**9. Dressings**


**•** Alginates. These are made from the sodium salts of algenic acid. Alginic acid is produced from seaweed. When exposed to fluid it is activated and forms a gel and absorbs the exudates. It comes in different size and shape as flat squares and ribbons. It is very commonly used in UK. Flat square and ribbons are manufactured by many pharmaceuticals. Kaltostat (Convatec) is the most widely used in our institute.

with wound healing, gentle irrigation with a syringe filled with saline or sterile water is

f. Irrigation of wounds with antiseptic solution has been tried with hypochloride (*Eusol*) solution, Aserbane™ and hydrogen peroxide as caustic agents have been tried but there are

a. Using flowcharts and a structured approach with clear guidance is essential to ensure

F. Post-operative wound complications: The most common and significant post-operative wound complications are wound infection and wound dehiscence. Once suspected, active management should start and this includes swabs for culture and sensitivities, followed by empirical antibiotics administration in the first instance [21]. Debridement in some cases might

**a.** The ideal dressing should carry certain characteristics to assist wound healing. It must maintain some moisture at the wound site, act as a barrier against fluid or bacterial contamination, potentially remove excess exudates that might lead to wound maceration and finally it should be adherent to skin but removed with no/minimal trauma [24]. Tegaderm™ and Opsite™ dressings are two such dressings. These are water resistant and

**b.** Wound which are producing lot of debris and discharge need cleaning with aseptic technique. There are a number of different materials available, some of the commonly

**•** Hydrocolloid dressings. These contain sodium carboxymethylcellulose which is combined to elastomers and applied to a carrier, usually polyurethane foam. The hydrocolloid absorbs the exudates and becomes gel and when dressing is removed the whole lot lifts off without disturbing the granulation tissue. Common ones are Granuflex™, Comfeel Plus™, Aqua-

**•** Polysaccharide beads. This comes in powder form and swells when it comes in contact with fluid or exudates. This can be left in place for a few days and then removed with gentle wash

with saline. It is available as Debrisan (Pharmacia Ltd) and Iodosorb (Perstrop).

allow patient to have a wash next day if the patients wish so.

preferred [3, 22].

no reliable data available to prove their efficacy [3].

b. Continuous education about recent updates in wound care.

a. Topical antibiotics in wounds healing by primary intention. b. Moist cotton gauze or mercury-based antiseptic solutions.

D. Structured wound care approach

352 Wound Healing - New insights into Ancient Challenges

be necessary to promote wound healing.

used ones are described below.

cel™ and DuoDerm Extra Thin™.

continuity within the team.

E. Methods to avoid

**9. Dressings**


Skin is considered the largest organ of the human body representing about 16% of the total body weight. Skin loss is commonly encountered in problems such as burns or de-gloving injuries. The skin plays a vital role in terms of immunity, protection and thermoregulation of the human body. Consequently, skin loss can be associated with significant morbidities and even mortalities. Over decades, Research has been carried out to provide biologic skin substitutes that can take the skin function and can be readily available. Cadaveric and porcine grafts have been used for decades as a biologic skin substitutes. When cadaveric grafts are used, they are called allograft as they are originated from the same species. On the contrary, porcine grafts are called xenografts because they are taken from one species and transplanted on to another one.
