Integ (wound care)

Question 1

What are some topical antimicrobial agents?

Answer 1

Silver nitrate
Silver sulfadiazine
Erythromycin
Gentamicin
Neomycin, triple antiobiotic

Question 2

How can you help manage edema?

Answer 2

Elevation, and exercise (ankle pumps)
Compression therapy (contraindicated with ABI

Question 3

Which type of electrical stimulation can be used to improve circulation?

Answer 3

Pulsed currents (monophonic, biphasic, and polyphasic)
Monophonic (low-volt continuous, or high-volt pulsed) used more for wound healing

Question 4

How can a monophonic current (low-volt continuous modulations, high-volt pulsed currents) help with wound healing?

Answer 4

Electrical potential theory: Restoration of electrical charge in area
Bactericidal effect: Disruption of DNA, RNA synthesis, or cell transport system of microorganisms
Biochemical Effects: Increased ATP concentration, amino acid uptake, and increased protein and DNA synthesis
Galvanotaxic effect: Attraction of tissue repair cells via electrode polarity.

Question 5

Which polarity would you use to get the galvanotaxic effect? (attract of tissue to repair cells)

Answer 5

During inflammation: Positive polarity attracts macrophages, negative polarity attracts mast cells
During Proliferation Phase: Positive polarity brings in fibroblasts
Wound Contraction Phase: Alternate between positive and negative.
Epithelialization phase: Epithelial Cells are brought in by positive polarity

Question 6

Describe autolytic debridement

Answer 6

Natural debridement. selective; only necrotic tissue is liquefied. It is also virtually painless for the patient.

Question 7

When do you want to use autolytic debridement and when don’t you want to use it?

Answer 7

Use: Individuals on anticoagulant, can’t tolerate other forms of debridement

Don’t: Infected wounds, wounds of immunosuppressed individuals, dry gangrene or dry ischemic wounds

Question 8

When and when do you not want to use enzymatic debridement?

Answer 8

Use: All moist necrotic wounds, eschar after cross-hatching, homebound individuals, people who cannot tolerate surgical debridement.

Don’t: Ischemic wounds, dry gangrene, clean granulated wounds

Question 9

What’s the difference between mechanical and sharp debridement?

Answer 9

Mechanical: uses wet-to-dry cause dressing and may remove healthy tissue as well (don’t use on clean granulating wounds)

Sharp: Uses sterile instruments that sequentially remove only necrotic wound tissue without anesthesia (don’t use on clean wounds or when infection is threatening patient’s life or if they are on anticoagulant therapy

Question 10

When is surgical debridement needed?

Answer 10

for deep (stage III and IV) or complicated pressure ulcer.