Dressing Material Moisture facilitate

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Carmella Jackson
6 years ago
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synthesis - Autolysis debridement - Limit pain better than non-occlusive occlusive dressing Moist Wound Healing Desirable dressing Biocompatibility

1 Wound Healing Concept Dressing Material นพ.ส ทธ ส ทธ ส ณห ส ณห จ นทร ขจร ศ ลยศาสตร ตกแต ง โรงพยาบาลพระมงก ฎเกล า Moisture facilitate - Epidermal migration - Angiogenesis - Connective tissue synthesis - Autolysis debridement - Limit pain better than non-occlusive occlusive dressing Moist Wound Healing Desirable dressing Biocompatibility properties Protect from bacteria and foreign body Absorb exudates from wound Prevent heat and fluid loss Compression to minimize edema and close dead space Non-adherent to limit epithelial disruption Create warm, moist environment Minimize pain Esthetically attractive 1

2 Development of Wound Management Products Traditional Dressing Spider Web Linen T Conventional Dressing Leaves Mud I Honey Gauze M Absorbent pads E Advanced Wound Dressing Low adherent pad Tulle Gras Films Activated carbon Foams Biotech. & Bio-eng. Hydrogels Products Hydrocolloids Alginates Bioactive products Growth factors Gene therapy Tissue engineering Category of Wound Dressing Natural Fiber Dry Dressings Low Adherence Dressing Film Dressing Hydrogel Hd Hydrocolloid Calcium Alginate, Chitin Hydrocellular / Foam Negative Pressure Therapy Devices / VAC Tissue Engineering / Skin Substitute Type of Wound Dressing Passive Dressing Gauze, Paraffin gauze, Vaseline gauze Interactive Dressing Film, Foam, Hd Hydrocolloid, llidhd Hydrogel, Alginate Bioactive Dressing Xenograft, Amniotic membrane, Homograft Tissue engineering skin substitute Passive Dressing Gauze Derivative from woven gauze, Tulle gras Consist of fine mesh gauze Adapted to occlusive and antimicrobial properties Bactigras, Xerofrom, Mepitel, Melolin Guaze Minimal absorption Frequency changes Wet to dry dressing, Difficult to maintain moist wound bed Non selective debridement Painful on removal No barrier to contamination 2

3 Vaseline Gauze Bactigras Xeroform 3% Bismuth Tribromophinate in Petrolatum base Relative occlusive hydrophobic dressing Decrease odor Antimicrobial activity Xeroform Mepitel Silicone-coated coated polyamide (Nylon) Gridlike net Maximally non-adherent dressing Bacteriostatic Mepitel 3

Melolin Low adherent Wound protection and concealment Absorption : mild - moderate No fiber deposit Limited bacterial barrier Melolin ( Low Adherence Dressing ) Product structure

Antimicrobial activity Absorption exudates Film, Foam, Hydrocolloid, Hydrogel Alginate, Chitin Film dressings Advantage Translucent polyurethane membrane Acrylic adhesive Water proof

4 Melolin Low adherent Wound protection and concealment Absorption : mild - moderate No fiber deposit Limited bacterial barrier Melolin ( Low Adherence Dressing ) Product structure Outer Hydrophobic Layer Central Absorbent Layer Wound Contact Layer Interactive Dressings Occlusive dressing concept Moisture environment Protect from bacteria and foreign body Antimicrobial activity Absorption exudates Film, Foam, Hydrocolloid, Hydrogel Alginate, Chitin Film dressings Advantage Translucent polyurethane membrane Acrylic adhesive Water proof O 2, CO 2, water vapor transmission Thin film Disadvantage Non-absorbable Exudate collection leak out Need intact skin for adhesion Slow wound contraction Disrupt new epithelium when remove 4

5 Opsite Film dressing combine with Gauze Tegaderm Hydrocolloids Containing hydrocolloid matrix Galatin, Pectin, Carboxymethycellulose Adhesive wafers, Pastes, Powders Contact exudate - Moist gel formation Gas transmission Bacteria protection DuoDerm, Cutinova Hydro, Replicare 5

6 DuoDERM Cutinova Hydro Hydrogel Consist of starch polymer - Polyethylene oxide - Carboxymethycellulose polymer Water composition 80% Gels, Sheets, Impregnated gauze Function rehydrating agents for dry wound DuoDerm Gel, IntraSite Gel 6

Foam Hydrophobic polyurethane foam sheet

Expand and conform to the wound Comfortable

dressing Allevyn, Flexan ALLEVYN* Adhesive

polyurethane film Hydrocellular foam Core

wound contact layer Alginate Nonwoven soft

derived from calcium salt of Alginic acid

7 Foam Hydrophobic polyurethane foam sheet High Adsorbent Adhesive, Non-adhesive Expand and conform to the wound Comfortable and easy to remove Hydrogel with Film dressing Allevyn, Flexan ALLEVYN* Adhesive Structure ALLEVYN* Standard Outer polyurethane film Hydrocellular foam Core Outer polyurethane film Hydrocellular foam Core Adhesive contact layer Polyurethane wound contact layer Alginate Nonwoven soft fiber of cellulose-likelike Polysaccharide derived from calcium salt of Alginic acid (Seaweed) High absorption in exudate wound Generate hydrophilic gel when contact exudate Kaltostat, Algisite M, Sorbsand 7

Insoluble Ca - Alginate fiber Soluble Na - Alginate Absorbency

Dressing ) Low Film* Hydro-Gel Hydrocolloid Ca-Alginate Moderate

Xenograft Interspecies transplant Pig Skin 2.

8 Insoluble Ca - Alginate fiber Soluble Na - Alginate Absorbency Hydro cellular/foam Skin Substitution Temporary ( Biologic Dressing ) Low Film* Hydro-Gel Hydrocolloid Ca-Alginate Moderate Exudates High Unprocess Skin Products 1. Xenograft Interspecies transplant Pig Skin 2. Human Allograft Cadaveric Skin 3. Human Amnion Amniotic Membrane from Human Placenta Porcine Skin Amniotic Membrane 8

Processed Skin Products 4. Biobrane Nylon fabric bond with collagen 5.

Dermagraft Vicryl mesh with Human Fibroblast Cultured Biobrane TransCyte

Terudermis Cultured Epithelial Autograft ( CEA ) Epicel Integra Dermal

of fibers - Cross link Bovine collagen and Glycosaminoglycan Epidermis (

9 Processed Skin Products 4. Biobrane Nylon fabric bond with collagen 5. TransCyte Nylon mesh with Human Fibroblast Cultured Cadarveric Skin 6. Dermagraft Vicryl mesh with Human Fibroblast Cultured Biobrane TransCyte Permanent Skin Substitute Dermal Replacement 1. Integra 2. AlloDerm 3. Terudermis Cultured Epithelial Autograft ( CEA ) Epicel Integra Dermal regeneration template Bilayer membrane for skin Dermis - Porous matrix of fibers - Cross link Bovine collagen and Glycosaminoglycan Epidermis ( Temporary ) - Silicone Polymer Fibroblast, Macrophage, Capillaries in growth 9

10 Integra Cultured Epidermal Autograft VAC Dressing ( Negative Pressure Therapy Device ) Contact to pump pressure mm.hg Foam, Vacuum tube and Film dressing Diminish collection and edema Enhance local blood flow Limit bacterial growth and promote healing VAC Machine Development of Technology 10

11 Select the proper dressing for the wound 11

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