| Post-Op Care - Section
Summary |
|
In this section,
you have learned:
- Each dressing is designed to perform
a specific function. Ultimately, the goal of the dressings
is to protect the grafts by preventing shearing and
dislodgement, while still enabling routine visual examination.
The use of antimicrobials is essential in reducing the
risk of infection. Acticoat*, silver nitrate 0.5% and
Sulfamylon® Solution 5% are most commonly used.
- Dressings should be built in
layers to protect the INTEGRA® Template site from shear
and infection
A: Sterile
elastic net dressing is applied in OR.
B: The
antimicrobial layer (e.g., moistened Acticoat*) is
applied over the elastic net dressing. It is important
to remoisten or re-apply antimicrobial dressings as
needed. The antimicrobial layer is most critical during
the first week after application.
C: A bulky
gauze dressing is applied over the antimicrobial layer
to protect the site and to help reduce the potential
of shearing and graft dislodgement. It also helps
keep the antimicrobial dressing moist and in contact
with INTEGRA® Template.
D: A compression
bandage is applied over the bulky dressing. The compression
wrap provides additional support and protection. As
edema subsides, the wrap should be re-applied to ensure
it is snug.
- The adjunctive use of bolsters and
splints help achieve intimate contact with the wound
bed and immobilize graft sites. Bolsters provide padding
in concave areas, enhancing intimate contact between
INTEGRA® Template and the wound bed. Splinting also aids
in keeping the INTEGRA® Template site in a fixed position,
particularly when the matrix is applied across a joint.
- When making a dressing change: Take
down the dressing, but leave elastic net in place (do
not remove sutures or staples). Inspect INTEGRA® Template by checking seams, interstices, and edges for
signs of hematomas, infection, fluid accumulation, silicone
layer separation, and areas of non-take. Re-apply or
re-moisten the antimicrobial layer as needed.
- The techniques deployed in positioning
and moving the patient may help to reduce the chance
that this mechanical dislodgement will occur when the
patient is transported or positioned. It is important
to plan your strategy for moving the patient ahead of
time.
- Your visual inspection regimen should
include recognition of maturing Neodermis as well as
the ability to identify the various complications that
may arise. Although developing Neodermis can be described
as ranging in color from red to pink to orange/peach
to vanilla, your ability to distinguish healthy neodermis
from that which requires intervention will come largely
from your own experience.
To continue your review of the
COURSE, select from the course outline on the left side
of your screen
or simply click on “Next.”
*Acticoat is a trademark of Smith & Nephew.
