Debridment choice

Question 1

this type of debridement is least painful, all wound types utilize some aspect of it and req. minimal technical skill form PT

However, arterial wounds have difficulty solely depending on this debridement for healing, slow process, & req. multiple dressing changes

Answer 1

Autolytic debridment

Question 2

what is an absolute contraindication for use of autolytic debridment?

Answer 2

infection

Question 3

The pro’s of using this debridment tech. is that it selectively tragets + destroys collagen that anchors necrotic tissue with no increase in discomfort for the patient and is faster than autolytic.

However, there is potential for skin maceration and can be deactivated when used with other things (silver, iodine)

Answer 3

enzymatic

Question 4

list 4 types of mechanical debridment

Answer 4

1. soft abrasion (use on epibole)
2. wet to dry/moist (NOT recommended)
3. hydrotherapy (NOT recommended espec w. CVI or diabetic wounds)
4. Low freq. ultrasound

Question 5

PROs
if need for sterile env and wound is infected

CONs
wounds come back larger and healthy tissue removed as precaution

Answer 5

Surgical debridement

Question 6

Patients on blood thinners are considered as a precaution when using which debridement technique?

Answer 6

sharp conservative deb.

Question 7

this type of debridement works by removing necrotic tissue, has antimicrobial activity, and facilitates healing

Answer 7

biological deb.

Question 8

what are goals of a primary dressing?

Answer 8

prevent adherence
moisture additive/retention

Question 9

what are goals of secondary dressings?

Answer 9

absorb exudate
provide cushion/protection
prevent drying

Question 10

skin protectants act as ______ and protect skin from mechanical injury caused by tape and help prevent maceration

Answer 10

moisture barriers

Question 11

what are contact layers?

Answer 11

barrier b.w wound surface + secondary dressing

Question 12

T / F Contact barriers allow exudate to pass and protect wound from trauma

Answer 12

T

Question 13

what wounds would you avoid using contact layers with?

Answer 13

dry wound or wound that needs contact moisture from secondary dressing
3rd degree burns?

Question 14

Transparent films should not be used on wounds that are _____ or have lots of exudate because this dressing type is only used as prevention from _______ forces on heels.

Answer 14

infected; shear/friction

Question 15

which dressing promotes autolytic debridement via rehydration?

Answer 15

hydrogels

Question 16

what wounds would you avoid using hydrogels with?

Answer 16

heavy exudate
macerated periwound
infected wounds

Question 17

______ provide cushion over bone, maintain moist wound environment, promotes autolytic debridment and can be used under compression wraps

Answer 17

hydrocolloids

Question 18

Hydrocolloids are not effective on wounds with _____ and should not be used if a wound is _____

Answer 18

dry eschar; infected

Question 19

this type of dressing wicks away fluid from a wound and can be used if there is mod-heavy exudate and if a wound is infected

Answer 19

foams

Question 20

precautions when using foam as dressing?

Answer 20

if 3rd degree burn or if there is little exudate present (probably wouldn’t use this)

Question 21

if patient has dry wound, which dressing would u avoid using?

a. alginates
b. foams
c. contact layers
d. hydrocolloids
e. more than one
f. collagens

Answer 21

a. (fibers react w. exudate and form gel for moisture)
b. used on mod-heavy exudate cause wicks away fluid
c. barrier b.w 2nd dressing that will provide moisture
f. absorbs mod exudate

dry wound: use hydrogels, hydrocolloid, saline soaked gauze

Question 22

which dressing can you use on infected wounds?
a. hydrocolloid
b. foam
c. alginates
d. transparent film
e. hydrogels
f. more than one

Answer 22

more than one
b. c

Question 23

this dressing is used as a primary dressing that absorbs exudate and can be used with partial thickness burns, diabetic foot ulcers, and trauma wounds

Answer 23

hydrofibers

Question 24

this dressing type should not be used with oil based products especially if infused with silver

Answer 24

Hydrofibers

Question 25

_____ provide mod absorption of exudate and is used if wound does not have necrotic tissue but precautions should be taken if dealing with 3rd degree burns, dry wounds, or wound with eschar

Answer 25

collagens

Question 26

this dressing type can be used as secondary dressing to absorb exudate

Answer 26

gauze

Question 27

during contamination phase of bioburden is there multiplying or sxs of infection?

Answer 27

NO

Question 28

during colonization phase of bioburden is there multiplying or sxs of infection?

Answer 28

yes and no

Question 29

during critical colonization is there multiplying or sxs of infection?

Answer 29

Yes and 1-2 sx’s of infection

Question 30

during infection phase there are both local and systemic sxs of infection
T or F?

Answer 30

T
3 or more Sxs

Question 31

Which antiseptic is good for keeping eschar stable and dry?
a. methylene blue
b. betadine
c. hydrogen peroxide
d. cadexomer iodine

Answer 31

b. betadine

Question 32

which antiseptic may cause a gas emboli in deep wounds if used?

Answer 32

hydrogen peroxide

Question 33

this antimicrobial is used to decrease bioburden, should not be used w. other antimicrobials, and should only be used for short periods cause body can become resisted to it

Answer 33

silver

Question 34

this antimicrobial promotes autolytic debridement and moistens the wound bed with it’s acidic pH and can be used on infected or highly contaminated wounds

Answer 34

honey

Question 35

this antimicrobial has limited research on it’s use but has been clinically shown to dec inflammation, improve granulation, and reduce epibole

Answer 35

methylene blue

Question 36

which antimicrobial should be avoided if patient has a dry wound, hyper/hypothyroidism, or is pregnant?

a. methylene blue
b. cadexomer iodine
c. betadine
d. silver

Answer 36

b

Question 37

this can be used to tx chronic, non-healing wounds and to reduce odor by removing pus, exudate, and debris.

a. methylene blue
b. cadexomer iodine
c. betadine
d. silver

Answer 37

b