Wound and Bone Healing

Question 1

53 year old female with an infected diabetic foot ulcer. which therapeutic modality is contraindicated in this patient?

Answer 1

moist heat pack

Question 2

What are the 4 types of skin ulcers*

Answer 2

-venous stasis
-arterial
-diabetic
-decubitus

Question 3

what is the main cause of failed wound healing?

Answer 3

lack of blood flow

Question 4

venous stasis ulcers*

Answer 4

venous insufficiency

Question 5

aterial ulcers*

Answer 5

narrowing arteries

Question 6

diabetic ulcers*

Answer 6

small vessel disease

Question 7

decubitus ulcers*

Answer 7

pressure sores

Question 8

what interferes with wound healing?

Answer 8

mostly intrinsic factors

person: smoking, obesity, nutrition, age
environ: blood flow, o2

Question 9

what are the stages of healing*

Answer 9

hemostasis
inflammatory
proliferative
maturation

Question 10

hemostasis*

Answer 10

clotting

Question 11

inflammatory*

Answer 11

help prevent infection

Question 12

proliferative*

Answer 12

pink or red granulation, does not bleed easily

dark tissue, easy bleeding can be a sign of infection

Question 13

maturation*

Answer 13

remodeling of collage
3 weeks after injury and lasts up to one year

Question 14

healthy epidermis has a ______ charge, healthy dermis is _________ charged. Natural current difference __________ healing and external stimulus can enhance healing

what is this theory?

Answer 14

negative
positive
stimulates

current of injury theory

Question 15

what triggers would healing? what enhances healing? what do chronic open wounds lack?

Answer 15

initial polarity
maintaining this polarity
this polarity

Question 16

what kind of current do we want to use for wound and bone healing

Answer 16

high voltage pulsed current

Question 17

what are the two ways electrotherapy try to do to improve wound healing

Answer 17

improve vascular status
localized edema control

Question 18

what is the most common chronic non-healing wound?

Answer 18

diabetic ulcers

many lead to amputation
often recurrent, in remission, not fully healed

Question 19

How do you handle wound healing if infection is present?*

Answer 19

cathode (black) over the dressing/wound

Question 20

How do you handle wound healing if no infection is present?*

Answer 20

aimed at prevention

anode (red/+) of DC stimulator over wound

Question 21

what kind of muscle contraction do we want for edema control settings?

Answer 21

rhythmic

Question 22

what edema control settings do we want?

Answer 22

pulse or burst modulated AC
- >100 pulse duration
-want rhythmic muscle contraction
high voltage pulsed current
- 2-50us
-90% of motor threshold
30 min treatment every four hours

Question 23

duration of treatment for wound healing and LADC

Answer 23

2 hours twice a day

Question 24

duration of treatment for wound healing and HVPC

Answer 24

30 mins twice a day

Question 25

_______ over dressing over wound (infected), __________ when infection resolves

Answer 25

cathode
switch orientation

Question 26

What are some factors leading to nonunion of bone*

Answer 26

• patient (blood supply)
• biology (poor blood flow)
• fracture type (gaps)
• surgeon (mechanical stability)
  -clinical (high energy open fract)