WOUND BLOG » Wound Care Tool Kit

Wound Care Tool Kit (Stoma Paste)

Matthew Livingston R.N. C.W.S. — Sat, 19 Dec 2009 21:05:38 +0000

Stoma Paste is a very useful tool when trying to provide a uniform surface for the placement of wound VAC drape over uneven surfaces. Uneven surfaces include skin folds, incision line deformations, or anatomical irregularities related to surgery or trauma. There are many brands of stoma paste available, but I have had good luck with Convatec and Hollister Brands. I recommend using the following process to prevent the paste from doing what it does best – sticking to everything.

1. Prewarm the past in a tray of warm water for a few minutes to make the paste less thick

2. Squeeze a little paste out on the clean side of the opened VAC kit package (let it sit for about a minute).

3. Pour a little water or normal saline into an appropriate container.

4. Dip into the water with a wood depressor or the back of the 10 blade scalpel (that you are using to cut the VAC foam)

5. Take up the stoma paste with the moist utensil surface and place it into the uneven surface. Leaving the top of the stoma paste even with the corresponding topside tissue. If you need to add more paste remember to re-moisten the utensil or else it will stick fast to the applicator.

6. Smooth out the paste between the inserted stoma paste with the corresponding topsided tissue by re-wetting the utensil and gently moving across it surface.

7. Wait a few minutes for the paste to firm and then apply the VAC drape over it. If you don’t wait for the stoma paste to firm up the VAC suction could pull it in, which could loose the seal.

Wound Care Tool Kit – Acticoat flex.

Matthew Livingston R.N. C.W.S. — Thu, 03 Sep 2009 03:40:59 +0000

The new Acticoat flex dressing (Smith and Nephew) is a flexible low adherent polyester layer coated with nanocrystalline silver. Nanocrystalline silver provides a high kill rate against microbes and serves as an effective barrier against microbial contamination.

Indications: include grafts, surgical sites, venous, pressure and diabetic wounds.

Authors take:

1. Very flexible material with a little stretch that allows full contact with wound surface.

2. Works as antimicrobial layer under NPWT or VAC foam dressing allowing fluid transfer from wound base through to the foam.

Wound Care Tool Kit – Conformant 2 Wound Veil

Matthew Livingston R.N. C.W.S. — Mon, 10 Aug 2009 01:59:32 +0000

Description
The Conformant 2 wound Veil consists of high-density polyethylenenon which is non-adherent, permeable, and flexible.

Indications
The veil is useful for partial and full thickness wounds, grafts or donor-sites. It also an appropriate cover for Apligrafs and Dermagrafts

Authors Take
Much like Mepitel this non-adherent product protects the wound bed during the removal of the secondary dressing. It also an appropriate barrier to protect the wound bed during removal of the VAC or S&N NPWT Therapy foam. The advantage of this product over Mepitel (which I have used for years) is that the the Conformant 2 comes in large sheets 12×12. It is also very easy to work with versus Mepitel (which seems to stick to everything and is hard to reposition on the wound bed).

Warning – The Conformant 2 Wound Veil is somewhat transparent which allows for some monitoring of a wound or graft. But it also blends well into granulating tissue. So make sure that you document your placement of the veil for the next person who changes the dressing.

Wound care Tool Kit – Xenaderm

Matthew Livingston R.N. C.W.S. — Tue, 10 Feb 2009 02:31:13 +0000

Xenaderm (Ointment) – Healthpoint
Description: Xenaderm is a vasodilator that promotes healing with a non-petrolatum base that provides a fluid repealing barrier.
Indications: Xenaderm is appropriate for partial thickness wounds, perineal wounds, and radiation skin reactions (Healthpoint, 2008).
Authors notes:
1. Xenaderm is particulary useful for difficult to dress incontinence-related skin injuries.
2. Xenaderm may cause rashes in a limited population of patients.
3. Keep the Xenaderm ointment on the wound bed (as much as possible) and don’t use as a barrier cream. Xenaderm placed on normal skin will often cause a reddened inflammatory response, that will subside in a few days with discontinuation of the product.

Wound Care Tool Kit – Santyl Collagenase

Matthew Livingston R.N. C.W.S. — Mon, 09 Feb 2009 01:09:32 +0000

Santyl Collagenase (Enzymatic Ointment) – Healthpoint
Description: Santyl Collagenase digests collagen in necrotic tissue and contributes towards the formation of granulation tissue and subsequent epithelization
Indications: debridement for chronic dermal ulcers including pressure ulcers, venous ulcers, arterial ulcers, diabetic foot ulcers, and severely burned areas (Healthpoint, 2007).
Authors notes:
1. Can be used in a wound bed that has a combination of non-viable tissue along with granulation tissue and epithelization.
2. May work better with a moist dressing on top.
3. Can be used with NPWT (as we did with accuzyme)
4. Can be used alternatively with silvadine

Wound Care Tool Kit, Mepitel

Matthew Livingston R.N. C.W.S. — Sat, 07 Feb 2009 21:42:54 +0000

Mepitel (Silicon Dressing)- MoInlycke Health Care

Description: Mepitel can be removed from the skin surface with minimum pain and without damaging delicate new tissue.

Indications: Mepitel is used in the management of wounds where adherence of a dressing to the underlying tissue represents a particular clinical problem. Typical applications include skin tears or abrasions, surgical excisions, second-degree burns, blistering conditions such as epidermolysis bullosa, lacerations, partial and full thickness skin grafts, bio-engineered skin and skin damage following radiotherapy or steroid therapy (Mölnlycke Health Care, 2008).

Authors notes:

1. Best option versus Adaptic, Xeroform, or other impregnated dressings including gauze as there is a possibility these dressings fibers will get tangled into newly formed granulation.

2. Very useful in protecting wound edges and reducing pain with NPWT during foam removal (Foam can entangle into granulation tissue).

3. Place over vital structures (bone, organs, etc..) before placing the NPWT foam in the wound bed.

4. Helps to retain moisture and stability on larger open or very fragle skin tears.

5. Helps retain moisture and stability with Apligraf and Dermagraft (after skin substitute is secured with steristrips)

6. A comparable product would be the Wound Veil by Smith and Nephew

Wound Care Tool Kit, Acticoat and Iodosorb.

Matthew Livingston R.N. C.W.S. — Sat, 07 Feb 2009 21:35:52 +0000

Acticoat 3 & 7 (Antimicrobial Dressing ) - Smith and Nephew

Description: `nanocrystals’ of metallic silver exhibit pronounced antibacterial activity against a wide range of organisms.

Indications: for partial and full-thickness wounds such as leg ulcers, pressures sores and other chronic wounds with Gram-positive and Gram-negative bacteria including strains resistant to many types of antibiotics. It is also effective against clinically important strains of yeasts and fungi (Smith and Nephew, 2008).

Authors notes:

1. Fastest kill rate verses other silver dressings on the widest group of organisms.

2. May be best used with a uniform wound bed so the silver can contact the wound bed.

3. Use alternatively with Iodosorb for bioburden

Iodosorb (Antimicrobial Ointment) - Smith and Nephew

Description: In the presence of aqueous solutions or wound fluid, the beads in the ointment take up liquid and swell, slowly releasing the iodine, which imparts antibacterial properties to the dressing.

Indications: chronically wet wounds such as leg ulcers, pressure ulcers and diabetic ulcers, particularly when infection is present or suspected. (Smith and Nephew, 2008 )

Authors notes:

1. Fast kill rate.

2. Try in place of silver, if silver treatments are not effective.

3. Can be used on regular or irregular base wound beds.

4. Best used on small to medium sized infected wounds. (because of the risk of thyroid toxicity in larger dosages).

5. Good for medium and high draining infected wounds.

6. Use alternatively with Acticoat 3 or 7 with bioburden.