MODERN DRESSING ON

WOUND HEALING

Arranged by:
Fhany Grace Lubis G99171063
Fauzi Novia Isnaening Tyas G99172075

Period: 9 – 15 th April 2018

Mentor :
Amru Sungkar, dr.,Sp.B,Sp. BP-RE
What is a wound?
 It is a circumscribed injury which is caused by an
external force and it can involve any tissue or organ.
surgical, traumatic
It can be mild, severe, or even lethal.

3
Parts of the wound
Wound edge Wound
corner
Surface of
the wound

Base of the wound

Cross section of a simple wound

Wound edge
Wound Skin surface
cavity
Surface of Subcutaneus tissue
the wound
Superficial fascia
Muscle layer
Base of the wound
4
Classification of the wounds
(Character of wound)
 1. Abraded wound (vulnus abrasum)
 2. Puncured wound (v. punctum)
 3. Incised wound (v. scissum)
 4. Cut wound (v. caesum)
 5. Crush wound (v. contusum)
 6. Torn wound (v. lacerum)
 7. Bite wound (v. morsum)
 8. Shot wound (v. sclopetarium)
Classification of the wounds
(healing process)

a. healing by primary intention

b. healing by secondary intention
c. delayed primary healing
In primary healing, the wound edges can be
reunited, the surface is clean, no tissue is lost.
Usually occurs after an incision of wound healing
process that goes from internal to external. In
secondary healing, some tissue is lost, the healing
process takes place from the formation of
granulation tissue at the base of the wound and its
surroundings. As well as on tertiary healing, wound
healing is slow, often accompanied by infection,
required wound closure manually (Kartika, 2015).
Classification of the wounds
(time of healing)
acute injuries and chronic wounds. Acute
injuries are wounds that correspond to normal
healing processes, which can be categorized
into surgical wounds (incisions), non surgery
(burns) and / or trauma. While chronic injury is a
process of healing wounds that have delays,
such as sores decubitus, diabetic wounds, and
or leg ulcer
Wound healing

 is a natural restorative response to tissue injury.

 Healing is the interaction of a complex cascade of
cellular events that generates resurfacing,
reconstitution, and restoration of the tensile
strength of injured skin.
 Under the most ideal circumstances, healing is a
systematic process, traditionally explained in
terms of 3 classic phases: inflammation,
proliferation, and maturation.
 Wound healing
 The inflammatory phase: a clot forms and cells of
inflammation debride injured tissue during
 The proliferative phase: epithelialization,
fibroplasia, and angiogenesis occur; additionally,
granulation tissue forms and the wound begins to
contract.
 The maturation phase: Collagen forms tight cross-
links to other collagen and with protein molecules,
increasing the tensile strength of the scar.
Modern wound dressing

Modern wound dressing have been developed

to facilitate the function of the wound rather
than just to cover it. These dressings are focused
to keep the wound from dehydration and
promote healing.
Modern wound dressings are usually based on
synthetic polymers and are classified as passive,
interactive and bioactive products. Passive
products are non-occlusive, such as gauze and
tulle dressings, used to cover the wound to
restore its function underneath. Interactive
dressings are semi-occlusive or occlusive,
available in the forms of films, foam, hydrogel
and hydrocolloids.
Semi-permeable film
dressings
-> Composed of transparent and adherent
polyurethane which permits transmission of
water vapor, O2 and CO2 from the wound and it
also provides autolytic debridement of eschar
and impermeable to bacteria
Semi-permeable foam dressing

Made up of hydrophobic and hydrophilic foam with

adhesive borders sometimes.

Suitable for lower leg ulcers and moderate to highly

exudating wounds, also indicated for granulating wounds.

Requiring frequent dressing and is not suitable for low

exudating wounds, dry wounds and dry scars as they
depend on exudates for its healing
Hydrogels dressing

 Insoluble hydrophilic materials made from synthetic

polymers such as poly (methacrylates) and polyvinyl
pyrrolidine.

 Used for dry chronic wounds, necrotic wounds,

pressure ulcers and burn wounds.

 Difficulties of hydrogel dressings are exudate

accumulation leads to maceration and bacterial
proliferation that produces foul smell in wounds.
Hydrocolloid dressing

 Made up of the combination of gel forming agents

(carboxymethylcellulose, gelatin and pectin) with
other materials such as elastomers and adhesives

 Permeable to water vapor but impermeable to

bacteria and also have the properties of debridement
and absorb wound exudates.

 Recommended for paediatric wound care

management, as they do not cause pain on removal
Alginate dressing

 Made from the sodium and calcium salts

comprising mannuronic and guluronic acid
units.

 Suitable for moderate to heavy drainage

wounds and not suggested for dry wound,
third degree burn wound and severe wounds
with exposed bone.
Bioactive wound dressings

 Produced from biomaterials which play an

important role in healing process.

 These dressings are known for their

biocompatibility, biodegradability and non-
toxic nature and are derived generally from
natural tissues or artificial sources such as
collagen, hyaluronic acid, chitosan, alginate
and elastin.
Tissue engineered skin
substitutes
 Human skin or dermal equivalent (HSE) has
two types of tissue engineered substitutes
available, one mimics the layer of skin
composed of Keratinocytes and fibroblast on
collagen matrix (Cell containing matrix).

 Bioengineered dressings are suitable for

Diabetic foot ulcer and venous leg ulcer.
Medicated dressings

 Incorporated drugs plays an important role in

the healing process directly or indirectly by
removal of necrotic tissues.

 Has been achieved by cleaning or debriding

agents for necrotic tissue, antimicrobials which
prevents infection and promotes tissue
regeneration.
 References
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Dhivya, S., Padma, V. V., & Santhini, E. (2015). Wound dressings–a review. Biomedicine, 5(4).
Guest, J. F., Singh, H., & Vowden, P. (2018). Potential cost-effectiveness of using a collagen-containing dressing in managing
diabetic foot ulcers in the UK. Journal of wound care, 27(3), 136-144.

Guo, S. A., & DiPietro, L. A. (2010). Factors affecting wound healing. Journal of dental research, 89(3), 219-229.
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