- Section Summary
In this section, you have learned:
- Each dressing is designed to perform
a specific function. Ultimately, the goal of the dressings
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
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
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.
- 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.
- 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 a new section
from the course outline on the left side of your screen
or simply click on "Next."
*Acticoat is a trademark of Smith & Nephew.