Wound Bed Preparation
    Application Guidelines
    Estimating the Number and Size of Sheets
    Product Preperation
    Placement, Shaping and Cutting
    Stapling and Suturing / Negative
Pressure Therapy
  Post-Op Care

Application - Section Summary
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In this section, you have learned:

  • Estimate the number and size of sheets, and anticipate when the product will be needed. Begin rinsing sheets to allow for a 1-2 minute hydration in saline before wound bed prep has been completed. Follow product preparation protocol as outlined in this course. When removing the INTEGRA™ Meshed Bilayer Wound Matrix from the foil pouch use gloved hands (do not use instruments).
  • When placing, shaping and cutting the INTEGRA™ Meshed Bilayer Wound Matrix, gently remove sheets from the holding basin with gloved hands and place directly onto the wound bed. Do not try to move or "float" sheets like a STSG; instead, lift sheets up and reposition. Place sheets on prepared wound bed, affix parallel to inside edge of wound bed and trim excess; or, place sheet on prepared wound bed, trim sheet to fit site, and affix perpendicular to seam (place staples across seams). Cut sheets to avoid gaps and be sure to place seam lines along Langer's Lines to reduce risk of contracture. Make sure INTEGRA™ Meshed Bilayer Wound Matrix lies flat with no wrinkles or bubbles.

  • In a staged procedure, do not place INTEGRA™ Meshed Bilayer Wound Matrix in contact with non-viable tissue, rather maintain a safety margin between the prepared wound bed and any non-viable tissue.
  • Stapling, suturing or other suitable alternative may be used when applying INTEGRA™ Meshed Bilayer Wound Matrix; however, with either technique remove all air bubbles. Fix sheets independently and/or affix adjacent sheets together to minimize gaps, reducing granulation tissue formation. Interrupted stapling (i.e., leaving a 1-2 centimeter space between staples) can be used to seal edges.
  • It is recommended that dressings be built in layers and to inspect for hematoma and seroma formation upon dressing changes

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