Debridement Flashcards
What to debris?
slough and eschar to minimize growth of organism
What is non selective debridement
removes necrotic and living tissue
no way of telling what you are taking out wound, may be taking good and bad tissue
Examples of non selective debridement?
wet to dry dressings
chemical
water debridement
Indications of of non selective
- infected wounds
- wet slough
- > 70% nerotic tissue
- stop whirlpool when >30% granulating tissue
What is semi-selective debridement?
viable and non viable tissue removed
What does semi-selective debridement remove?
loose, mobile nonadherent slough
What do you use for semi-selective debridement?
sharps, stop if bleeding; contraindicated if arterial wound and anticoagulants
Four reasons why you should stop debridement?
Bleeding
patient requests
fatigue
inexperience
What kind of debridement is it if no viable tissue is distrubed?
selective
Two types of selective debridement:
enzymatic (chemical to break down specific components) and autolytic
What are 3 specific enzymes used in debridement?
Collagenase (digests collagen and is slow)
Papain and Urea (digest fibrin and is banned)
What is autolytic debridement?
natural enzymes in wound fluids are contained under synthetic dressings, allowing macrophages and engulf necrotic tissues (contraindicated with infection)
What are advantages of Calcium Alginates?
-with infection
-deep wounds
- light to mod exudate
- easily removed
Disadv: maceration
Semipermeable films
- transparent
- permeable to moisture vapor and oxygen
- impermeable to bacteria and water
- idea for minimul exudate
- covers stage I or II
Semipermeable Foam
- moderate to high exudate
- not transparent
- not for infected wounds
Impermeable Hydrocolloids
impermeable to water, bacteria, oxygen, other gases
anaerobic healing
-expands as it absorbs
-high levels of exudate
What compound is effective against SA, MRSA and Pseudomonas?
Silver
What is active against gram positive infections?
Mupirocin
How many mmHg of pressure would be on a venous ulcer compression?
at least 30
What is hemociderine
red color that forms on wounds
On arterial ulcers do not
elevate or sharp debride
What should you apple silver sulfadiazine to?
trunk burns
Facial burns apply:
neomycin, bacitracin
autograft
person
allograft
another person
xenograft
animal
Culture:
not good
