Abdominal or combine pads are the “soaker uppers” of dry dressings. Anytime a wound in draining and you need something to absorb the exudate this is the product to use.
The inner layers of soft padding offers high absorbency.
This pad is usually placed on top of gauze pads and then taped or kling wrapped to stay in place. Abdominal pads are available in both sterile and non-sterile. Sterile pads are individually sealed and are available in two sizes 5”x 9” and 8” x 10”. The “clean” pads, also known as non-sterile and are available in a large roll 8” x 72yds, or precut into 8” x 50” pieces.
Adhesive tape has many uses one of which is securing dry dressings to a wound. With tape it is important to consider what you are using it for and is it being stuck to sensitive or fragile skin.
Some of the tapes available are 3M micropore tape or paper tape gentle and hypoallergenic, 3M transpore tape or plastic tape more adhesive but not gentle on the skin. Available in ½”, 1” or 2” width. Coverroll tape or mefix are hypoallergenic mesh like tape, hypoallergenic and conforming. Available in 2”, 4”, or 6” width.
Alginates and Hydrofibers
Alginates dressings are derived from natural sources such as seaweed or brown algae. Hydrafiber dressings are a soft, sterile, nonwoven pad or ribbom dressing made from carboxymethylcellulose fibers.They are best known for their ability to absorb large amounts of exudate. When exudate is in contact with the fibers of the dressing either alginate or hydrofiber, they form a gel and this maintains a moist healing environment. An alginate and hydrofiber can absorb up to 20 times its weight.
Alginates and hydrofibers are used to manage exuding wounds, pressure ulcers, leg ulcers, abrasions, lacerations, incisions, donor sites, oncology wounds, first and second degree burns, surgical or traumatic wounds left to heal by secondary intent or from the inside out. May be used for wounds prone to bleeding, such as mechanically or surgically debrided wounds, donor sites and traumatic wounds. May also be use to facilitate the control of minor bleeding. It is not advised to use an alginate or hydrofiber if it is a light drainage wound or a dry eschar wound. Alginates and hydrofibers require a secondary dressing that means you would place a gauze pad or abdominal pad on top.
Wear time is between 12 hours and 4 days. It is dependent on how much the wound is draining. Examples of an alginate is Kaltostat, and Aquacel.
Cotton Tip Applicators
Cotton Tip Applicators are used for a variety of things including first aid. They are a stick, either wood or plastic with a small wad of cotton wrapped around the end of the rod. They are used to clean a wound or incision, or to apply a ointment. Cotton tip applicators are available in either 3” or 6”lengths. They are available as non sterile packages of 100 or as sterile individually packaged applicators in boxes of 100.
Foam dressings are non-linting and absorbent. They vary in thickness and have a non- adherent layer, allowing non-traumatic removal. Some have an adhesive border and may have a film coating as an additional bacteria barrier. Foam dressings provide a moist environment and thermal insulation. They are manufactured as pad, sheets and pillow (cavity) dressings.
Foam dressings can be used as primary and secondary dressings for partial and full thickness wounds with minimal, moderate or heavy drainage. As a primary dressing it is used for absorption and insulation, or as a secondary dressings it is used for wounds with packing. They may also be used to provide additional absorption and to absorb drainage around tubes.
The advantages of a foam dressing is they are nonadherent, may repel contaminants, are easy to apply and remove, absorbs light to heavy amounts of exudate, and may be used under compression. The disadvantages are not effective on removing eschar or dead tissue, may macerate peri-wound skin if they become saturated, and may require secondary dressing.
Examples of foam dressings are Allevyn, Mepilex , Mepilex with Border, Mepilex Lite with Border.
A gauze pad is a piece of fabric used to guard or protect a wound either as a primary or secondary dressing. They can be used for other things as well such as: absorbing blood or other fluids, to apply ointments, or apply saline solution for the purpose of cleaning a wound or incision. Gauze pads are made of a thin, loosely woven fabric commonly made of cotton or some other fiber. The fibers in a non-woven gauze pad are pressed together to resemble a gauzy weave and tends to have a rougher texture.
Gauze sponges are available in a variety of sizes 2”x2”, 3”x3” & 4”x4”. They are also available in both sterile and non sterile packaging. Sterile gauze available 2 per package, non sterile gauze is available in packages of 100 or 200.
When would you use sterile vs. non sterile gauze? In a home environment sterile technique can not be maintained, this is a fact. Sterile gauze allows you to purchase smaller amounts than the non sterile, that is the advantage. If using non sterile gauze, store in a zip loc bag so they can be kept clean. Make sure hands are washed when picking up gauze from the package and hold by corners only.
Gauze wrap is long piece of gauze fabric used to guard or protect a wound typically as a secondary dressing holding on another wound dressing. Gauze wrap is made of a thin, loosely woven fabric commonly made of cotton or some other fiber.
Gauze wrap is available in a variety of widths; 2”, 3” & 4”, as sterile and non sterile. Non sterile is most often used since once you have handled sterile it is now non sterile. Non sterile is sold as singles or in boxes of 12.
Hydrocolloids create a moist healing environment that allows clean wounds to granulate and necrotic wounds to debride autolytically. These dressings are occlusive or semi-occlusive composed of materials like gelatin, pectin, and carboxymethylcellulose. The composition of the wound contact layer may differ considerably among dressings.
Hydrocolloids are available in various shapes and sizes and forms including wafers, pastes, gels and powders. Hydrocolloids are either used as primary or secondary dressings to treat pressure ulcers, partial and full thickness wounds, wounds with necrosis or slough, wounds with light to moderate exudate. The wear time of a hydrocolloid is 3 to 7 days. The wound should be checked and cleaned at this time, if needed a new dressing should be applied.
Advantages of a hydrocolloid dressings is they are impermeable to bacteria and other contaminants, facilitate autolytic debridement, are self-adherent and mold well, provide light to moderate absorption, minimize skin trauma and disruption of healing, and may be used under compression products. The disadvantage is not recommended for heavy exudate or infected wounds, may injure fragile skin when removed, and provide an occlusive property that limits gas exchange between the wound and the environment.
Convatec manufactures DuoDerm CGF Dressing with or without border, DuoDerm Xthin Dressing are examples of hydrocolloidal dressings. Also available is combination dressings that are a hydrocolloid with a foam, CombiDerm ACD. The absorbent pad wicks exudate and doesn’t damage tissue.
Hydrogels are water or glycerin-based amorphous gels, impregnated gauze, or sheet dressings. Due to their high water content some can’t absorb large amounts of exudate. Hydrogels help maintain a moist healing environment, promote granulation and epithelialization and facilitate autolytic debridement.
Hydrogel dressings may be used as primary dressings (amorphous and impregnated gauze) or as primary or secondary dressings (sheets). They may also be used to manage partial-and full-thickness wounds, deep wounds (amorphous, impregnated gauze), wounds with necrosis or slough, minor burns, and tissue damaged by radiation.
Advantages to using a hydrogel dressing are soothing and reduce pain, rehydrate the wound bed, facilitate autolytic debridement, fill in dead space (amorphous, impregnated gauze), provide minimal to moderate absorption, easily applied and removed from wound and can be used when infection is present. The disadvantages to using a hydrogel are not usually recommended for heavily exudative wound, dehydrates easily if not covered, requires secondary dressing, difficult to secure, and may cause maceration.
Some examples of hydrogel dressings are Intrasite Gel available in 8g, 15g, 25g applipaks. Restore Hydrogel Dressing is available in 3 oz. amorphous tube, 4”x4” impregnated gauze, and 2” x 3 ½” impregnated gauze packing strip.
Medical Honey Products
Medical honey products are an antimicrobial dressing with active leptospermum honey. These products provide a moist environment to promote optimal healing of a wound.
Medical honey products are indicated for lightly to moderately exuding wounds such as: diabetic foot ulcers, leg ulcers, pressure ulcers, first and second degree burns, donor sites, traumatic and surgical wounds. This product is not recommended for third degree burns, or a person with a known allergy to honey.
During initial use of the medical honey products and the dressings high osmolarity may contribute to increased exudate. Manage additional moisture by adding an absorptive cover dressing and or adjusting the frequency of dressing change. During the healing process, due to the autolytic debridement, it is common for non-viable tissue to be removed from the wound resulting in an initial increase in wound size. Although an initial increase in wound size may be attributed to the normal removal of non-viable tissue, consult a healthcare professional if the wound continues to grow larger after the first few dressing changes. Not recommended for use in body cavities.
The frequency of dressing change will be dependent on the condition of the wound and the amount of wound exudate. Monitor the wound in order to ensure that the appropriate amount of honey is present in the wound bed. Sufficient honey must be maintained for full therapeutic effect. If the wound bed appears dry, moisten with sterile saline before removal of the dressing.
An example of a medical honey product is Medihoney. This is available in a tube, in a hydrocolloidal dressing and in an alginate dressing. This product is an amazing product that works on any stage of wound.
Medical Surgical Shoe
Medical surgical shoes are generally used for a client postoperatively or for someone who has suffered a foot wound. They are an oversized shoe, with a large, wide opening to accommodate the various dressings that some one may have to wear. They have a sole with good grip. Medical surgical shoes are worn by anyone who is unable to wear their regular footwear.
Research done on wound care has shown there is no reason to use antiseptic or medicinal types of cleansers. Something as simple as sodium chloride solution will provide a gentle, non-caustic cleanser that does not interrupt the wound healing process.
Other cleanser like hydrogen peroxide will destroy any new cell growth and delay the healing process. The wound basically has to start over and begin laying down new cells. Saline Solution (sodium chloride 0.9%) is available in a 500ml pour bottle, 120 ml squirt top, and 15 ml ampoules available as singles or box of 24.
Silver added to commercial dressings has increased in popularity in the last five years. Regular bandaids now have silver as an option. Silver is an effective disinfectant and antimicrobial and has been around for hundreds of years. This is not a new concept.
Silver has antimicrobial benefits so they are effective in treating an infected wound. Health professionals will consider using silver dressings when there is delayed wound healing. A wound may not heal due to a low grade infection that is not presenting through cultures or symptomatically.
Any time a dressing or product has letter Ag associated with the name, it has silver. Ag is the chemical abbreviation for silver. Aquacel Ag, Silvasorb, Acticoat 7 are all examples of silver dressings.
A tongue depressor is a medical instrument which is used to hold the tongue against the floor of the mouth during examinations. Without the use of a tongue depressor, the patient’s tongue may drift up, impeding the practitioner’s view of the mouth and throat. Many medical supply catalogs sell tongue depressors, and they are also available from craft stores, because some people like to use them in craft projects.
Traditional tongue depressors are wooden with rounded ends. The devices are designed to be kept in a clean, but not necessarily sterile, environment; tongue depressors do not need to be sterile as a general rule because they are not being introduced to a highly vulnerable area of the body. However, they are usually discarded after use to reduce the risk of passing microorganisms between patients, and some companies also make individually packaged tongue depressors which are intended to be as clean as possible.
While it is technically possible to use metals and plastics for tongue depressors, the effort of cleaning and sterilizing such materials between patients is generally deemed too much work. It is more efficient and effective to use disposable tongue depressors, since they are routinely used in patient examinations.
Tubular Elastic Netting (Surgifix)
This is a soft, white, elastic net bandage knitted from polyester, polyamide and latex yarns. The special construction ensures that it can be stretched without shrinking or distorting and minimizes tourniquet effect.
Elastic netting is ideal for stabilizing dressings on heads, torso, hips, legs and other awkward sites. It is very useful when dealing with a chronic wound that requires frequent dressing changes. The netting spares the user the discomfort of pulling tape on and off the skin and prevents the skin from breakdown.
Available in sizes 2 thru 10, allows for a more appropriate fit. Size 2 fits small to medium hand, size 3 fits medium to large hand, small knee, small elbow or arm, size 4 fits medium knee, medium foot, large arm. Size 5 fits small head, large foot, large knee. Size 6 fits adult head, adult hip and buttocks, small torso. Size 7-10 fits adult torso. If you are unsure of which size you need, it is better to choose a bit smaller than larger.
Tubular gauze is a seamless tube fabric used to guard or protect a wound either as a primary or secondary dressing. Gauze is made of a thin, loosely woven fabric commonly made of cotton or some other fiber. Tube gauze is available in a variety of sizes; the measurement is applicable to the diameter of the tube. They are sold in both a box of 50 yards or by the yard. Tube gauze is typically worn on an area of the body that needs to be able to bend and move freely, such as a finger. Some people find it easier to apply if an applicator is used.
Wound Cleanser Products
The number one recommended wound cleanser is Saline Solution also known as sodium chloride 0.9%. It is the preferable wound cleanser because it is does not disturb the wound pH level and it does not interrupt the wound healing process as many of the traditional cleansers do. There are other types of wound cleansers, which are typically sprays. They are usually a saline solution base, with additives and preservatives in them to prolong shelf life.
Wound Closure Strips
Wound closure strips, commonly known as Steri-strips or butterfly strips, are used in place of sutures to close small incisions or wounds. They are made of non-woven, porous elastic backing coated with a hypoallergenic adhesive which responds to pressure. Wound closure strips are now a common item in many first aid kits but they are also used in professional medical settings for surgical wound care. These strips are ideal for contoured areas or in areas that are delicate and may not maintain sutures. The use of these strips helps to reduce the risk of infection or scarring. They are typically worn for a week to ten days and will usually peel and curl until they fall off on their own. They are available in a range of sizes, this allows the user to choose they most applicable size for the size of the wound that is being treated.