Hydrogels

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Hydrogels

• Hydrosorb a Gel With Polyurethane Film Covering,
  Moist Wound Dressing
• Examples Aquasorb, Biolex Wound Gel, Carrasyn
  Gel (2)

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The Main Features of Hydrogel

• Prevent fluid loss
• Provide extra moisture, gel is between 60-90
  water
• Prevent micro-organism and water entry
• Absorb contaminating bacteria and debris

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The Main Features of Hydrogel

• Maintain an optimal healing temperature
• Transparency to view wound
• Cushioning effect
• Reduce friction and pressure, which inhibit
  healing

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The Main Features of Hydrogel

• Improve patient comfort
• Easy to apply
• Easy and painless to remove
• Allow water vapour to pass out
• Help cleanse wound
• Breakdown necrotic tissue
• Promotes granulation and re-epithelisation
• Continuous long term absorption 

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Hydrogels on the Market

• A number of companies manufacture hydrogel
  products for wound care.
• There are slight differences between each
  hydrogel.
• But there is a common theme amongst the design of
  all hydrogel products

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All Hydrogels

• Provide a moist wound environment to enhance
  healing.
• Debride necrotic tissue to allow the regeneration
  process to begin.
• Absorb excess exudate from the wound to prevent
  slough formation.
• Hydrogels are available in sterile and
  non-sterile sheets and amorphous gels.

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Indications

• Useful in partial- and full- thickness wounds
• Deep wounds with tunnelling or sinus tracts
• Light to moderately exudative wounds

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Indications

• Chronic and reoccurring wound, with prolonged
  formation of granulation tissue
• Burns first and second degree, hydrogel has
  cooling and pain relieving properties

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Indications

• Skin grafts, promotion of re-epithelialisation at
  donor sites
• Can conform to body contours, therefore can be
  used in conjunction with an elastic compression
  bandages to prevent the development of oedema at
  the wound edges
• Reduction in scar sizes

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Indications

• Cushioning effect for pressure reduction.
• Can be impregnated with topical. medications.
• Pressure sores.
• Radiation tissue damage.

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Contraindications

• Not useful for highly exuding wounds
• Should not be used on exposed structures such as
  bones, muscles or tendons in clinically infected
  wounds or ulcera resulting in chronic infections,
  following tuberculosis, syphilis, deep mycotic
  infections

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Methods of Use

• Application
• Clean and dry wound.
• Apply Hydrogel, sheet, gel or impregnated
  dressing.

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Methods of Use

• 3. Cover wound with an adherent dressing to
  secure it. Sloughy wounds may need an absorbent
  dressing for maximal absorption.
• 4. All gels can be irrigated from the wound with
  saline solution without causing tissue damage or
  pain to the patient. (5).

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Frequency of Dressing Change

• Hydrogel dressings such as Hydrosorb and
  Hydrosorb plus are permanently moist, transparent
  dressings.
• The transparent nature allow for easy inspection
  of the wound at any time without removal.

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Frequency of Dressing Change

• Hydrosorb and Hydrosorb plus save the wound from
  fluid loss and posses a sucking activity that
  provides sustains long term absorption of fluid.

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Frequency of Dressing Change

• Daily redressing not required to monitor wound.
• The dressing can remain undisturbed for up to 7
  days.
• However some particularly nasty wounds would
  require redressing every 4-5 days.

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Advice to Patient

• Points to discuss with patients and caregivers
• Wound healing can be a long process.
• Need clinician, patient, caregiver
  communication.
• Common goals and outcomes some patients could
  begin to feel discouraged.

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Advice to Patient

• Patients need to be aware of factors that delay
  wound healing
• Malnutrition.
• Cancer.
• Diabetes mellitus.
• Other chronic medical conditions (e.g. Heart
  disease).
• Infection.
• Poor blood supply.

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Advice to Patient

•  .
• Alert clinician if any adverse reactions or
  irritations occur.
• Patients need to know how to store Hydrogels
  appropriately.
•  TO CHECK OUT MORE HEAD TO http//www.nice.org.uk.
  

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Cost of hydrogels

• Approximately 30USD for a package of 10 44
  Hydrogel Impregnated Gauze Dressings.
• (source http//shopcart.shopmash.com discount
  medical supplies web page).

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Case Study

• Mr. Plod. Aged 75.
• Medical history Peripheral arterial disease,
  Long standing type II diabetes, with some
  associated complications, renal disease and
  micro-vascular changes.
• Lives alone, home care once a week.
• Receives the pension.
• Acquired a deep puncture injury last week while
  gardening.
• Producing mild exudate. But no signs of
  infection.

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Why Use a Hydrogel Dressing?

• Mild exudating wound, hydrogels absorb slowly and
  continuously.
• Arterial disease means there will be a decreased
  blood supply. The hypoxic environment under the
  occlusive wound dressing enhances angiogenesis.
  Therefore increasing blood flow, which brings
  products for healing.

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Why Use a hydrogel Dressing?

• Hydrogel is soft and elastic. Provides cushioning
  and protection that can assist wound healing.
• Mr. Plod can continue working in his veggie
  garden with minimal risk to his injury.
• Can leave dressing on for the week between
  homecare visits.
• More economically viable, decreased wound
  dressing decreases cost to Mr Plod who receives
  the pension.

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Why Use a hydrogel Dressing?

• Hydrogels help maintain a moist wound
  environment.
• This assists epithelial migration, therefore
  decreasing healing time.
• But doesn't trap exudate that may decrease
  granulation tissue and cause local ischemia.
• Hydrogels also provide optimum temperatures for
  wound healing.

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Remember to Manage..

• Mr. Plods nutritional status. Make sure he is
  having his Weet-Bix for breakfast!!
• Management of diabetes, bacteria love glucose.
  Need tight glucose control.
• Monitoring of PVD to insure adequate blood supply
  to wound.
• Wound care needs a multidisciplinary approach.
  Even a super dressing alone is not enough!!!