Week 10 Debridement Flashcards
1
Q
What is debridement ?
A
The removal of damaged or necrotic tissue
2
Q
Purpose of Debridement
A
- Decreased bacterial load/risk for infection
- Improve body’s ability to heal
- Decrease energy required to heal
- Remove physical barrier to healing
- Decrease odor
3
Q
Selective Method of Debridement
A
- sharp
- Autolytic
- Enzymatic
- Biological
4
Q
Non-selective methods
A
- Surgical
- Mechanical
5
Q
T/F you should debride granular wounds?
A
Flase
6
Q
T/F you should debride in the presence of devitalized tissue
A
True
7
Q
What are the contraindications to debridement?
A
- Granular wounds
- Stable, hard dry eschar in ischemic limbs
- When surgical debridement is more appropriate
- When surgical debridement is already scheduled
- Debridement of bone, nerves, tendon, muscle, fascia, ligaments, capsules, blood vessels
- when tissue is unidentifiable
- Large category III or
IV pressure ulcer with significant undermining/tunneling
8
Q
Sharp Debridement
A
- Using forceps, scalpels or scissors to selectively remove devitalized tissue, debris, or foreign material from a wound bed
- Requires and MD order even if your state allows it to be performed by a PT
- Fastest and most aggressive form of debridement PT’s can perform
9
Q
Indication for Sharp Debridement
A
- Large amounts of eschar, necrotic tissue, calluses
- Chronic wounds
10
Q
Contraindications for Sharp Debridement
A
- Ischemic ulcers with low ABI’s prior to revascularization
- Lack of clinical competency
- Inability to identify tissue to be debrided
- Inability to visualize the debridement area
- Wound closure not consistent with POC
- Hyper-granular tissue
- Caution: immunosuppressed or thrombocytopenic patients; those on anticoagulants
11
Q
Autolytic Debridement
A
- Using body’s own enzymes to digest necrotic tissues
- Need moisture retentive dressing to stay in place at least 2 days
- Least painful and invasive method but slow
- GOOD for patients who cannot tolerate other forms of debridement
- GOOD for dry eschar removal : crosshatching then moisture retentive dressing
- Commonly done in home or long term care setting
- Often used on conjunction with sharp debridement
12
Q
Autolytic debridement is not good for…
A
- Not good for infected wounds or deep cavity wounds
- Not for wounds requiring surgical or sharp debridement
13
Q
Enzymatic Debridement
A
- Chemical or enzyme debridement (exogenous substance)
- ONLY helps destroy devitalized tissue
- NOT for use on wounds with deep tissue exposure, calluses, and facial burns
- Not a rapid process but can be effective
- Requires a physician order
14
Q
What is Enzymatic Debridement good for?
A
- Infected and uninfected wounds
- in conjunction with antimicrobial
- In conjunction with cross hatched eschar
15
Q
Biological Debridment
A
- Maggot Therapy
- Seldom used in the US
- Eat necrotic tissue and release enzymes that break down necrotic tissue
- Maggots not affected by antibiotics
- May decrease odor
- Psychological aspect
