|Application - Section
In this section, you have learned:
- Estimate the number and size of sheets,
and anticipate when the product will be needed. Anticipate
when the product will be needed and begin rinsing sheets
to allow for a 1-2 minute hydration in saline before
wound bed prep has been completed. Follow product preparation
protocol as outlined in this course. When removing the
INTEGRA Bilayer Matrix
Wound Dressing from the foil pouch use gloved
hands (do not use instruments).
- If meshing INTEGRA
Bilayer Matrix Wound Dressing use 4 x 10 inch
sheets to avoid folding. Mesh sheets 1 : 1 through a
"non-crushing" mesher (e.g. Brennen®)
but do not expand. This technique minimizes fluid accumulation
under the graft, minimizes amount of graft loss in the
event of hematoma and minimizes the risk of graft loss
in the event of bacterial colonization.
- When placing, shaping and cutting
the INTEGRA Bilayer Matrix
Wound Dressing gently remove sheets from the
holding basin with gloved hands and place directly onto
the wound bed. Do not try to move or "float"
sheets like a STSG, instead, lift sheets up and reposition.
Place sheets on prepared wound bed, affix parallel to
inside edge of wound bed and trim excess; or, place
sheet on prepared wound bed, trim sheet to fit site,
and affix perpendicular to seam (place staples across
seams). Cut sheets to avoid gaps and be sure to place
seam lines along Langer's Lines to reduce risk of contracture.
Make sure INTEGRA Bilayer
Matrix Wound Dressing lays flat with no wrinkles
- In a staged procedure, do not place
INTEGRA Bilayer Matrix
Wound Dressing in contact with non-viable tissue,
rather maintain a safety margin between the prepared
wound bed and any non-viable tissue.
- Stapling, suturing or other suitable
alternative may be used when applying INTEGRA
Bilayer Matrix Wound Dressing, however with either
technique remove all air bubbles. Fix sheets independently
and/or affix adjacent sheets together to minimize gaps,
reducing granulation tissue formation. Interrupted stapling
(i.e., leaving a 1-2 centimeter space between staples)
can be used to seal edges.
- It is recommended that dressings
be built in layers and to inspect for hematoma and seroma
formation upon dressing changes. The elastic net dressing
can be attached by staples or other suitable methods.
It will be left in place until the silicone is removed.
When applied correctly, the expanded interstices will
be open about 1-2 cm and the silicone will have slight
indentations from the elastic net dressing.
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