Week 11 Irrigation/Physical Agents/ Wound Management Flashcards
T/F wound irrigation is just wound cleansing
False
Wound Irrigation: Definition
- Using fluid to remove dressing residue/residuals form topical agents and loosely adhered devitalized tissues as well as surface bacteria from a wound bed
T/F every wound should be irrigated after removal of dressing?
True
Goal of Irrigation
To remove necrotic tissue/debris/bacteria
Angiocath/Waterpik
- 35 ml syringe and 19 Gauge angiocatheter
- waterpiks setting at 6psi
- Pressurized saline canister
- Pressure between 4-15 psi but psi is really high be careful
- After WP, is shown to remove 4x amount of bacteria
- messy
- NOT FOR PROFUSELY BLEEDING WOUNDS
Pulsed Lavage
- Irrigant delivered under controlled pressure (4-15psi) with suction using hand-held device
- Suction Provides negative pressure removing irrigant and pathogens
- GOOD for wounds with tunneling and undermining
-NOT for wounds with exposed deep tissue/body cavities - Anticoagulant precaution
Whirlpool
- Are appropriate for very large amounts of necrotic tissue
- appropriate for individuals with eschar from burns
- Treatment time 10-20 minutes
- Turbine/ jet shouldn’t be directly on wound
- Water additives: know why you are doing it not always necessary
- Goal is to get rid of necrotic tissue, debris, bacteria
- Increase in limb size even if they don’t have VI
Whirlpool Contraindications
- Venous Insufficiency
- Edematous extremities
- Acute phlebitis
- Acute cellulitis
- DVT
- Incontinence
- Dry gangrene
PPE for Pulsed Lavage
- Face shield
- Mask
- Fluid proof gown
- Fluid resistant shoe covers
- Gloves
- Hair covers
Electrical Stimulation for Wound Healing Theory
- Use of bioelectrical current attracts cells to increase wound healing
**GALVANOTAXIS -
Stimulate cell migration, proliferation
-Increases bactericidal effects - ***Promotes autolytic debridement
- Restores positive potential to wound
- Increased blood flow
- reduces edema
Indications for Electrical Stimulation for Wound Healing
- Chronic wounds
- Recalcitrant wounds ( wounds that won’t heal) clean or infected
- Stage III/IV pressure ulcers
- Recalcitrant stage II pressure ulcers
What are the Medicare Guidelines for Electrical Stimulation for Wound Healing
- must treat wound conservatively for 30 days prior to initiating,
- must be stage III/IV pressure ulcer
- will cover arterial, venous and diabetic wound treatments
- progress must be documented at 30 days to continue treatment
Electrical Stimulation For Wound Healing Protocol Negative
Cathode
- Inflammatory phase
- Pulse rate 100-128pps
- Intensity 100-150 volts
- Duration 60 minutes 5-7x a week
Electrical Stimulation For Wound Healing Protocol Positive
Anode
- promote granulation tissue (proliferation)
- 100-128pps, 100-150 volts for 60 minutes 5-7 times a week
- Promote epithelialization
- 60-64pps, 100-150 volts, 60 minutes 3-5 times a week
Electrical Stimulation for Wound Healing Contraindications/Precautions
- Malignancy in wound
- Osteomyelitis
- Thrombophlebitis
- Pacemaker
- Over carotid sinus
- Over uterus
- Where there are metal ions (silver dressing)