Home' Australian Pharmacist : Australian Pharmacist June 2012 Contents Australian Pharmacist June 2012 I ©Pharmaceutical Society of Australia Ltd. 471
Continuing Professional Development
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COUNSELLING IN PRACTICE
Joanna should be given appropriate
advice about cleaning and covering
Alex's abrasions. She should be advised to
inspect the abrasions for contamination
(e.g. embedded dirt), and assess their size
and depth, in order to decide whether
they require medical attention. Additional
advice about di erent types of wound
dressings, the use of antiseptics, rst aid for
minor wounds and burns, criteria for taking
an injured child to a doctor and suggested
contents of a rst aid kit will help Joanna
deal safely and appropriately with her
children's injuries in the future.
Key learning points
• Covering a wound with a dressing
that creates and maintains a moist
environment provides the optimal
conditions for wound healing.
• Various factors need to be considered
when selecting a dressing, including
wound colour, appearance and depth,
and the level of exudate.
• Dressings can be divided into three
broad categories -- passive dressings
that simply provide a protective
cover over the wound (e.g. gauze,
tulle/para n gauze, absorbent pads
covered with a perforated plastic lm);
interactive dressings that maintain an
optimally moist micro-environment
at the wound/dressing interface
(e.g. semi-permeable lms, hydrogels);
and bioactive dressings which deliver
substances that actively assist in wound
healing (e.g. hydrocolloids, alginates).
• Routine use of antiseptics for cleansing
non-infected wounds is no longer
recommended. Some antiseptics are
cytotoxic and can inhibit wound repair,
and several commonly-used antiseptics
are inactivated by organic material,
which limits their e cacy. Current
recommendations are to avoid long-term
use of antiseptics and to reserve them
for disinfecting acute, contaminated
traumatic wounds and bites.
• Irrigation with normal saline or clean tap
water is su cient to adequately cleanse
most wounds. If necessary, a mild liquid
soap or soap substitute can be used
to assist the removal of visible dirt and
particulate matter from wounds.
1. DermNetNZ. Wounds [online]. Aug 2011.At: http://dermnetnz.
2. CliniMed education. Wound Essentials [online] [accessed 26
Mar 2012]. At: www.clinimed.co.uk/wound-care/education/
3. Better Health Channel. Skin cuts and abrasions [online]. Feb
2012. At: www.betterhealth.vic.gov.au/bhcv2/bhcarticles.nsf/
4. Mercandett M. Wound healing and repair. Medscape
Reference. [online]. Aug 2011. At: http://emedicine.medscape.
5. eTG complete [online]. Melbourne: Therapeutic Guidelines;
6. Sansom LN, ed. Australian pharmaceutical formulary and
handbook. 22nd edn. Canberra: Pharmaceutical Society of
1. Maintaining an optimally moist
environment at a wound surface:
a) stimulates the formation of granulation
tissue and promotes epithelialisation.
b) causes the wound tissue to become
desiccated, inhibiting granulation and
c) causes maceration of the skin around
d) leads to the formation of excessive
2. Interactive wound dressings:
a) tend to be occlusive and may cause
maceration of the skin around the
b) include hydrocolloids, alginates and
c) are generally permeable to water vapour
and oxygen and non-permeable to
d) deliver substances to the wound tissue
that actively assist in wound healing.
3. Which of the following dressings
would be most suitable to use on
a super cial burn with minimal
c) Allevyn Plus.
d) Opsite Flexigrid.
4. Which of the following statements
regarding topical antiseptics is
a) Topically applied chlorhexidine is
readily absorbed through the skin,
causing systemic adverse e ects such as
insomnia and depression.
b) The oxygen released by hydrogen
peroxide when it is applied to the skin
has the e ect of stimulating wound
granulation and epithelialisation.
c) When povidone-iodine 10% solution is
used to disinfect a wound it should be
left on the skin for three to four minutes
only before being rinsed o .
d) The advantage of cetrimide as a wound
antiseptic is that it is not inactivated in
the presence of organic matter.
5. Which of the following counselling
points on rst aid for a laceration is
a) Clean the laceration with a gauze pad
soaked in undiluted Savlon.
b) A lightweight cohesive retention
bandage can be wrapped over the
c) If possible, keep the wound area below
the level of the heart.
d) Do not apply any pressure to the
A score of 4 out of 5 attracts 2 CPD credits.
7. Jones V, Grey JE, Harding KG. ABC of wound healing: Wound
dressings. BMJ. Apr 1 2006; 332(7544):777--80. At: www.ncbi.
8. DermNetNZ. Synthetic wound dressings [online]. Jul 2011. At:
9. Bernard DB. Minor wounds and secondary bacterial skin
infections. In: Berardi R, Newton G, McDermott JH et al, eds.
Handbook of nonprescription drugs. 16th edn. Washington,
DC: American Pharmacists Association; 2009. pp. 759--73.
10. Weller C, Sussman G. Wound dressings update. J Pharm Prac
and Research. 2006; 36(4):318--24.
11. Khan MN, Naqvi AH. Antiseptics, iodine, povidone iodine and
traumatic wound cleansing. Tissue Viability Society [online].
Nov 2006; 16(4):6--10. At: http://tvs.org.uk/sitedocument/
12. Drosou A, Falabella A, Kirsner RS. Antiseptics on Wounds: An
Area of Controversy. Wounds [online]. 2003; 15(5). At: www.
13. Howard N, ed. Promoting evidence-based nursing practice --
the use of antiseptics in wound management: a community
nursing focus [online]. Glenside: RDNS Research Unit; 2002. At:
14. Sibbald RG, Leader DJ, Queen D. Iodine Made Easy
[online]. Wounds International 2011; 2(2). At: www.
15. eMIMs. St Leonards: UBM Medica Australia; 2012.
16. Sweetman S, ed. Martindale: The Complete Drug Reference.
36th edn. London: Pharmaceutical Press; 2009.
17. Thomas GW, Rael LT, Bar-Or R et al. Mechanisms of Delayed
Wound Healing by Commonly Used Antiseptics [online].
J Trauma. 2009; 66:82--91. At: http://home.comcast.
18. Burns MM, ed. Hydrogen peroxide. Clinical Toxicology Review
[online]. Regional Centre for Poison Control and Prevention;
2004. At: www.maripoisoncenter.com/assets/images/pdfs/
19. Patient.co.uk. Cuts (Lacerations) [online] [accessed 10 Apr
2012]. At: www.patient.co.uk/health/Cuts-%28Lacerations%29.
20. Senarath-Yapa K, Enoch S. Clinical review: Management of
burns in the community [online]. Wounds UK. 2009; 5(2):38--48.
21. Better Health Channel. Burns [online]. May 2011. At: www.
22. Better Health Channel. First aid kits [online]. Aug 2011. At:
23. The Royal Children's Hospital. Home safety checklist [online].
Melbourne: Royal Children's Hospital Safety Centre; 2008.
24. The Royal Children's Hospital Clinical Practice Guidelines.
Wound dressings -- acute traumatic wounds [online]. The Royal
Children's Hospital Melbourne. [Accessed 11 Apr 2012]. At:
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