|Application - Section
In this section, you have learned:
- Estimate the number and size of sheets,
and anticipate when the product will be needed. Begin
rinsing sheets no later than 15-20 minutes before excision
has been completed. Follow product preparation protocol
as outlined in this course. When removing the INTEGRA® Template from the foil pouch use gloved hands (do not
use instruments). Rinse each sheet for a minimum of
5-10 minutes in each of the first two basins. Also be
sure to change the saline after every 1-2 sheets, or
as needed. The detectable odor of alcohol should subside
when finished rinsing.
- If meshing INTEGRA® Template use 4
x 10 inch sheets to avoid folding. Mesh sheets 1 : 1
through a "non-crushing" mesher but do not
expand. This technique minimizes fluid accumulation
under the graft, minimizes amount of graft loss in the
event of hematoma and minimizes the risk of graft loss
in the event of bacterial colonization.
- When placing, shaping and cutting
the INTEGRA® Template gently "scoop out"
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 excised wound
bed, staple parallel to inside edge of wound bed and
trim excess; or, place sheet on excised wound bed, trim
sheet to fit site, and staple perpendicular to seam
(this allows staples to be placed across seams). Cut
sheets to avoid gaps and overlaps and be sure to place
seam lines along Langer's Lines to reduce risk of contracture.
Make sure INTEGRA® Template lays flat with no wrinkles
- Stapling or suturing may be used
when applying INTEGRA® Template, however with either
technique remove all air bubbles. Fix sheets independently
and/or staple 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 while checking under dressings more
frequently. The elastic net dressing can be attached
by staples or other suitable methods. It will be left
in place until the silicone is removed. When applied
correctly, the expanded interstices will be open about
1-2 cm and the silicone will have slight indentations
from the elastic net dressing.
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COURSE, select a new section from the course outline on
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