Medical Surgical Nursing

• Standard wound dressings are multiple layers of gauze applied over the topical agents

on the burn wound

Wound Débridement

1. Natural Débridement

2. Mechanical Débridement

3. Surgical Débridement

Wound Grafting

• coverage of the burn wound is necessary until coverage with a graft is possible.


• The purposes of wound coverage are to:
  
  
  • Decrease the risk of infection;
  
  
  • Prevent further loss of protein, fluid, and electrolytes through the wound; and
  
  
  • Minimize heat loss through evaporation.
  
  
  
  


• Wound coverage may consist of biologic:

1. Biosynthetic,

2. Synthetic, and

3. Autologous methods or

4. A combination of these approaches

• The main areas for skin grafting include the face (for cosmetic and psychological

reasons); functional areas, such as the hands and feet; and areas that involve joints.

• Grafting permits earlier functional ability and reduces wound contractures.


• It should have a bacterial count of less than 100,000 per gram of tissue to optimize

graft success.

• Biologic, Biosynthetic and Synthetic Dressings

Biologic Dressings (Homografts and Heterografts)

• In extensive burns, biologic dressing save lives by providing temporary wound

coverage and protecting the granulation tissue until autografting is possible.

• used as temporary coverings, eventually rejected because of regiction.


• Two types of biologic dressing
  
  
  1. Homografts (or allografts): skin obtained from living or recently deceased
     humans or amniotic membrane.