Amorphous – Without a clear shape as in a wound dressing in gel form

Antimicrobial – An agent that inhibits the growth of bacteria

Arterial Ulcer – Related to the presence of arterial occlusive disease.  Presenting symptoms mainly involve pain and tissue loss.

Autolytic Debridement – Removal of devitalized tissue through normal wound exudate or through the use of any topical dressing or preparation that encourages moisture retention or by the body’s own mechanisms

Bedsore – The traditional name for a pressure ulcer. Also called a decubitus ulcer.

Beefy Red – A term used to describe a healthy looking wound with good blood supply

Blanching – To become white with pressure

Biocompatible – refers to the ability of a product to perform its desired function without eliciting any undesirable effects

Cellulitis – Inflammation of tissue characterized by redness.  Signifies a spreading infection.

Chemical Debridement – The removal of dead or devitalized tissue by using enzymatic debriding agents.

Chronic Wound – A wound that takes longer than normal to heal due to underlying conditions such as pressure, diabetes, poor circulation, immune deficiencies or infection.

Contraction – The pulling together of wound edges/margins in the healing process.

CWOCN – Same as “ET Nurse” (Certified wound, ostomy, continence nurse).

CWS – Certified Wound Specialist

Debride – to remove dead or devitalized tissue

Debridement – Removal of dead or devitalized tissue.

Decubitus Ulcer – The Latin term for a pressure ulcer. (Sometimes referred to as a “decub.”)

Dehisced – Describes a surgical wound which has broken open or is not healing properly

Denuded – Loss of epidermis.

Depth – Distance from the wound’s surface downward. The last measurement in wound description in centimeters.

Dermis – The second layer of skin that contains hair follicles, sweat glands, sebaceous glands, blood vessels and lymph vessels: involved in stage 2, 3, and 4 pressure ulcers as well as partial and full thickness wounds.

Edema – Observable swelling from fluid accumulation in body tissues

Enterostomal Therapy Nurse or Certified Wound, Ostomy, Continence Nurse –
Often referred to as “ET nurse.”  Nurse who provides Care expertise to patients with abdominal stomas, draining  wounds and fistulas, incontinence and general wound care.

Epidermis – The outer cellular layer of the skin

Epiboly – edges of the top layer of the epidermis roll down to cover lower edge of epidermis, causing the inability of epithelial cells to migrate from wound edges. Wound healing cannot take place in this circumstance.

Epithelialization – Regeneration of the epidermis across a wound surface

Erythema – Redness of the skin surface produced by widening of the blood vessels.

Eschar – Thick, leathery dead or devitalized tissue.

Etiology – The science and study of the causes of diseases and their mode of operation.

ET nurse – Commonly used term for an Enterostomal Therapy Nurse.

Excoriation – Linear scratches on the skin.

Exudate – Accumulation of fluids in a wound.

Fenestrated – sliced or cut open

Fibrous Tissue – Tightly bound yellow film found on the granulation tissue surface composed of or containing fibroblasts

Friable – refers to a delicate wound that may bleed easily

Friction – Surface damage caused by skin rubbing against another surface.

Full Thickness Wound – Tissue destruction extending through the dermis to involve subcutaneous tissue and possibly muscle/bone.

Granulation Tissue – The formation or growth of small blood vessels and connective tissue in a full thickness wound and a stage 3 and 4 pressure ulcer: beefy red, shiny, granular tissue which generally indicates healing.

Growth Factors – refers to naturally occurring substances capable of stimulating cellular growth and proliferation

Hydrophilic – Attracting moisture

Hydroactive – Activated by moisture

Hypertonic – movement of water from a high H2O concentration inside the cell, to a low H2O concentration outside the cell. Hypertonic wound dressings pull water or exudate out of an area and create a moist environment that is more conducive to wound healing.

Hypergranulation – Increased thickness in the granular layer of the epidermis.

Ionic exchange  Denotes the processes of purification, separation, and decontamination.

Infection – Overgrowth of microorganisms capable of tissue destruction and invasion, accompanied by local or systemic symptoms

Inflammation – Defensive reaction to tissue injury: involves increased blood flow and capillary permeability Signs and symptoms include heat, redness, swelling and pain of the affected area.

Inflammatory Phase – The first phase in the normal wound healing process that lasts approximately from time of the initial injury to four days post injury.

Ischemia – A deficiency of blood supply due to functional constriction or obstruction of a blood vessel.

Maceration – A “waterlogged” appearance of the area surrounding a wound which is an indication of excessive moisture or an inappropriate dressing or dressing application.

Macrophage – “Giant Eater:” eats up unwanted dead tissue, cleans the wound and releases chemicals.

Mechanical Debridement – The removal of dead or devitalized tissue, for example by the use of wet-to-dry dressings, whirlpool or surgical debridement.

Moisture Retentive Dressings – Dressings that allow wounds to remain moist.

MMP’s – Enzymes in chronic wounds which when imbalanced with their natural inhibitors can become destructive and delay the healing process.

Necrotic – Dead

Negative pressure – a vacuum-action that is used to reduce pressure around a wound, drawing out excess fluids and cellular wastes.

Non-occlusive – Allowing the passage of moisture and air

Occlusive – A dressing that prevent the passage of air that can dry out a wound bed or to prevent unwanted or unneeded moisture from going into or out of an area.

Osmotic – relating to osmosis: a physical process in which a solvent moves, without input of energy, across a semi-permeable membrane. This term relates to movement of wound fluid from one place to another.

Osteomyelitis – Inflammation of the bone marrow and adjacent bone.

Partial Thickness Wound – Tissue destruction through the epidermis extending into but not through the dermis.

Periwound – Around the wound

Permeability –  Ability to pass through

Pressure Ulcer – An area of localized damage caused by ischemia due to pressure.

Serous – Producting a serous secretion or containing serum

Sinus tract – A pathway which can extend in any direction from the wound surface resulting in dead space

Sodium Hypochlorite – a chemical compound frequently used as a disinfecting agent

Slough – Necrotic tissue that is usually loose, stringy, yellow, tan, white or gray in color.

Shear – Trauma caused by tissue layers sliding against each other.

Stasis – Stagnation of blood caused by venous congestion.

Staging – An anatomical description of depth used to describe pressure ulcers.

Surgical Debridement – The removal of dead or devitalized tissue by a physician or trained healthcare professional at the bedside or in the operating room.

Tunneling – Tissue destruction underlying intact skin along wound margins.

Ulcer – An open lesion or sore

Undermining – Another term used to describe tunneling: tissue destruction underlying intact skin along wound margins

Vasoconstriction– Dilation of blood vessels

Vasodilation – Dilation of blood vessels

Venous – pertaining to the veins.

Venous Ulcer – Local losses of epidermis and variable levels of dermis and subcutaneous tissue occuring over or near the ankle and/or lateral lower leg.

WOCN – An acronym for Wound, Ostomy, Continence Nurse

 


GAUZE ROLLS & GAUZE SPONGES

ANTIMICROBIAL GAUZE WRAP – ANTIMICROBIAL GAUZE SPONGE

Roll gauze impregnated with an antimicrobial substance to prevent contamination of a wound site.

Examples:
Bioguard roll gauze
Bioguard gauze sponge
Kerlix AMD 

Indicated for
Use on any wound site to prevent infection from entering the wound site from the outside

Action
Prevents infection by eliminating bacteria

Contraindications
None known


 

ANASEPT  ANTIMICROBIAL SKIN AND WOUND CLEANSER

Anasept is an extremely safe and gentle antimicrobial skin and wound cleanser with exceptionally rapid broad-spectrum bactericidal, fungicidal and virucidal properties.  It is a pure, colorless, isotonic, tissue-compatible solution and has a two-year shelf life.

Anasept will eliminate bacteria and fungi within 2 minutes or less including resistant strains such as MRSA, VRE, Pseudomonas, Candida albicans and Aspergillus niger.  There is no known microbial resistance to Anasept.

This product may be used as a wound cleanser and to prepare sites for IV fluids, dialysis, central lines and more.


CALCIUM ALGINATE DRESSINGS
Secondary dressing should be used to cover 

Hydrophilic, non-woven fiber dressings that are derived from seaweed and when contacted by wound exudate form a gel mass in the wound.  These come in a sheet or rope form and are absorbent.

Examples:
Algicel
Melgisorb
Reliamed 

Indicated for
Partial thickness and full thickness wounds having moderate to heavy exudate, Infected wounds, Filling cavities, tracts andunderminingPartial thickness and full thickness wounds

Action
Absorbs excess exudate while maintaining a moist wound environment Facilitates autolytic debridement of loose, necrotic tissue

Contraindications
Dry wounds


CALCIUM ALGINATE WITH SILVER
Secondary dressing should be used to cover 

Same composition and indications as calcium alginate with silver added for antimicrobial benefits.

Examples:
Silverlon CA
Algicel AG
Reliamed AG-CMC (hydrofiber)

Indicated for
Draining wounds with signs of infection Filling cavities, tracts and undermining

Action
Absorbs excess exudate while maintaining a moist wound environment Facilitates autolytic debridement of loose, necrotic tissue Decreases or eliminates bacterial load in an infected wound

Contraindications:
Do not use with hydrogels
Should not be used with products that create an ionic exchange in the wound site
Cannot be used with enzymes (ie Santyl Collagenase)


CALCIUM ALGINATE WITH HONEY
Secondary dressing should be used to cover

Active Leptospermum Honey impregnated into a calcium alginate pad.  As wound exudate is absorbed, the alginate forms a gel to assist in maintaining a moist wound environment for optimal wound healing.  Alginate is removable in one piece.

Example:
Medihoney 

Indicated for diabetic foot ulcers, leg ulcers, pressure ulcers
1st and 2nd degree partial thickness burns
donor sites
traumatic and surgical wounds

Action Cleanses and debrides lowers overall wound pH promotes a moisture-balanced environment eliminates bacteria and multi-resistant bacteria with natural honey


COLLAGEN DRESSINGS

These dressings come in pads, gels or particles and promote the deposit of newly formed collagen in the wound bed. They can be used on any type of wound with any type of drainage. Some specific brands require the wound to be free of necrotic tissue.

Examples:
pads – Promogran Prisma, Promogran Matrix (collagen with silver), BioPad, Fibracol Plus (alginate/collagen combination)
gel – Stimulen Gel
powder – Stimulen 

Indicated for
Any type of wound with minimal, moderate or heavy drainage Some specific brands require the wound to be free of necrotic tissue

Action
Provides a moist healing environment
Some brands reduce destructive elements in wound fluid to “kick-start” healing while allowing the patient’s growth factors to effectively heal the wound Promotes tissue granulation and epithelialization Burns Grafts

Contraindications
none known


HYDROCOLLOID DRESSINGS
Can be either a primary or a secondary dressing 

Wafer-type dressings that contain hydroactive particles which, when in contact with wound exudate, form a fluid/gel environment over the wound bed.  They can be self-adhering  with a surface that repells water, bacteria and other outside contaminants.  They are considered occlusive or semi-occlusive.

Examples:
Tegaderm Thin
Reliamed border sacral
Reliamed beveled
Flexicol bordered
Medihoney sheet (hydrocolloid with honey)
Medihoney tube  

Indicated for
partial thickness to shallow full thickness wounds

Action
maintains a moist wound environment provides protection and insulation to a healing wound facilitates autolytic debridement

Contraindications for use
infected wounds
wounds with heavy exudate, deep cavities, sinus tracts (unless used as a secondary dressing over packing)
Burns
Grafts


HYDROFERA BLUE
Foam impregnated with Methylene Blue and Gentian Violet

Indicated for
Wounds containing bacteria, yeast and fungus

Action
Provides a protective, bacteriostatic cover which may help prevent infection

When used under an occlusive dressing, product will create a mild negative pressure that will reduce an epiboly (rolled edge).

Contraindications
None known


HYDROGEL DRESSINGS
Must be covered with a secondary cover dressing

Vary in composition but most are non-occlusive and water or glycerin based, depending on manufacturer.  This product comes in sheets, impregnated in gauze and in gel form.

Examples:
hydrogel sheets – Spand-Gel, Avogel
amorphous hydrogel – Normlgel 

Indicated for
Any type of wound needing additional moisture
Burns
Grafts
Sheet form can be used for quicker healing of cosmetic procedures and/or scar reduction

Action
Adds moisture to dry wounds
Maintains a moist wound environment
Facilitates autolytic debridement.
Avogel sheets provide a barrier to prevent heat and water loss through the skin which aids in scar reduction

Contraindications
Because of the moist nature of these dressings, care must be taken to observe the wound edges and protect from maceration.


HYDROGEL – ANTIMICROBIAL

Amorphous hydrogel combined with sodium hypochlorite for elimination of bacteria, multi-resistant bacteria, viruses and fungi.

Example:
Anasept

Indicated for
Any wound needing additional moisture and infection protection
Dry wounds with signs of infection
Burns
Grafts

Action
Provides moisture to a wound site while eliminating or preventing infection Biocompatible with other dressings

Contraindications
None known


HYDROGEL WITH SILVER

Hydrogel with silver added for antimicrobial benefits

Examples:
SilverSept
Elta silver hydrogel 

Indicated for
Wounds needing additional moisture and infection protection
Dry wounds with evidence of infection

Action
Provides moisture in a wound site while eliminating or preventing infection
Absorbs a small amount of wound exudate

Contraindications:
Should not be utilized in conjuction with Tegaderm Matrix as deactivation of both dressings will result


HYPERTONIC DRESSINGS

Available in impregnated gauze and gel form, these dressings provide a high sodium chloride level to eliminate necrotic tissue.

Examples:
Hypergel – gel used to break down eschar of necrotic tissue
Mesalt– dry sheet or strip (used to wick infection out of tunneling areas)
Curasalt – moist hypertonic tape

Indicated for
autolytic debridement of necrotic tissue fills wound space to wick drainage out of a tunnel or undermining provides or encourages a moist environment

Action
creates osmotic changes in the wound environment to encourage debridement

Contraindications:
cannot apply to granulation tissue as it can cause a burning sensation


FOAM DRESSINGS, BORDERED FOAM DRESSINGS, FOAM DRESSINGS WITH SILVER
May be used as a primary or secondary dressing

Available as self-adhering or non-adherent (though some may have adhesive border). Polyurethane foam dressings which have an absorbent wound contact surface and most have a moisture-repellant outer surface which is non-occlusive.  Ability to absorbexudate is dependant upon thickness and density of the dressing.

Examples:
Mepilex (with Safetac technology)
Mepilex Border (water resistant with Safetac technology)
Polymem
Polymem Dot (with silver)
Reliamed

Indicated for
Partial and full thickness wounds
To cover wounds containing packing material

Action
Absorbs excess exudate to prevent maceration
Provides a moist wound environment
Insulation and protection

Contraindications
Wounds with dry eschar
No or minimal exudate


MOISTURE REGULATION
Requires a secondary dressing to cover it

An inert breathable polymer combined with a nonwoven medium which provides fluid balance at the wound surface instead of within the dressing.

Example:
TheraGauze 

Indicated for:
partial and full thickness wounds of any type
grafts
burns

Action:
Controls moisture and facilitates healing by releasing or absorbing moisture based on wound conditions
Prevents maceration
High oxygen permeability
Compatible with most other medications
One-piece removal

Contraindications:
Wet wounds unless fenestrated


MMP REDUCTION
Requires a secondary dressing to cover it

Cellulose impregnated with potassium, zinc, calcium and rubidium.

Examples
Tegaderm Matrix
EpiMax

Indicated for
All types of wounds including burns, grafts and incisions
“Kick-starting” stalled wounds

Action
Corrects the MMP balance in the wound site enabling the patient’s growth factors to heal the wound
Creates a moist wound environment while preventing maceration

Contraindications
Use with silver products will cause deactivation of both products.


TRANSPARENT FILM DRESSINGS

Semipermeable membranes which are self-adhering, thin and waterproof. They allow gaseous exchange between the wound bed and the environment, but water, bacteria or other contaminants cannot penetrate the dressing

Examples:
Mepore
ReliaMed Transparent Thin film dressings

Indicated for:
partial thickness wounds
stage II ulcers
dry, necrotic wounds requiring debridement

Action
helps to maintain a moist wound surface
facilitates autolytic debridement.

Contraindications for use:
heavy exudating wounds
deep cavities, sinus tracts or undermining (unless used as a secondary dressing) or wounds with friable skin in the periwound area.