Surgical dressings i

Surgery Dressings

1. SURGICAL DRESSINGS Part- I 13/08/2021 Dr. Ankita Singh Assistant Professor ACMS, Delhi Cantt

2. Learning Objective What is surgical dressing? History Ideal wound dressing How to select appropriate surgical dressing? Types/classification Commonly used dressings Modern/miscellaneous dressings

3. What is surgical dressing ? Surgical dressing: sterile pad or compress applied to a wound to promote healing and prevent further harm Bandage: piece of material used either to support a medical device such as a dressing or splint

4. History Material like fabric, leaves, cobweb, dung etc. Ancient Eqyptians ( 1500BC)- honey Hippocrates (460BC)- vinegar & fig leaves Roman physicians (100)- spices like saffron, thyme, mint; silver & lead ( antiseptic) but were lost to Dark Ages

5. History.. Joseph Lister (1860s)- I ntroduced antiseptic dressings ( carbolic acid) Decreased mortality

6. History.. “Johnson & J ohnson”(1886)- I odinated dressings Debuted commercial first aid kit

7. History.. “Johnson & J ohnson”(1920)- e Earle dickson - a cotton buyer invented BAND- AID (brand adhesive bandage)

8. History.. George Winter (1962)- P ioneered concept of moist healing & occlusive dressings

9. History to modern dressings.. 1990 onwards- Hydrogels Hydrocolloids Alginates Synthetic foam dressings Vapor permeable adhesive films Anti adhesives: silicon meshes Tissue adhesives Barrier films Silver/collagen dressings Miscellaneous: Combination products Engineered skin substitutes

10. Ideal wound dressing Creates moist environment Removes excess exudate Prevents desiccation Allows for gaseous exchange Impermeable to microorganisms Thermally insulated

11. Ideal wound dressing.. Prevents particulate contamination odorless Non toxic to benefit host cells Provides mechanical protection Non traumatic Easy to use Cost effective

12. How to select appropriate surgical dressing ? Concept of occlusion & absorption Occlusive dressing- Principle of moist healing faster wound healing by reducing pH and oxygen tension Stimulating fibroblast proliferation Harmful in infected wounds Absorptive dressing- Preferred in wounds with high bacterial counts & ↑ exudate

13. How to select appropriate surgical dressing?

14. Types of dressings Simple vs. Composite dressings Simple- S aline gauze dressings Film dressings Parrafin gauze dressings Composite- Multilayered dressing – outer, middle & inner layer

15. Types of dressings.. Nonadherent fabrics Absorptive dressings Occlusive dressings Creams, ointments, and solutions

16. Types of dressings..

17. Types of dressings.. Non adherent fabrics Fine mesh gauze supplemented with substance to augment occlusive property/ antibacterial properties E.g. Paraffin gauze, Scarlet Red, Xeroform

18. Types of dressings.. Non adherent fabrics E.g. Paraffin gauze

19. Types of dressings.. Non adherent fabrics E.g. Xeroform

20. Types of dressings..

21. Types of dressings.. 2. Absorptive dressings Wounds with significant amount of exudate E.g. W ide mesh gauze, Foams

22. Types of dressings.. 2. Absorptive dressings E.g. W ide mesh gauze- not effective when saturated, Foams

23. Types of dressings.. 2. Absorptive dressings E.g. Foams-

24. Types of dressings.. 2. Absorptive dressings E.g. Foams-

25. Types of dressings..

26. Types of dressings.. 2. Occlusive dressings Two types- Non biological-e. g. Films , Hydrocolloids, Alginates, Hydrogels Biologic-e.g. Homograft , Xenograft , Amnion, Skin substitutes

27. Types of dressings.. 2. Occlusive dressings Non biological- Films

28. Types of dressings.. 2. Occlusive dressings Non biological- Hydrocolloid matrix gelatin , pectin, carboxymethylcellulose

29. Types of dressings.. 2. Occlusive dressings Non biological- Hydrogels Polyethylene oxide or carboxymethylcellulose polymer and water (80 %) Rehydrating agents for dry wounds ;little water absorption

30. Types of dressings.. 2. Occlusive dressings Non biological- Alginates derived from brown algae contain long chains of polysaccharides ( mannuronic and glucuronic acid) Processed as the calcium form, alginates turn into soluble sodium alginate

31. Types of dressings.. 2. Occlusive dressings Biologic- Homograft , Xenograft , Amnion , Skin substitutes- Integra, Alloderm , Apligraf

32. Types of dressings..

33. Types of dressings.. 2. C reams, Ointments & Solutions Traditional materials- zinc oxide paste Antibacterial creams and ointments Acetic acid, Silver nitrate, Silver sulfadiazine, iodine containing ointments( iodosorbs ), bacitracin Enzymes Growth factors Indicated in infected wounds

34. Types of dressings.. 2. C reams, Ointments & Solutions Z inc oxide paste Antibacterial creams and ointments Acetic acid, Silver nitrate, Silver sulfadiazine, iodine containing ointments( iodosorbs ), bacitracin

35. Types of dressings.. 2. C reams, Ointments & Solutions Nano silver Betadine

36. What did we learn? What is surgical dressing? History Ideal wound dressing How to select appropriate surgical dressing? Types/classification Commonly used dressings Modern/miscellaneous dressings

37. Bibliography Sabiston 21 st ed., Chap. 6, Wound Healing, wound dressings SRB 5 th ed., Chap 36-G, Dressings and Bandages Additional reading- Science of wound healing and dressing material- Vibhakar & Payal Surgical wound healing and management- Mark & Luc

38. Next reading Pye’s Surgical Handicraft, 22 nd ed.- Chap.6, Application of bandages

39. Attendance!! & ?