NPWT

Question 1

What do you use to clean a wound

Answer 1

• noncytotoxic wound cleaners (normal saline or commercial)
• will not damage or kill fibroblasts and healing tissue

Question 2

why is a 35ml syringe with 19-gauge angio catheter used for wound irrigation? and what pressure is being delivered for wound?

Answer 2

does not damge wound tissue. Uss low pressure of 4-15psi to avoid trauma to wound bed and to not damage healing wound

Question 3

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?

Answer 3

contraindicating - avoid irrigating wounds when the base cannot be determined

Question 4

what is debridement and what is its use

Answer 4

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

Question 5

which kinda debridement does a nercotic heel ulcer use?

Answer 5

none. Black eschar should not be debrides if there is no evidence of infection

Question 6

sharp/ surgical debridement

Answer 6

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).

Question 7

autolytic debridement

Answer 7

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.

Question 8

chemical/enzymatic debridement

Answer 8

• 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.

Question 9

A student nurse applied topical enzymes on the wound bed and the peri wound tissue. Whats wrong with this statement

Answer 9

you dont apply that kinda debridement on the periwound

Question 10

biological debridement

Answer 10

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.

Question 11

mechanical debridement

Answer 11

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).

Question 12

A nurse used hydrocolloid dressing on a pt and after a week, the wound starts getting better, what must the nurse do next?

Answer 12

choose a different type of dressinf after assessing wound base characteristics

Question 13

what is negative pressure wound therapy?

Answer 13

• 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

Question 14

when is NPWT effective/used?

Answer 14

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

Question 15

disadvantage of NPWT

Answer 15

expensice and are changed x3 a week (especially w this inflation goddayum)

Question 16

vaccum assisted closure

Answer 16

• 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

Question 17

what is hyperbaric oxygen therapy?

Answer 17

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.

Question 18

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

Answer 18

a4/a6
b5
c6/c4
d3
e1/e2
f1/f2

Question 19

What are some signs that the wound has too little moisture

Answer 19

• Base non glistening.
• Grey in colour.
• Dressing sticks to base.
• Some products are still dry.
• No breakthrough outer dressing

Question 20

some wound care principles

Answer 20

• 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.