I am in and out of long term care facilities every day. I not only educate providers and nursing staff about product selection and usage, but focus on state survey readiness. Now days, state surveyors are looking at dressing orders more frequently. Many state surveyors are now mandated to get wound care certified.
While working out in the field, I observe physician orders written for name brand products all day long. It is good practice to use dressing category names, not brand names. Otherwise, when writing an order with a specific name brand, you are setting your facility up for a possible medication error. If a physician is set on a specific brand name product, you can write DAW (dispense as written). This will avoid any discrepancies.
I have listed the categories below, along with some key points to remember. The frequency follows Medicare reimbursement guidelines.
DRESSINGS BY CATEGORY
ALGINATES
Pads and ropes available
Variety of sizes
Derived from seaweed
Designed to absorb and wick away drainage
Autolytic debridement
*MODERATE TO HEAVY EXUDATE, DAILY
COLLAGENS
Pads and particles available
Collagen is a protein that gives strength for the skin
Ideal for stalled wounds
*MINIMAL TO HEAVY EXUDATE, DAILY OR QOD
COMPOSITES
Variety of sizes available
Multifunctional dressing
Bacterial barrier
Primary or a secondary dressing
*MINIMAL TO HEAVY EXUDATE, DAILY OR QOD
CONTACT LAYERS
Variety of sizes available
Thin, non-adherent sheets placed on an open wound bed to protect tissue
Conforms to the shape of the wound
Porous to allow exudate to pass through for absorption by an overlying, secondary dressing
Indicated for infected wounds, donor sites and split-thickness skin grafts
May be used with topical medications
*ONCE A WEEK DRESSING
HYDROCOLLOIDS
Variety of thicknesses, shapes and sizes available
Promotes an optimal moist healing environment
Cost effective, adhesive dressing
Autolytic debridement
*LIGHT TO MODERATE EXUDATE, CHANGE EVERY 3 DAYS
HYDROGELS
Gel, impregnated gauze, strands, and sheet covers available.
Promotes moist healing
*MINIMUM TO MODERATE EXUDATE, DAILY TREATMENT
ANTIMICROBIALS
Honey, Silver, Cadexomer Iodine, PHMB, Methylene Blue, and Gentian Violet
One or more ingredients may be impregnated into dressings such as: foams, gels, hydrocolloid, sheets, and or alginates.
Can help maintain a moist healing environment, reducing surface bacteria
Autolytic debridement
*DAILY TREATMENT
FILLERS
Wound fillers can consist of non-adherent beads, foams, gels, ointments, pads, pastes, pillows, powders, strands.
They maintain a moist environment, while absorbing exudate
*DAILY, 3 OZ MONTH
GAUZES
Readily available
Sterile and non-sterile types
With and without an adhesive border
Woven and non-woven gauze dressings
Can be used as a primary or secondary dressing
*DAILY UP TO THREE TIMES A DAY
FOAMS
Bordered and non-bordered available
Variety of sizes and shapes
Used for moderate to heavily exuding wounds
*MODERATE TO HEAVY EXUDATE, DAILY (HEAVY) OR QOD (MODERATE)
TRANPARENCIES
Variety of sizes available
Promotes a moist wound healing environment
Ideal for minimally draining wounds
*THREE TIMES A WEEK DRESSING
