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Wound management, dressings and bandages

image of Wound management, dressings and bandages
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Abstract

This chapter is designed to give information on the normal wound healing process; assessment of the wound patient and wounds; types of wound and wound features; wound classification; types and methods of wound closure and open wound management; types and management of wound drains; complications of wound healing; functions and types of wound dressings, bandages, casts and splints; management of dressings, bandages and casts, and care of the patient.

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/content/chapter/10.22233/9781910443064.chap14

Figures

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14.1 The normal wound healing process.From wounding to wound resolution, healing follows a series of characteristic phases, each playing a role in the repair and reconstruction of damaged tissues.
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14.3 Local factors influencing wound healing. Establishment and maintenance of the optimal wound microenvironment is critical to promote normal wound healing.
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14.5 An infected and contaminated wound. Necrotic wound edges, an irregular wound bed and a surface biofilm are significant.
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14.6 Sample wound management document. The wound management process can be documented to allow the accurate and systematic tracking of wound healing, facilitating effective wound treatment from wounding to wound resolution.
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14.7 Wound closure decision making. The initial assessment of a wound is critical in determining the strategy for wound closure. The decision-making process is aimed at ensuring that the wound is free from contamination and that wound tissues are viable before wound closure is attempted.
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14.8 Wound closure by second intention healing. A healthy wound bed is established with granulation tissue. Early re-epithelialization is evident around the wound margins. The wound bed of granulation tissue is reduced in size as new epithelium advances from the wound margins. A small residual wound bed is surrounded by an extensive margin of new delicate epithelium. A thin scab covers the remaining area of wound yet to be covered by new epithelium.
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14.9 A wound lavage system.
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14.10 Pressure dressing applied over a thoracotomy wound. A light pressure dressing consisting of a Primapore dressing covered by an elasticated Tubegauz vest covers a thoracotomy site and chest drain; this protects the surgical site and chest drain and prevents the formation of dead space under the loose skin of the thorax.
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14.11 Active drains. Grenade active suction units (left) and bottle active suction units (right) use negative pressure to drain fluid from a wound. Two bottle active suction units in place draining fluid from the surgical site of a large mass resection from the dorsum of a dog. Wound fluid striking through a dressing.
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14.12 Examples of three different types of wound, with likely factors to be managed and suggested management.
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14.16 A selection of wound dressings. Contact layer dressings come in different sizes, suitable for wounds of different sizes and patients of different sizes.
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14.17 A selection of materials used for bandaging. Examples of materials for padding, conforming and protective layers.
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14.19 Applying an ear and head bandage. Drawn by S.J. Elmhurst BA Hons (www.livingart.org.uk) and reproduced with her permission.
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14.20 Applying a thoracic bandage. Drawn by S.J. Elmhurst BA Hons (www.livingart.org.uk) and reproduced with her permission.
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14.21 Applying an abdominal bandage. Drawn by S.J. Elmhurst BA Hons (www.livingart.org.uk) and reproduced with her permission.
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14.22 Applying a Robert Jones bandage. Drawn by S.J. Elmhurst BA Hons (www.livingart.org.uk) and reproduced with her permission.
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14.23 Applying a foot and lower limb bandage. Drawn by S.J. Elmhurst BA Hons (www.livingart.org.uk) and reproduced with her permission.
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14.24 Applying a Velpeau sling. Drawn by S.J. Elmhurst BA Hons (www.livingart.org.uk) and reproduced with her permission.
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14.25 One method of applying an Ehmer sling. Drawn by S.J. Elmhurst BA Hons (www.livingart.org.uk) and reproduced with her permission.
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14.26 Applying a tail bandage. Drawn by S.J. Elmhurst BA Hons (www.livingart.org.uk) and reproduced with her permission.
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14.27 Applying wing dressings (see main text for details). (Courtesy of R Best; reproduced from .)
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14.28 Applying a foot bandage on a bird (see main text for details). Here, a donut-ring corn dressing is being applied to a lesion on a Himalayan griffon vulture. The dressing is held in place with cohesive bandage wrapped around the foot and between the digits. (Reproduced from )
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14.29 A selection of casting and splinting materials. Centre back: Hexalite/Vet-lite, a thermoplastic casting material; right: Dynacast, a fibreglass resin-impregnated casting and splinting material. Various pre-made splints are available, such as gutter type (left front) and complete limb splint systems (left back).
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14.31 Lister bandage scissors, designed to cut through bandage layers with the blades kept safely away from the patient’s skin.
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14.32 A fluid bag used to protect a limb/foot dressing. Cutting a section of appropriate length from a fluid bag provides a strong and waterproof ‘boot’ for a foot dressing. The fluid bag is held in place by a tie made from open-weave bandage material.

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