Bioburden Flashcards
bioburden definition
microbial burden in the wound
microorganisms present in the wound
what is biofilm scientifically
extracellular polysaccharide matrix
what is biofilm in basic terms
protective coating produced by colonies of microorganisms
what types of wounds does biofilm cover
chronic wounds
after debreiment of microfilm, what is effective within what time frame
topical agents - within 24 hours
after debreiment of microfilm, what is not effective within what time frame
topical agents - after 72 hours
how do topical agents affect a wound
they kill non-dormant microbes that are metabolically active
how to microbial colonies communicate? who do they communicate with? why?
other microbial colonies via chemical messages
planned dormancy across a wound to ensure non-effectiveness of topical agents
examples of bioburden formations
eschar
slough
necrotic tissue
what are the types of deberiment?
slow and fast
examples of slow debreiment
autolytic
enzymatic
how is autolytic vs enzymatic debreiment different
autolytic - use of the body’s own enzymes under the cover of dressing
enzymatic - added solution containing enzymes
what medical professionals can perform sharp debreiment
PT and MD
what is mechanical debreiment
person performed clearing of the wound using manual techniques
what is something to keep in consideration of bioburden
can communicate a planned spread of the injury to nonaffected areas
how is a biofilm formed
microorganisms will
contaminate the wound surface
attach to the surface
alter genetic code
exude extracellular polymeric substance
what is biofilm resistant to
antibiotics
antimicrobials
how is biofilm removed
sharp
maggot
ultrasonic
– debreiment techniques
what controls the risk of infection in the body
individuals immune system
environment in the wound
type of organisms looking to attack
virulent
rapidly producing microorganisms
- will take over tissue easily
what environment is best for avoidance of infection
moist and warm
balanced pH
sufficient oxygen supply
how does diversity of microbes affect the wound care plan
more diversity (aerobic and anaerobic) microbes cause topical agents to be less effective
– will need very strong topical agents that could in turn damage healthy cells
contamination
organism present on wound surface
colonization
organisms multiply on wound surface
early reversible adherence
irreversible adherence of organisms in the tissue
s/s associated with contamination
none
s/s associated with colonization
none
what is another name for biofilm
critical colonization
s/s of biofilm
delayed healing
local infection
infection definition
organisms invade tissue
systemic response occurs
organism # related to infection
100,000/gm
induration of ___ cm indicates infection
within 2 cm of wound edge
compare local vs systemic infections and the relation of each to the wound
local - within the margins of the wound up to 2cm outside the wound
systemic - extend beyond the margins of the wound
examples of systemic infections
cellulitis
osteomyelitis
meningitis
endocarditis
bacteremia
sepsis
what is an indirect result of endocarditis
cardiac tamponade
if bone is seen in a wound, what should you be concerned with? what is the plan of action from there?
osteomyelitis
MRI
what # of symptoms do you need on a clinical signs and symptoms checklist to rule in an infection
3
what are the clinical signs and symptoms frameworks
NERDS
STONEES
what is NERDS
n - non healing
e - increased exudate
r - red/bleeding granular tissue
d - debris / eschar in wound
s - smell
what is STONEES
S - size
T - temperature increase
O - exposure to bone
N - new areas of breakdown
E - exudate changes
E - erythema / edema
S - smell
management of bioburden
cleanse wound / periwound skin
irrigation/pulsating lavage
debride necrotic tissue
antimicrobial dressings
time table of antimicrobial dressings
work for up to 7 days
methods of wound culture
cleanse thoroughly
pick healthiest wound tissue
- no necrotic tissue
take sample
what are the types of culture taking techniques
z - culture
spin culture
how often is sharp debreiment repeated
every 7 days
NPWT
negative pressure wound therapy
examples of topical agents
cadexomer
iodine
silver sulfadizaine
honey
chlorhexidine
explain how iodine kills microbes
nondiscriminatory
how does honey kill microbes
cuts off their oxygen supply
how does cadexomer iodine kill microbes
modifies the iodine compound and releases iodine on a timed basis
compare iodine and antimicrobial agents
iodine - kills everything
antimicrobial - discriminates the cells killed
low toxicity antiseptics
saline
tap water
PHMB
chlorhexidine
povidone-iodine
high toxicity antiseptics
hydrogen peroxide
socium
hypochlorite
ammonia
dyes
iodine
what is cadexomer put on
granular / new tissue
