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Michelle Whyte Pharmacist Kawerau Pharmacy Largest organ in the human body Key role in immunity (interfaces with the environment – protection from bacteria, viruses, fungi) Controls water loss Insulation Temperature regulation Sensation Synthesis of Vitamin D Pain Redness Swelling Heat Loss of function All skin wounds are colonised by bacteria but not all are infected Most minor skin infections are self limiting Wounds will show symptoms of inflammation while healing – care not to confuse with infection Need to watch for multiple wounds New or increased pain Swelling Erythema (redness) Purulent exudate Malodour Localised warmth Multiple sites eg impetigo Antiseptic – not always necessary Saline wash – not always necessary Appropriate dressings – waterproof, nonwaterproof and gentle paper dressings (for delicate skin) Preventing cross-contamination Referral if necessary Reduces infection risk Increases healing rate Reduces scarring Change dressing every 2 to 3 days or more frequently if a lot of bleeding occurs Most dressings allow you to be able to see the discharge coming from a wound so you can monitor if it is infected or not Diabetic Chemotherapy patients Elderly History of cellulitis Tracking from wound site up the vein Multiple infected wound sites that require oral antibiotics Wound that needs cleaning (debris in wound) Deep wounds that require stitches (deep, high movement area of body) Draw around the outside of the red ring around the wound and write the time next to the line Every few hours repeat this process If the redness covers a bigger area each time then need to refer to the doctor Watch for tracking Prevent growth and development of a wide range of micromicro-organisms without necessarily killing them. Work externally only Help to prevent infections Can contribute to bacterial resistance but not to the same extent as antibiotics Available on prescription and over the counter Some controversy over whether they slow down the healing process Some are not suitable for use on open wounds Contains povidone iodine Cream is funded on prescription Apply two to three times daily Got for a wide variety of micro-organisms (bacteria, viruses, fungi) Cetrimide, chlorhexidine Use once or twice a day Chloroxylenol Dilute according to pack and use to cleanse wound Contains hydrogen peroxide No known resistance to crystaderm Apply two to three times a day and do not use for longer than 3 weeks Chemicals that kill and stop the growth of bacteria Only work on bacteria Issues with bacterial resistance Should only be used for minor localised areas of infection eg impetigo Only available on prescription It is important that it is used until the wound has completely cleared up to prevent resistance issues (do not use intermittently) First line treatment One tube per prescription is funded, repeats are not funded Recently was on the news in regards to helping increase antibiotic resistant rates Often prescribed with an oral antibiotic Second line agent when treating Fobanresistant bacteria Should be reserved for treatment of MRSA that is not resistant to Bactroban (via testing)