Skin Deep
January/February 2013
An Advanced Tissue newsletter written by Carolyn Brown BS, MEd, RN, ARM, CWS, FACCWS Ask Carolyn:
Q: I am a new treatment nurse in Utah and have a question. Our Medical Director
is ordering Silvadene Cream for all chronic wounds. Would you describe this
product and summarize any precautions.
A Silvadene
A:
Sil d
Cream
C
is
i a topical
t i l antimicrobial
ti i bi l drug
d used
d ffor the
th prevention
ti and
d
treatment of wound infection in patients with second- and third-degree burns.
Before using Silvadene, obtain a medical history specifically including:
•Allergy to silver sulfadiazine or another sulfa antibiotic (such as sulfamethoxazole)
•Kidney or liver problems or low WBC
Various products may interact with Silvadene, including:
•Cimetidine (Tagamet)
•Phenytoin (Dilantin),skin products containing sodium sulfacetamide
•Enzymes used to remove dead tissue such as collagenase (Santyl)
Have a question for Carolyn? E-mail mhendrix@advtis.com .
What is the difference
between Slough and
Eschar isn’t it all dead tissue?
Injury or lack of blood flow to the skin results in
necrotic or dead tissue. As the tissue dies, it
changes color and consistency and adheres to the
wound bed.
bed Necrotic tissue is called either slough
or eschar.
Slough is hydrated (moist) necrotic tissue. The
color of slough varies, including: yellow, gray, tan
and brown. Slough is soft and thin, fibrinous or
stringy.
Eschar is dryy ((no moisture)) necrotic tissue;; it has a
firm, dry, leather, black-to-brown appearance. As
eschar is moistened, it slowly turns to slough.
The presence of slough or eschar indicates full
thickness tissue damage and effective treatment
requires debridement.
Possible Alternative
for Silvadene Cream
An alternative treatment
for wounds not caused by
a burn is SilvaSorb Gel.
A detailed study
comparing Silvadene
Cream and SilvaSorb Gel
can be found on the
Advanced Tissue website
for your review.
www.advtis.com
Weight Loss:
Indicator for delayed healing
Adequate nourishment is critical to healthy skin and
wound healing. Literature suggests that weight loss is a
significant predictor of pressure ulcer development and a
strong indicator of delayed healing. The dietician should
be consulted regarding significant weight loss as a
prevention intervention.
intervention
Variations in Normal Healing
The events associated with wound healing do not always
proceed smoothly. Two deviations in healing may occur
even with optimal care: Exuberant granulation, or proud
flesh,, results from the formation of excessive ggranulation
tissue that may protrude above the margins of the
wound.
Keloids are large, bulging, scars
caused by abnormal amounts of
collagen present in the connective
tissue. Consult the physician for
treatment orders.
For more information about Advanced Tissue, please call 866‐217‐9900 or go to advtis.com
We recommend you copy our newsletter and post for your clinicians to read. After all clinicians have initialed--file in an education binder.
During survey, this binder will document multiple educational opportunities you have provided.