Modalities Flashcards
E-Stim theory
Skin: (-) Charge
Wound (+) Charge
Galvanotoxic Effect:
-Anode: attracting neutrophils and macrophages
-Cathode: attracting neutrophils (when inflamed) and fibroblasts
-Can be inhibited by dehydration, non-conductive material
*E-stim mimicking body’s electrical signal to promote healing
Electrical potential for wound healing during first 3-4 days is ____ and then becomes _____
first 3-4 days: positive then becomes negative
Parameters for HVPC
Frequency
Pulse duration
Amplitude
Placement
Frequency: high
Pulse duration 60-100
Ampltiude: sub-motor
Electrode placement: monopolar w/ active wound bed
Ultrasound effective in (what stages)
- inflammatory
- early proliferation
*if used at low intensities
Ultrasound and Inflammatory Phase
-US can increase the release of growth factors & stimulation of cells in early healing (mast cells, microphages)
-Accelerates the inflammatory phase - not an anti-inflammatory agent
Ultrasound Proliferation Phase
-Accelerated
-fibroblastic activity increased
-increases macrophages
Ultrasound and Remodeling Phase
-mechanical properties of scar tissue are altered when exposed to US during the inflammatory and proliferation phases
-better patterning of scar tissue
UV light
- Bactercidal effect; due to interruption of DNA or RNA synthesis
- Erythemal Response; inititaling inflammaotry response, vasodialation and increase capillary permeability
- Vit. D Production
Infrared
Superfical dry heating agent - effects of increased blood flow and capillary permeability
Mechanical Debridement used for
superficial and scant slough; small visual foreign bodies
Mechanical Debridement Advantages
Easy
Inexpensive
Mechanical Debridement Disadvantages
Non-selective
Can be harmful to healthy/granulating tissue
Chemical Debridement used for
Large areas, eschar
Chemical Debridement advantage
more selective than mechanical
Chemical Debridement disadvantage
expensive
-when they aren’t selective they can be dangerous
Autolysis used for
most wounds at some point in healing
Autolysis advantage
Natural process
Autolysis disadvantage
slow; microbials can get in and cause infection
Whirlpool objectives
- clean and debride wound
- decrease bacteria formation
- increase circulation
- promote granulation and epithelialization
Systemic effects of whirlpool
- decrease HR and RR
- Supress thermoregulatory system
- Sedation and analgesia
- muscle relaxation
Physical and Mechanical Effects of whirlpool
- softens eschar, loosens necrotic tissue
- deodorizes and cleanses the wound
- soaking removes dressings
- stimulates granulation tissue due to agitation
- maceration of periwound area
Indications for whirlpool
Necrosis
Ischemia (poor blood flow)
Debris
Contraindications of whirlpool
-venous insufficiency
-DVT
-DM
-fever
-incontinence
-compromised pulm status
-lethargy
-cardiac diseases (pacemakers & defib)
-gangrene (dry)
-renal failure
-severe phebitis
-unresponsive
-serve contractures that limit positioning in whirlpool
-casts
Pulsatile Levage only has ___ effects
local
