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  Excision
  Application
    Neodermis formation
    Signs of mature Neodermis
    Dressing regimen
    Bolstering and splinting
    Frequency of dressing changes
 
    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
   

Positioning the Patient
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Dressings and splints are critical to protecting INTEGRA® Template sites, however, extra care must be taken to avoid shearing and dislodgement when moving the patient. Shearing can result in the formation of hematomas, fluid accumulation, and ultimately, infection. The techniques deployed in positioning and moving the patient may help to reduce the chance that this mechanical dislodgement will occur when the patient is transported or positioned. It is important to plan your strategy for moving the patient ahead of time, ensure that you have sufficient help to move the patient.

Specialty Beds can be an important tool in caring
for the INTEGRA® Template patient. These beds, generically known as intermittent zero pressure or
air fluidized specialty beds, have low air loss mattresses designed to maintain appropriate core
body temperatures. Additionally, they are adjustable, compensating for the prone or supine patient. Care should be taken to ensure that the patient is appropriately dressed and bolstered while manipulating the bed.
Specialty Beds

Elevation of Appendages. The occurrence of edemas is not uncommon in burn patients. Left unattended, edemas may lead to excessive fluid accumulation and infection in INTEGRA® Template patients. Elevating arms and legs may help in reducing edema. Elevate the appendage to decrease edema by suspending the limb by the stretch net, bulky dressing, or padded elbow from an IV tree. Care should be taken to ensure that excessive stress is not placed on INTEGRA® Template sites as a result of this technique. Elevation of Appendages.

Walkers and Other Self-Assistance Devices. Most of these devices are common sense driven. Your physical therapist may be able to suggest alternative modifications to existing ambulatory devices that will better fit your patient's needs. Generally, devices that allow you to keep your hands off the patient are ideal. If patients are able to ambulate, helping them do so may help speed their recovery. There are a variety of walkers that allow patients to bear weight on their arms and not on their INTEGRA® Template sites. They alleviate the need to hold patients by their arms and can actually enable them to ambulate on their own. Self-assistance, "monkey bars," and overhead bars that allow patients to pull themselves up will help you move and position the patients. Walkers and Other Self-Assistance Devices.

Re-Positioning the Patient (Straight Lift with Sheet). It is easy to make a mistake and try to move the patient by grabbing an INTEGRA® Template site.

If you grab a patient under the arms and drag them across the bed, you will risk shearing the INTEGRA® Template sites, particularly on the patient's back, buttocks, or legs. Use a straight lift with a sheet or blanket under the patient. Use enough manpower to adequately lift the patient comfortably.

(Straight Lift with Sheet).

 

 
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