Modalities In Wound Care Flashcards
Which 2 modalities are used for cleaning
pulsed lavage and whirlpool
which modalities are used for healing
estim, wound vac, pulsed lavage, MIST ultrasound, hyperbaric oxygen
what occurs during the acute phase of healing
trauma
vasoconstriciton
increased vessel permeability
what occurs during the proliferative phase
granulation tissue forms
angiogenesis occurs
epithelial cells migrate across the wound bed
what occurs during the maturation phases
type III collagen remodelded to type I collagen
tissue strength increases to up to 80% pre-injury state
mechanism of action for estim
the current of injury is used to increase circulation and oxygenation
facilitates phagocytosis
attracts fibroblasts and epithelial cels to control infection
what is estim indicated for
just about any chronic wound
chronic means that it hasn’t healed after 30 days
contraindications for estim
placement of electrodes over the heart, gentials, carotid sinus
cardiac pacemeaker
malignancy
osteomyelitis
what is the charge of the skin
the skin is electronegative because sweat accumulates on the skin with Cl- left on the surface
what is the charge of the wound bed
electropositive in relation to the surrounding tissue
when skin breaks a current is started and all the neutrophils and fibroblasts that are negative are attracted to the positive wound to promote healing
how long do we wait until using estim and why
wait 30 days because this is when the natural current of injury disappears
procedure for estim
rotate every 3 days between negative and positive and start with the NEGATIVE electrode
What is pulsed lavage
hydrotherapy that uses pulsed, pressurized saline to cleanse and debride a wound, suction removes saline and matter from the wound
mechanism of action for pulsed lavage
removal of necrotic tissue and suction promote granulation
indications for pulsed lavage
just about anything (pressure, arterial, venous, nerptahic, traumatic and surgical wounds)
when is whirlpool more efficient than pulsed lavage
for wounds that are too large
advantages of pulsed lavage
quicker set up time
decreased risk of cross contamination and maceration
cost-effective
access to sinus tracts and tunnels**
what is whirlpool indicated for
arterial insufficiency
diabetic ulcers
necrotic wounds
ischemic wounds that need more circulation
contraindications for whirlpool
clean wounds new skin grafts ****venous wounds/edematous wounds**** febrile conditions incontinence renal failure dry gangrene
mechanism of action of whirlpool
warm water vasodilates superficial blood vessels, the increased circulation removes metabolites and brings leukocytes for cleaning
water also allows for mechanical and autolytic debridement
granulation tissue is stimulated from agitation of the water
exudate is rinsed by the water
warm water also offers pain relief and sedation
mechanism of ultrasound
vibration causes mast cells to release histamine which attracts monocytes and neutrophls
when is ultrasound indicated
for all types of wounds
contraindications of ultrasound
pregnancy
malignancy
ossificans
acute infection
disadvantage of ultrasound
not effective and not well supported by research
mechanism of action for hyperbaric oxygen
increases tissue oxygenatoin, collagen deposition, angiogenesis while decreasing anaerobic bacteria and excess MMP’s in chronic wounds
what is HBO therapy indicated for
wounds that aren’t healing well
commonly diabetic ulcers
contraindications for HBO therapy
untreated pneumothorax
taking any medications for cancer treatment
what is the advantage to HBO therapy
evidence has showed decreased incidence of LE amputations when used on diabetic ulcers
mechanism of action for NPWT
promotes granulation, increases blood supply and draws in the wound via suction
what is NPWT indicated for
chronic wounds trauma partial thickness dehisced wounds diabetic and pressure ulcers
contraindications for NPWT
malignancy
untreated osteomyelitis
exposed vessels or organs
necrotic tissue with eschar
