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Integ > Lab 2 - Debridement > Flashcards

Lab 2 - Debridement Flashcards

1
Q

Selective vs Non-selective debridement

A

Selective removes specific devitalized tissue

non-selective may include healthy tissue aswell

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2
Q

What are the 4 types of selective debridement?

A

Sharp

Autolytic

Enzymatic

BIological

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3
Q

If there are multiple options of debridement availible, what should be the first choice?

A

Sharp debridement

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4
Q

When is sharp debridement done?

A

When there is large amounts of necrotic tissue/callus/or bioburden

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5
Q

What is serial instrument debridement?

A

Use instrument to remove loosely adherent necrotic tisue

not very painful, sometimes called maintenance debridement

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6
Q

What is selective sharp debridement?

A

Use tool to cut nonviable tissue ALONG THE BORDER or viable tissue

note: painful, may bleed

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7
Q

When using sharp debridement, keep tool _____ to wound surface and rinse regularly with ________

A

Parallel

Saline

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8
Q

What are contraindications to sharp debridement?

A

Arterial insufficiency

pyoderma gangrenosum

Dry stable heel ulcer without signs of edema/fluctuance/drainage

Anything you cannot identify

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9
Q

How does autolytic debridement work?

A

Natural promotion of liqufacation of tissue by phagocytic cells and proteolytic enzyme that soften tissue and macrophages digest it

Cover wound in appropriate amount of moisture retentive dressing

slow process

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10
Q

Cross hatching can help with what forms of debridement?

A

Enzymatic and autolytic

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11
Q

What is enzymatic debridement?

A

Uses Collagenase(Santyl)

Works by digesting collagen from bottom up

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12
Q

Enzymatic debridement is most effective in ________ wound beds

A

Moist

note: may see increased drainage w/ enzymatic debridement

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13
Q

What are contraindications for enzymatic debridement?

A

Facial wounds,

emergent cases/ infection

heavy metals in dressing

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14
Q

Enzymatic debridement should be layed on how thick?

A

Approximately 2mm thick (thickness of a nickel)

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15
Q

What is biological debridement?

A

Green bottle fly or maggots are placed on wound every 2-3 days

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16
Q

T or F, maggots may harm viable tissue

A

F

17
Q

What are contraindications to biological debridement?

A

life threatening/limb threatening wound

bleeding abnormally

deep tracking wound

location of pressure

18
Q

T or F, nonselective debridement can increase risk of a wound becoming chronic

A

T

19
Q

What are types of mechanical (nonselective) debridement?

A

Wound irrigation

wound scrubbing

wound cleansing

wet-to-dry

whirlpool

pulse lavage

low frequency contact ultrasound

20
Q

What is wound irrigation?

A

Use of saline in a light pressure stream to clean wound surface

gentle enough to not harm viable tissue, appropriate for any wound

21
Q

What is wound scrubbing

What direction should you scrub?

A

Use gauze or sponge to get slough off of wound surface

scrub from the center -> outward

22
Q

What is wound cleansing?

A

Simular to wound scrubbing but with a cleanser

solution with surfactants that loosen material in wound bed

23
Q

What is wet-to-dry debridement?

A

Letting the dressing dry then pulling it out to pull out what tissues are stuck to it

can cause maceration

Gauze can stick and be left behind

Increase infection risk

Very labor intensive (x3 per day)

24
Q

What is whirlpool debridement

A

C level evidence

Wound is dipped in thermal whirlpool

increases fibroblast activity w/ heat and bloodflow

risk of maceration

25
Q

Whirlpool precautions?

Whirlpool contraindications?

A

precaution- clean granulating wounds, epitheliasing wounds, CHF, new skin graft

Contraindications- maceration, febrile condition, venous insufficiency, diabetic neuropathy

26
Q

What is the normal temp of the whirlpool?

Normal treatment time?

A

36.5-40C 37C optimal

10-20 minutes 1-2x per day

27
Q

What is pulse lavage?

What are the benefits?

What is the normal PSI?

A

Used gun to provide pressurized saline and then negative suction to remove debris

can effectively get into tunnels and undermining

normal psi is 4-8, dont go over 15

28
Q

What are pulse lavage contraindications?

A

Body Cavities

Facial Wounds

Recent Grafts

Near arteries,nerves,tendons,bones

29
Q

What is low frequency contact ultrasound?

A

Use of ultrasound for anti-microbial properties

contraindications: pregnant, over gonads, cancer, DVT, spinal cord after laminectomy, hemophiliac w/o medication

30
Q

What is surgical debridement?

A

Done by physician or podiatrist

31
Q

Overall debridement indications

A

Necrotic tissue

foreign material

debris

callous

blister

32
Q

overall debridement contraindications?

A

granular tissue

stable/hard

deeper tissue

needs surgical debridement

unable to see clearly

unable to identify structure

Integ (14 decks)

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