Page 57 - Wound Care at End of Life Content: A Guide for Hospice Professionals - DEMO

Wounds 360. Ostomy Wound Management (OWM) Online Buyers Guide. [Internet] Available from: http://www.wounds360bg.com/ Accessed 6/6/2012
Burghardt JC, Robinson JM, Tscheschlog BA, Bartelmo JM. Wound Care Made Incredibly Visual. 2 nd ed. Philadelphia:Lippincott Williams Wilkins © 2012

Comments Purulent‐appearing fluid may collect under the film but is  not indicative of infection. Contraindicated: acutely infected wound; arterial ulcers  Skin sealant recommended to protect periwound tissue  Change dressing every 3‐7 days  Not for wounds with depth, undermining or tunneling  Rinse wound bed with normal saline after cleansing with  antimicrobials to minimize toxic effects Product (Commercially Available Concentrations)

Normal Saline: wound cleanser of choice in hospitals; does not
loosen and lift debris; follow product specific expiration dating
Sodium hypochlorite (Dakin’s® solution): activity against Gram
Commercially prepared cleansers: contain surfactants which
Chlorhexidine: activity against Gram (+) & Gram (‐) bacteria

contain preservative‐ use fresh solution daily to prevent
Hydrogen Peroxide: provides mechanical debridement

Acetic Acid 0.5‐5%: activity against Pseudomonas
Products Chart
eschar to promote autolytic debridement

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Wound dry to minimal exudate partial‐thickness wound Promotes autolytic debridement Use as primary or secondary dressing bacterial contamination Povidone‐iodine: broad spectrum antimicrobial minimal to moderate exudates full‐thickness wounds with depth infected or non‐infected wound wounds with dead space Bryant RA, Nix DP, eds. Acute & Chronic Wounds: Current Management Concepts. 4 th ed. St Louis, MO:Elsevier/Mosby. © 2012

Indications Appropriate for:     Reduces friction   Types of Cleansers:   Antimicrobial Cleansers:      (‐) bacteria, MRSA Appropriate for:    

Product & Description Transparent Film: Semi‐permeable membrane; waterproof yet permeable  to water & oxygen No absorption capacity; impermeable to fluids &  bacteria Brands: Mepore, Opsite, Suresite, Tegaderm  Wound Cleanser: Every open wound requires cleansing with each  dressing change to physically remove surface bacteria & debris Brands: Allclenz, Carraklenz, Skintegrity.  Irrigate with 4‐15 psi: Spray bottle: 1.2 psi