Home' Australian Pharmacist : Australian Pharmacist June 2012 Contents Australian Pharmacist June 2012 I ©Pharmaceutical Society of Australia Ltd. 487
Continuing Professional Development
Submit your answers online at www.psa.org.au and receive automatic feedback
EVIDENCE IN PATIENT CARE
moisture leads to maceration and further
tissue breakdown. The goal, therefore,
is to maintain moisture balance -- this will
in uence wound dressing selection to a
large extent. The current edition of the
Australian Pharmaceutical Formulary and
Handbook (APF22, page 226) provides an
excellent overview of the characteristics of
wound dressings available in Australia.5
Table 1 shows examples of dressing types
available for maintaining moisture balance.5
It should be noted that wounds require
regular reassessment -- the wound will
change during the healing process and
this may necessitate a change in dressing.
Interactive dressings use the environment
of the body to encourage moist wound
healing.5 Semipermeable lm dressings are
sterile plastic sheets and are used mainly
as a transparent primary wound cover.
While they are impermeable to bacteria,
and permeable to air and water vapour,
they are unable to cope with large amounts
of exudate.16 Hydrocolloid dressings form
a gel on the wound surface, promoting
moist wound healing. They can be bonded
to a semipermeable lm to produce a at,
occlusive, adherent dressing. Hydrocolloid
sheet dressings are impermeable to water
vapour and air and can be used to rehydrate
dry wounds. They can reduce wound pain
and allow patients to continue with normal
daily activities without disturbing the
dressing.16 Hydrogel products contain a
high proportion of water, enabling them to
donate water to the wound and maintain
a moist environment. However, they can
still absorb a degree of wound exudate as
the polymers are only partially hydrated.
They are not suitable for wounds producing
a high level of exudate.16 Alginate dressings
are derived from alginic acids found
naturally in brown seaweed. When placed
on a wound, calcium ions exchange with
sodium ions from the wound to form a
gel, providing a moist environment for
wound healing. Alginate dressings are
haemostatic, highly absorbent, protective
and non-adherent.5 Foam dressings
are produced from polyurethane.
They transmit moisture vapour and oxygen
and provide thermal insulation. They
may contain multiple layers, capable of
absorbing increasing amounts of exudate.
They provide a moist environment,
are absorbent, conformable, protective,
non-adherent and cushioning.5,16 Other
dressing types include charcoal dressings
(useful in controlling malodour), hypertonic
saline dressings (used for hypergranulating
or infected wounds), silicone-based
dressings (to reduce scarring),
inert dressings (e.g. gauze, plastic strips)
and antimicrobial dressings.5
Wound healing is a complex
process in uenced by many factors.
Pharmacists, particularly those who are
practicing in primary care, are well placed
to assist patients to achieve the best
outcomes by assessing their wounds,
1. Which ONE of the following
statements is TRUE?
a) To achieve optimal wound healing,
wounds should not be allowed to
b) Wounds should be left to form a scab
to enable optimal wound healing.
c) Scabs allow wounds to retain moisture.
d) The formation of a scab facilitates
2. Which ONE of the following
statements related to wound
assessment is FALSE?
a) The cause of the wound should
b) The colour of the wound is an
c) The nature and amount of the exudate
d) Referral is required if the wound is a
3. Plastic strip wound dressings consist
of an absorbent pad attached to a
piece of plastic adhesive tape that is
impermeable to water vapour. Why
might this dressing be considered
sub-optimal for many wounds?
a) May result in skin maceration and
further tissue breakdown.
b) May result in desiccation (drying) of
c) May encourage scab formation.
4. Which ONE of the following is NOT a
characteristic of alginate dressings?
c) Highly absorbent.
5) Which of the following medications
is likely to impair wound healing to
d) All of the above.
A score of 4 out of 5 attracts 1 CPD credit.
referring where appropriate and helping
to provide the ideal environment for
wound healing through careful selection of
1. Enoch S, Grey JE, Harding KG. Recent advances and emerging
treatments. BMJ. 2006; 332:962--5.
2. Guo S, Dipietro LA. Factors affecting wound healing. J Dent
Res. 2010; 89:219--29.
3. Gosain A, DiPietro LA. Aging and wound healing. World J Surg.
4. Grey JE, Enoch S, Harding KG. Wound assessment. BMJ. 2006;
5. Sansom LN, ed. Australian pharmaceutical formulary and
handbook. 22nd edn. Canberra: PSA; 2012.
6. Arnold M, Barbul A. Nutrition and wound healing. Plast
Reconstruct Surg. 2006; 117:42S--58S.
7. Shepherd AA. Nutrition for optimum wound healing. Nurs
Stand. 2003; 18: 55--8.
8. Campos AC, Groth AK, Branco AB. Assessment and nutritional
aspects of wound healing. Curr Opin Clin Nutr Metab Care.
9. Tong BC, Barbul A. Cellular and physiological effects of arginine.
Mini Rev Med Chem. 2004; 4:823--32.
10. da Costa MA, Campos AC, Coelho JC, et al. Oral glutamine and
the healing of colonic anastomoses in rats. JPEN J Parenter
Enteral Nutr. 2003; 27:182--5; discussion 185--6.
11. Heyman H, Van De Looverbosch DE, Meijer EP, et al. Benefits
of an oral nutritional supplement on pressure ulcer healing in
long-term care residents. J Wound Care. 2008; 17:476--8, 480.
12. Franz MG, Steed DL, Robson MC. Optimizing healing of the
acute wound by minimizing complications. Curr Probl Surg.
13. Hofman D, Moore K, Cooper R, et al. Use of topical
corticosteroids on chronic leg ulcers. J Wound Care. 2007;
14. Krischak GD, Augat P, Claes L, et al. The effects of non-steroidal
anti-inflammatory drug application on incisional wound
healing in rats. J Wound Care. 2007; 16:76--8.
15. Ahn C, Mulligan P, Salcido RS. Smoking-the bane of wound
healing: biomedical interventions and social influences. Adv
Skin Wound Care. 2008; 21:227--36; quiz 237--8.
16. Jones V, Grey JE, Harding KG. Wound dressings. BMJ. 2006;
17. Carville K. Which dressing should I use? It all depends on the
'TIMEING'. Aust Fam Physician. 2006; 35:486--9.
Links Archive Australian Pharmacist July 2012 Australian Pharmacist May 2012 Navigation Previous Page Next Page