from soft and weak to hard and tough. Mostly liquid by weight but behave like solids due to three-dimensional crosslinked network within the liquid. The crosslinks within give gel its structure (hardness) and contribute to stickiness (tack).
26 also called Aquagel, network of polymer chains that are water-insoluble. Highly absorbent (they can contain over 99% water) natural or synthetic polymers. Possess degree of flexibility similar to natural tissue, due to significant water content. - breast implants - burns - creating/ maintaining moist environment.
27 Alginic acid is a viscous gum, abundant in cell walls of brown algae. It ranges from white to yellowish-brown, and may be filamentous, granular or powdered. Commercial varieties are extracted from seaweed, including the giant kelp. Uses - Pharmaceutical preparations such as Gaviscon. - Mold in making in dentistry and prosthetics. - Wound dressings that promote healing and can be removed with less pain than conventional dressings.
28 With moderate to heavy drainage, the alginate forms a gel when in contact with wound fluid. It can absorb 20 times its weight in fluid, and can be used in infected and noninfected wounds. Because it is highly absorbent, it should not be used with dry wounds or wounds with minimal drainage. An alginate dressing is packed into wound bed as primary dressing. A secondary dressing is added to hold the alginate in place and maintain a moist environment.
29 An appropriate secondary dressing is as important as correct primary dressing. Petrolatum gauzes or foams will secure the alginate and prevent drying. If wound is infected, the secondary dressing should be nonocclusive to permit monitoring and to avoid harboring bacteria. When secondary dressing is removed, hydration of the alginate should be assessed. If the alginate has absorbed wound exudate as intended, it will be in a gelled state and easy to remove from the wound. If tdifficult to remove or if fibrous material adheres to the wound base, the wound is drying out and use should be reevaluated.
30 highly absorbent dressing, allowing less frequent dressing changes and reduced maceration. indicated in heavily exudating wounds, especially after debridement or desloughing, deep cavity wounds; weeping ulcers. maintains moist environment and absorbs four times more exudate than hydrocolloids. May have nonadherent wound contact layer + semipermeable polyurethane film top layer. Uses - treatment of heavily exuding chronic and acute wounds. - available with or without adhesive border - may be used under compression bandages
31 also called activated charcoal or activated coal, is carbon that has been processed to make it extremely porous with consequent large surface area available for adsorption or chemical reactions. [one gram of activated carbon has a surface area of approximately 500 m² (or about 2.17 tennis courts). further chemical treatment enhances adsorbing properties of material. Activated carbon is usually derived from charcoal.
WOUND CARE INTRODUCTION TO WOUND DRESSINGS JEC 2017 Wound Care Successfully completed specialized skills training in Wound Management. WOUND CONDITIONS & SYMBOLS BY COLOURS Yellow Black Necrotic tissue
Wound Dressing Choosing the Right Dressing Benefits of using the correct Drsg Helps create the optimal wound environment Increases healing rates Reduces pain Decreases infection rates Cost effective Care
Category of Dressing Examples Advantages/Indications Disadvantages/Contraindications Hydrofiber Aquacel AG - ConvaTec Aquacel - Convatec Excellent for absorbing excess exudate These dressings form a gel
Uncovering the Pressure Ulcer Coverup Rhonda Kistler RN MS CWON Wound Care Concepts Gentell Objectives Identify the stages of pressure ulcer according to the depth of tissue destruction. Discuss the differences
Chapter XII WOUND DRESSING IN DIABETIC FOOT OVERVIEW OF DRESSINGS AND WOUNDS FUNCTIONS OF DRESSING TYPES OF DRESSING SELECTION OF DRESSING MATERIAL TOPICAL AGENTS AND ANTISEPTIC CLEANSERS NEWER OPTIONS
HyaloMatrix Product Profile Thank you for your interest in this product. If you have questions please contact; Malcolm Pearson MalcolmPearson@hospitalinnovations.co.uk 07715 335 218 HyaloMatrix: Patient
Open Med. 2015; 10: 452 456 Research Article Open Access Liu Wei* The application of moist dressing in treating burn wound DOI: 10.1515/med-2015-0078 received July 11, 2015; accepted September 15, 2015.
Making the Most of your Dressing Products 2013 Catherine Hammond CNS/CNE What do you need in your dressings cupboard? 2 Skin tear 3 4 Lack Confidence in Selecting Dressings? 5 Appropriate Use of Product
Anatomy and Physiology I Student Outline The Integumentary System Integumentary System Page 1 Have a very clear understanding of the each particular tissue and their unique functions in each layer of the
CHAPTER 4 Study of different tissues Abnormal cells and tissues can be compared to normal tissues to identify disease, such as cancer Being able to know and recognize normal tissues under the microscope
C h a p t e r 11 The Cardiovascular System: Blood PowerPoint Lecture Slides prepared by Jason LaPres Lone Star College - North Harris Introduction to the Cardiovascular System A circulating transport system
This slide belongs to iron lecture and it is to clarify the iron cycle in the body and the effect of hypoxia on erythropoitein secretion Topics of today lectures: Hemostasis Meaning of hemostasis Mechanisms
Integumentary System 1. Introduction (Open your text to the image of a cross section of skin) A. Integumentary System i. Organ of the Integument a. Tissues Connective Tissues * Tissue / Location Relationships
Confused about all the wound care products on the market today? Not sure which ones are best for a given patient and wound? This article will help you make smart dressing choices. CAROL CALIANNO, RN, CWOCN,
d e c u t a s t ar Modern wound care in all wound phases Adhesive and non adhesive foam dressings Hydrocolloids Hydro gel Films Alginates Collagen pads Hyaluron silver Wound hygiene sets necrosis necrosis
Wound Healing Basics & How Skin Grafts Take Bansari Shah 11/01/2008 MS III Phases of Wound Healing nsubstrate Phase (0-2 days) nproliferative Phase (3-30 days) nmaturation Phase (30 days-years) SUBSTRATE
Normal wound healing, and the enemies! Esther White Tissue Viability Nurse A wound - definition A wound may be defined as the interruption of continuity in a tissue, usually following trauma. Skin is predominantly
HOLE S ANATOMY CHAPTER 5, PART II Lecture notes I. Connective Tissue A. Structure 1. have few cells that are spaced apart and can divide; two categories: a. fixed cells cells that are present in tissue
UPDATES ON THE MANAGEMENT OF THE DIABETIC FOOT ULCER- WHAT EVERY ENDOCRINOLOGIST SHOULD KNOW Ann M. Zmuda, DPM Associate Professor, Sections of Endocrinology, Vascular Surgery & Orthopedic Surgery Objectives
ENLUXTRA E-LEARNING VIDEO COURSE TRANSCRIPT #1. Welcome to the Enluxtra Knowledge Base. #2. This video is about: Enluxtra technology Dressing application key points, including Sizing Peri-wound coverage
Suprasorb Moist Wound Management The right dressing for each wound. www.lohmann-rauscher.com 2 Contents The complete range of moist wound management 15 Wound healing a three-phase process 16-7 Suprasorb
The Proven Multifunctional Dressing belongs to an innovative class of multifunctional wound care dressings. dressings effectively cleanse, fill, absorb and moisten wounds throughout the healing continuum.
Tissue Repair Robert F. Diegelmann, Ph.D. OBJECTIVES After this presentation and discussion, the participants should be able to: 1. Define the biochemical responses to tissue injury 2. Describe the mechanisms
DME For the Diabetic Foot Jeffrey D. Lehrman, DPM, FASPS, FACFAS, MAPWCA Editorial Advisory Board, WOUNDS Board of Directors, American Society of Podiatric Surgeons Board of Directors, American Professional
Page 1 of 6 THROMBOCYTES Platelets are not cells in the strict sense. About one-fourth the diameter of a lymphocyte, they are cytoplasmic fragments of extraordinarily large cells (up to 60 µm in diameter)
WOUND ASSESSMENT Acute and Chronic OBJECTIVES Discuss classification systems and testing methods for pressure ulcers, venous, arterial and diabetic wounds List at least five items to be assessed and documented
WOUND CARE UPDATE -Commonly Used Skin Substitute Products For Wound Closure -Total Contact Casting Jack W. Hutter DPM, FACFAS, C. ped. Commonly Used Skin Substitute Products for Wound Closure why are they
Chapter 19 Blood Lecture Outline Cardiovascular system Circulatory system Blood 1. distribution 2. regulation 3. protection Characteristics: ph 7.4 38 C 4-6 L Composition: Plasma Formed elements Erythrocytes
The practical use of foam dressings Efficient and cost-effective management of excessive exudate continues to challenge clinicians. Foam dressings are commonly used in the management of moderate to heavily
Wound assessment part 2: exudate Wound exudate provides the moist environment required for cell regeneration. However, in chronic wounds exudate can become excessive and prevent healing. Changes in the
Treatment, Rehabilitation and Reconditioning Physiology of Tissue Repair PHYSIOLOGY OF TISSUE REPAIR Knowing when it is appropriate to begin rehabilitation and when it is acceptable to return to practice
THE 1 ST MICRO TECHNOLOGY THAT ACCELERATES WOUND HEALING 1 st Active Technology With efficacy at cellular level, stimulates patient s cells to restart healing Accelerates healing Accelerated granulation
Cost and dressing evaluation of hydrofiber and alginate dressings in the management of community-based patients with chronic leg ulceration Harding K G, Price P, Robinson B, Thomas S, Hofman D Record Status
Innovative Non-Silicone Low Trauma Adhesives versus Traditional Silicone Technology A Review and Comparison Alan Neil Medical Industry Consultant Advanced Wound Care Lohmann Corporation 2016 Chronic wound
Tissue Viability Service Wound Management Primary Care Formulary 2017 WMPF/TVS: March 2017 Review date: March 2019 Product Group Current Product Sizes Price per Item Hydrogel 1st Activheal Hydrogel 2nd
BRITISH JOURNAL OF Drawtex: a unique dressing that can be tailor-made to fit wounds Linda Russell, Amanda Evans This article is reprinted from the British Journal of Nursing, 1999, Vol 8, No 15, pp 1022-1026
Silver Dressings Sajida Khatri PrescQIPP Primary Care Lead www.prescqipp.info Available at: www.prescqipp.info/silverdressings 2 Introduction PrescQIPP Silver dressings bulletin published in March 2014
Wound management and compression with L&R Solutions from a single source. Wound management Debridement Compression www.lohmann-rauscher.com Table of contents Introduction Systematic wound management and
NOTES: CH 40 Introduction to Human Anatomy & Physiology THE HUMAN BODY Anatomy Physiology (= structures) (= functions or processes) Characteristics of LIFE: 1) Made up of 1 or more CELLS. 2) Obtain and
Tissue renewal and Repair Nisamanee Charoenchon, PhD Email: firstname.lastname@example.org Department of Pathobiology, Faculty of Science Topic Objectives 1. Describe processes of tissue repair, regeneration
Chapt. 45 Ch. 45 Blood Plasma proteins, Coagulation and Fibrinolysis Student Learning Outcomes: Describe basic components of plasma Inheritance of X-linked gene for Factor VIII hemophilia A Explain the
Blood 1 of 28 Boardworks Ltd 2012 2 of 28 Boardworks Ltd 2012 What is blood? 3 of 28 Boardworks Ltd 2012 Blood is a specialized liquid that circulates around the body in blood vessels. An average adult
Douglas Fronzaglia II, DO, MS LECOM Institute for Successful Aging LECOM Institute for Advanced Wound Care and Hyperbaric Medicine Consider the possibility of pressure ulcer development 1 Identify ulcer
Volume 1, December 2004 www.implant.co.il PRP Usage in Today's Implantology by Dr. R. Shapira Introduction: Treating patients suffering from hematological disorders or using anticoagulant medications always
Immunity Chapter 38 Part 1 Impacts, Issues Frankie s Last Wish Infection with a common, sexually transmitted virus (HPV) causes most cervical cancers including the one that killed Frankie McCullogh 38.1
Treatment EPUAP/NPUAP Publish New Pressure Ulcer Guidelines for Palliative Care Dealing with the end of a loved one s life is difficult enough, but when wound and skin care issues are involved, the decisions
68 Inspirational chemistry Cross-linking polymers alginate worms Index 3.1.9 3 sheets This practical provides a fun look at cross-linking and a chance to explore some of the many and varied uses of sodium
Integra Flowable Wound Matrix Table of Contents How Supplied...2 Storage...2 Product Information Disclosure...2 Symbols Used On Labeling...2 Instructions for Use... 3 Instructions for Use (Continued)...
Bleeding and Haemostasis Saman W.Boskani HDD, FIBMS Maxillofacial Surgeon 1 Beeding Its escaping or extravasation of blood contents from blood vessels Types: - Arterial - Venous - Capillary Differences
Interleukin-20 is associated with delayed healing in diabetic wounds Phillip Finley, PhD Integrated and Applied Sciences Program Biology and Statistics/Research Methodology Normal Healing Body s natural
An advanced hydrocolloid dressing for moderately exuding wounds Indications for use Wound debridement Pressure ulcers Moderately exuding wounds Leg ulcers Assess the wound and select a suitable size (so
Wound Management in the Elderly Stephanie Yates, MSN, ANP, ANP-BC, CWOCN Nurse Practitioner/CNS Duke University Medical Center Durham, NC email@example.com Skin Condition Key quality indicator To
Hemodynamic Disorders, Thrombosis, and Shock Richard A. McPherson, M.D. Edema The accumulation of abnormal amounts of fluid in intercellular spaces of body cavities. Inflammation and release of mediators
Venous Leg Ulcer A Complete Solution Therapy Approach with Adapted Products A Complete Solution for Venous Leg Ulcers No two wounds are the same, yet they share one thing: every wound needs the best possible
Connective Tissue??? Connective Tissue What is it? It Binds, It Supports, It Strengthens, It Protects, It Insulates, It Compartmentalizes, It helps us move, It helps transport stuff, It is a site for storing
DEBRIDEMENT: ANATOMY and PHYSIOLOGY Professor Donald G. MacLellan Executive Director Health Education & Management Innovations ANATOMY and PHYSIOLOGY Epidermal Layers ECM Structure Dermis Structure Skin
LECTURE OUTLINE: CTP (Connective Tissues Proper) (Ordinary Connective Tissues) General Definition: Tissues composed of cells embedded in an extracellular (intercellular) matrix, consisting of ground substance
Inflammation & Repair By Dr. Maha M. Abu-Hashim Spring 2016 Inflammation Definition:- It is local reaction of living tissue to injurious agents. It is the vascular response to injury. Aim of inflammation
CONNECTIVE TISSUE (C.T.) Objectives: By the end of this lecture, the student should be able to: 1. Enumerate the general characteristics of C.T. 2. Classify C.T into C.T. proper and special types of C.T.