NPWT Flashcards
What do you use to clean a wound
- noncytotoxic wound cleaners (normal saline or commercial)
- will not damage or kill fibroblasts and healing tissue
why is a 35ml syringe with 19-gauge angio catheter used for wound irrigation? and what pressure is being delivered for wound?
does not damge wound tissue. Uss low pressure of 4-15psi to avoid trauma to wound bed and to not damage healing wound
A pt. has a pressure ulcer X and a student nurse thinks about irrigating the wound? is this helpful or contrindicating to the clients condition?
contraindicating - avoid irrigating wounds when the base cannot be determined
what is debridement and what is its use
removal of non-viable, nercotic tissue:
- rids the injury of a source of infection
- enables visualization of wound bed
- provides a clean base for healing
which kinda debridement does a nercotic heel ulcer use?
none. Black eschar should not be debrides if there is no evidence of infection
sharp/ surgical debridement
Sharp or surgical debridement is the most efficient way to reach vitalized tissue at the base of a
wound.
- Used when sepsis is localized and excised.
- Scalpel, scissors or other sharp instrument is used.
- Must have the knowledge, skill and competence to perform this procedure (physicians, advanced
practice nurse).
autolytic debridement
In autolytic debridement synthetic dressings are used over a wound to allow the eschar and
fibrinous slough within the wound to be self-digested by the action of enzymes that are present in
wound fluids.
- Dressings that support moisture at the wound surface (e.g., hydrogel or hydrocolloid) maintain a moist wound bed (“moist like your eyeball”), which allows the movement of epithelial cells and facilitates wound closure.
- A wound that has excessive exudate (drainage) provides an environment that supports bacterial growth, macerates the peri wound skin, and slows the healing process.
- If exudate is excessive, an absorptive dressing (e.g., calcium alginate, hydro fibre, or foam) should be used, and volume, consistency, and odour drainage evaluated to determine whether infection may be present.
chemical/enzymatic debridement
- Chemical or enzymatic debridement is another option. Topical enzymes induce changes in the
substrate, resulting in the breakdown of necrotic tissue. - Depending on type of enzyme used, will either digest or dissolve tissue.
A student nurse applied topical enzymes on the wound bed and the peri wound tissue. Whats wrong with this statement
you dont apply that kinda debridement on the periwound
biological debridement
Biological debridement is the use of maggot therapy. Sterile maggots are used in a wound because they ingest the dead tissue and do not impede granulation.
- Wound before maggot debridement therapy. This wound, covered with a thick layer of slough, failed to respond to conventional treatment over 18 months.
- Wound following three applications of maggots. The wound is completely free of slough and rich with granulation tissue.
mechanical debridement
Mechanical debridement, or a “wet-to-dry” saline gauze dressing, is not considered appropriate, as it is nonselective in its removal of both devitalized and viable tissue.
-Wet-to-dry causes mechanical separation of eschar from the wound bed once the dressing is removed (can cause considerable pain).
A nurse used hydrocolloid dressing on a pt and after a week, the wound starts getting better, what must the nurse do next?
choose a different type of dressinf after assessing wound base characteristics
what is negative pressure wound therapy?
- another type of dressing
- uses a machine that applies localized negative pressure to surface and margins of the wound and pulls the base of wound and enhances healing rate
when is NPWT effective/used?
for wounds in whic rapid healing is viable and will enhance patients quality of life
- used to enhance viability of split-thickness skin grafts by placing it intaoperatively over grafe and decreases the graft’s ability to shift and evacuates fluid that builds up under the gragt
disadvantage of NPWT
expensice and are changed x3 a week (especially w this inflation goddayum)
vaccum assisted closure
- fast+effective healing
- reticulated opan cell foam placed directly on wound bed and drape is used to cover the dressing
- hole is made into the drape and a painter track pad over that drape to seal the wound and is then connected to a therapy unit
- provides uniform negative pressure to wound surface and induces physical and biological response
what is hyperbaric oxygen therapy?
Is the systemic delivery of oxygen at increased atmospheric pressures.
- The patient is placed in an enclosed chamber in which 100% oxygen is administered at 1.5 to 3.0 times the normal atmospheric pressure.
Match the following
EXUDATE LEVEL DRESSING TYPE
a. moderate- heavy 1.film dressing
b. antimicrobial 2. Hydrogel dressing
c. moderate - heavy 3. Hydrocolloid
d. Low-moderate 4. Alginate
e. Low 5. Crystalline silver
f. Low 6. foam dressing
a4/a6
b5
c6/c4
d3
e1/e2
f1/f2
What are some signs that the wound has too little moisture
- Base non glistening.
- Grey in colour.
- Dressing sticks to base.
- Some products are still dry.
- No breakthrough outer dressing
some wound care principles
- Base spongy
- Base after dressing removed: floods.
- Maceration (breakdown of tissue because of moisture)
- Dressing changed 2-3/day.-
- Cannot see base when using transparent fill.
