Exam 3: Debridement Flashcards
Sharp Debridement
SELECTIVELY remove using forceps, scalples, scissors
Sharp Debridement - When to use
large amts of calluse, eschar, chronic, necrosis
Sharp Debridement - Contraindications
- low ABI (<8)
- ischemic ulcer
- thrombocytopenic & immunocompromised
- hypergranular tissue
- inability to identify tissue or depth
Autolytic Debridement
uses bodies enzymes to digest necrotic
SELECTIVE
- sheet of hydrogel, semipermeable foam, or hydrocolloid to call enzymes to come to the wound and destroy
Autolytic Debridement - Indications
- pts who cant tolerate other forms
- dry eschar removal
- chronic wounds- cross hatching then moisture retentive dressing for 2 days
Autolytic Debridement - Contraindications
- infected wounds or deep cavity wounds
Enzymatic Debridement
- chemical or enzyme (exogenous)
- only destroys devitalized tissue
SELECTIVE - very slow process
- enzymatic
Enzymatic Debridement - Indications
- INFECTED and uninfected wounds
- if they FAIL to respond to AUTOLYTIC
- with an antimicrobial
- with cross hatched eschar
Enzymatic Debridement - Contraindications
- wounds with deep tissue exposure, calluses, and fascial burns
Biological Debridement
Maggot therapy– they chew away at the necrotic tissue and release enzymes that break down necrotic tissue
- maggots not affected by antibiotics
- may decrease odor
! phychological aspect !
Surgical Debridement
- sharp debridement with scalpels, scissors, laser in a STERILE environment
NONSELECTIVE
Surgical Debridement - Indications
- ascending cellulitis or WET gangrene
- osteomyelitis
- nectrotic wounds
- wounds with undermining
Surgical Debridement - Contraindication
- patients who are on palliative care
Mechanical Debridement
use of force to remove devitalized tissue, material, debris
NONSELECTIVE
Mechanical Debridement: Scrubbing
high porosity sponge or brush to scrape the surface to remove necrotic tissue
RISK: may get healthy tissue in the process to use it on highly contaminated superficial wounds
