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  Excision
  Application
 
  Neodermis formation
    Signs of mature Neodermis
    Dressing regimen
 
    Frequency of dressing changes
    Positioning the patient
    Moving and turning the patient
    Anti-shear techniques
    Physical Therapy
    Large Hematoma
    Small, late forming Hematoma
    Fluid accumulation
    Infection
    Infection at staple
    Areas of non-take
    Summary
  Summary
   


Bolstering and Splinting
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The adjunctive use of bolsters and splints help achieve intimate contact with the wound bed and immobilize graft sites. They should be initially applied in the OR. The specific needs of the patient should be assessed before applying a bolster or splint. Bolsters provide padding in concave areas, enhancing intimate contact between INTEGRA Template and the wound bed.

Splinting aids in keeping the INTEGRA Template site in a fixed position, particularly when the matrix
is applied across a joint. The length of time a patient remains in a splint varies; splints should only
be removed for dressing changes and physical therapy. The care of your patient should include consultation with the physical therapist, who may be able to suggest alternative measures for
addressing specific bolstering and splinting needs. Finally, it is important to assess and medicate
to the pain threshold of patients during this process.

In an axilla, a bolster is applied under an elastic net layer that is then secured by tying. Tying the elastic net allows for the bolster to
be easily changed during routine examination
.
Axilla

In this picture the patient has a knee immobilizer, with the knee strap removed. The knee immobilizer can be used on the lower extremities for approximately one week. Care should be taken to reduce or eliminate the pressure across the kneecap. Knee immobilizer

Thermoplastic splints are often applied in the OR to immobilize the patient following surgery Thermoplastic splint

This patient is having a paddle splint applied, assisting in the physical therapy of the arms Paddle  splint

 

 
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