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  Excision
  Application
    Neodermis formation
    Signs of mature Neodermis
 
    Bolstering and splinting
    Frequency of dressing changes
    Positioning the patient
    Moving and turning the patient
    Anti-shear techniques
    Physical Therapy
    Large Hematoma
    Small, late forming Hematoma
    Fluid accumulation
    Infection
    Infection at staple
    Areas of non-take
    Summary
  Summary
   

Dressing Regimen
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Dressings should be built in layers to protect the INTEGRA Template site from
shear and infection.

Layer 1.
Sterile elastic net dressing is applied in the OR
Dressing Regimen - Layer1

Layer 2.
The antimicrobial layer (e.g., moistened Acticoat* ) is applied over the elastic net dressing. The antimicrobial layer helps prevent bacterial contamination through seams and staple holes. In meshed INTEGRA Template sites, antimicrobials can penetrate down to the wound bed.

Acticoat*, Sulfamylon Solution 5% or silver nitrate 0.5% are most often applied. It is important to re-moisten or re-apply antimicrobial dressings as needed. The antimicrobial layer is most critical during the first week after application.

Dressing Regimen - Layer 2

Layer 3.
A bulky gauze dressing is applied over the antimicrobial layer to protect the site and to help reduce the potential for shearing and graft dislodgement. It also helps keep the antimicrobial dressing moist and in contact with INTEGRA Template.
Dressing Regimen - Layer 3

Layer 4.
A compression layer is applied over the bulky dressing. The compression wrap provides additional support and protection. As edema subsides, the wrap should be re-applied to ensure it is snug.
Dressing Regimen - Layer 4
*Acticoat is a trademark of Smith & Nephew.

 
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