Modalitites Flashcards
Define chronic wounds and explain why they may require adjunctive wound modalities.
- Chronic wounds fail to respond to standard care and show stalled healing for over 30 days.
- Adjunctive modalities can help reduce bioburden and necrotic tissue.
What are the main challenges in research supporting wound modalities?
Challenges include:
- Patient-related variables
- Wound-related variables
- Treatment-related variables
- Research-related problems
- Manufacturer-sponsored research
List general indications for adjunctive wound modalities and considerations for selection.
- Adjunctive modalities are indicated for chronic wounds needing enhanced healing.
- Consider patient characteristics, wound location, treatment setting, and equipment.
What is the purpose of wound irrigation, and what pressures are recommended?
- Removes debris, bacteria, and exudate
- Recommended pressures are 4-15 psi
List the indications, contraindications, and common methods for wound irrigation.
- indicated for all wound types
- contraindicated in profuse bleeding
- methods include syringe or pressurized saline
Describe the effects of whirlpool therapy and list its common indications.
- softens necrotic tissue, promotes circulation, and reduces pain
- indicated for infected wounds, thick eschar, and pain relief
What are the contraindications and disadvantages of whirlpool therapy?
- Contraindicated in clean, granulating wounds and hydrophobic or seizure-prone patients.
- Disadvantages include risk of maceration and cross-contamination.
What are the effects and recommended irrigation pressures for pulsed lavage?
- facilitates debridement and improves granulation
- 4-15 psi
- includes suction to remove contaminants
List indications, precautions, and key setup considerations for pulsed lavage.
- Indicated for wounds needing debridement
- Precautions include exposed deep tissues and anticoagulant use
- Requires clean room and PPE
What are the general purposes of electrical stimulation (ES) in wound care, and which types of wounds are typically treated?
- ES promotes healing, manages inflammation, and enhances wound contraction
- Suitable for all wound depths
Compare effects of the negative pole (cathode) vs. the positive pole (anode) in ES.
- Cathode: decreases edema, promotes granulation, bactericidal.
- Anode: promotes healing, coagulates protein, attracts macrophages.
What are contraindications for ES in wound care?
Untreated osteomyelitis, malignancy, heavy metal-based topical agents, pacemakers, and reflex center wounds.
Describe the method and common settings for ES, including polarity changes.
Frequency: 120 Hz,
Intensity: 75-200 V, submotor;
Change polarity every 1-3 days; 45-60 mins, 3-5 days/week.
What are the main purposes of high-frequency vs. low-frequency US in wound care?
High-frequency: improves collagen deposition and contraction.
Low-frequency: debridement, reduces wound bioburden.
Describe the indications, methods, and precautions for traditional high-frequency US.
- Indicated for recalcitrant wounds;
- Methods include direct or immersion;
- Precautions include osteomyelitis and DVT.
Explain diathermy’s mechanism and effects on wound healing.
Uses RF energy for heating; increases circulation, fibroblast function, and nitric oxide release; contraindicated on moist wounds.
Compare the effects and indications of UVB vs. UVC light in wound healing.
UVB induces inflammation and granulation
UVC is bactericidal, enhances granulation, and inactivates microorganisms.
What are common delivery methods and contraindications for UV therapy?
- Delivered via LEDs or lasers;
- Contraindicated:
- malignancy
- DVT
- deep vein thrombosis
List the main purposes and effects of NPWT.
- reduces edema
- increases granulation
- maintains moist environment
- promotes wound contraction
- decreases bioburden.
Describe Negative Pressure Wound Therapy:
- indications = ?
- contraindications = ?
- common settings = ?
- Indicated for chronic and postsurgical wounds
- contraindicated in necrotic or eschar wounds and exposed organs;
- Pressure: 50-175 mmHg
What are the setup steps and common disadvantages of NPWT?
- Steps: irrigate, debride, apply foam, connect tubing, cover with drape.
- Disadvantages: pain, mobility restriction, air-tight seal issues.
What are the purposes and effects of HBO on wound healing?
Increases oxygen gradient, reduces bacteria, enhances angiogenesis, reduces edema; useful in ischemic wounds.
List indications, contraindications, and general treatment protocol for HBO.
- indications: gas gangrene, ischemia, osteomyelitis
- contraindications: DVT, CHF, pregnancy; 2x/day–3x/week, 10-60 sessions.
Explain the mechanisms of ESWT and CAP in wound healing.
- Extracorporeal Shock Wave Therapy (ESWT): enhances microcirculation and metabolism.
- Cold atmospheric plasma (CAP): promotes fibroblast proliferation, keratinocyte growth, and angiogenesis.
List the main criteria for selecting a wound modality for a specific patient.
Consider patient characteristics, wound type, treatment setting, availability, and modality pros/cons.
What should be monitored when using adjunctive wound therapies, and when should a therapy be discontinued?
Monitor wound progress; discontinue if no improvement within 2 weeks.
Explain the role of the clinical setting and available resources in wound modality choice.
Availability, equipment access, and patient tolerance all influence modality choice and practicality.
Summarize the importance of modality effects, contraindications, and overall goal for wound adjunct therapies.
Understand effects, recognize contraindications, and aim to promote safe, effective healing by choosing suitable adjuncts.
