Advanced Dressing Selection for Burn Wound Injuries
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Top Contributors - Stacy Schiurring and Jess Bell
Introduction[edit | edit source]
Burn wound advanced dressings are designed to maintain a moist environment while being left in place for multiple days. The dressing's ability to be left in place for a greater amount of time, decreases the frequency of dressing changes that up to that point were being done on all wounds including burn wounds.
Characteristics and Guidelines of Antimicrobial Advanced Dressings:[edit | edit source]
General Characteristics include:
- broad spectrum against many microbes
- manage light to moderate surface bioburden
- none are able to independently eradicate spreading or systemic infection, however can be an adjunct dressing when used in combination with systemic treatments
- lower occurrence of bacterial resistance
Guildelines for Use of Antimicrobial Advanced Dressings:
- for at risk patients
- use with evidence of increasing bioburnden in the burn wound
- when patient has confirmed or suspected infection, use in combination with a systemic treatment
Antimicrobial Advanced Dressings for Burn Wound Care[edit | edit source]
Benefits | Risks | Burn-specific Considerations | |
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Silver-Based |
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cytotoxic to fibroblasts and keratinocytes, resulting in delayed re-epithelialization | Recommended to discontinue use when signs/symptoms of infection are no longer present |
Nanocrystalline Silver (Acticoat): broad spectrum for bacteria, yeast, and fungi |
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Was developed specifically for the management of burn wounds | |
Ionic Silver: available in multple forms of dressings (ie: foams, hydrogels, hydrocolloids, etc) | each dressing type will perform differently on burn wounds | ||
Silver-based Foam Dressings:
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Bordered foam dressings (Allevyn Ag border, Mepilex AG border) are NOT recommended for burn wounds | |
Silver-based fabric-type dressings (TRITEC Silver, Assist Silver, Silverlon Wound & Burn Dressing)
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Collagen-ORC (oxidized regenerated cellulose) with silver:
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Hydrofiber with Silver
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Has specific protocols for use | ||
Gentian Violet/Methylene Blue Dressing |
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Limited evidence for use with burn wounds |
Silver-based Dressing Protocols:
- most silver-based dressings are designed to manage moisture in the burn wound, however some require re-wetting (Anticoat, Silverlon), or can contribute to moisture in the burn wound (hydrogels)
Non-antimicrobial Advanced Dressings for Burn Wound Care[edit | edit source]
Non-antimicrobial advanced dressings are indicated for burns (1) nearing the end of their healing phase, and/or (2) are superficial with a minimal infection risk. These dressings are designed to be left in place for several days to allow maximum opportunity for the patient's own body to heal in an uninterrupted moist wound environment.
Benefits | Risks | Burn-specific Considerations | |
---|---|---|---|
Alginates | |||
Collagen-based products | |||
Films | |||
Foams | |||
Hydrocolloids | |||
Hydrocolloids | |||
Silicone Sheets | |||
Negative Pressure Wound Therapy for Burn Wounds[edit | edit source]
What is Negative Pressure Wound Therapy?[edit | edit source]
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Negative pressure would therapy is an emerging method of managing burn wounds and donor sites. Benefits of Use in Burn Wounds:
- facilitates moist wound environment
- decreases tissue oedema
- increases blood flow to wound
- stimulates angiogenesis (the development of new blood vessels)
- promotes granulation tissue formation
Resources[edit | edit source]
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