Wound Bed Preparation

Question 1

TIME

Answer 1

Tissue, infection/inflmmation, Moisture, Edges

Question 2

E-Stitm

Answer 2

-Level A for chronic wounds
-Highvolt: 80-125Hz, 50-100p, 75-100 intensity, 45-60min
-TENS

Indications:
-ulcers, burns, dehisced wounds, chronic wounds

Benefits:
-restores current
-stimulates cells
-reduces edema and pain
-increases BF
-helps debridement

Methods:
-Direct: conducting materal in wound with saline gauze
-Immersion: placed in water, good for multiple wounds but could spread infection
-Periwound: use around the wound to decrease contamination and avoid removing dressings

Contraindications:

Question 3

Cathode

Answer 3

-negative
-attracts neurtrphils and fibroblasts, macrophages
-vasoconstrictor
-denatures proteins
-used first

Question 4

Anode

Answer 4

-Positive
-attracts neurtrphils and macrophages
-fights infection
-decrease edema
-debrides
-increase blood flow
-stimulate growth of granulation tissue

Question 5

Ultrasound

Answer 5

-enhances all 3 phases of healing
-Cavication: air filled bubles in fluids of tissues that stimulate cell change
-Microstreaming: movement of fluiid along cell membrane can increase permeability

Benefits:
-reduces inflammation
-increases granulation tissue, tensile strength, scar pliability

Indications:
-chronic wounds, PI, VU, acute trauma, surgery

Methods:
-Direct: will wounds with hydrogel and cover then use US gel
-Periwound: treat around, dont have to move dressing, good for painful wounds
-Immersion

Contraindications:
-severe AI
-Acute DVT
-bleeding
-infection
-Cancer

Question 6

Ultrasound Parameters

Answer 6

Superficial: 3MHz
Deep: 1MHz

Healing: non thermal .5-1 intensity, 20-25%
Scars/Contractures: 1.5, thermal

Non-contact Low Frequency:
-active cell stimulation, decrease bioburden, increase BF
-increased microstreaming
-need PPE

Question 7

Negative Pressure Wound Therapy

Answer 7

-pressure and suction to remove fluid, enhance circulation, granulation tissues
-125mmhg to increase BF 4x

Indications:
-acute wounds
-dehiscence
-ulcers
-flaps

Contraindications:
-necrotic tissue
-cancer
-osteomyelitis
-exposed tissues

VAC:
-black foam for granulation
-white foam for pain
-silver for infection
-48-72hrs

Renasys:
-foam: deep wounds, large, max drainage
-gauze: painful, shallow, irregular, tunneling

Invia:
-nonadherant contact
-protect and deodorize
-home machine

NAD:
-shallow and mild draining wounds
-home machine

Question 8

Hyperbaric Oxygen

Answer 8

-100% to increase o2 dissolved in plasma
-can be topical

Benefits:
-increase concentrsation gradiant of o2
-increase WBc to kill
-synthesis
-reduced edema

Indications:
-periwound hypoxia
-gas gangrene

Contraindications:
-implants
-metal dressings
-DVT
-COPD
-CHF

Question 9

Ultraviolet

Answer 9

-reduce inflammation
-antibacterial
-pr0tect periwound with jelly
-UVC

Question 10

Laser

Answer 10

-no tissue damage
-increase cell response for healing (cells, synthesis, proliferation, growth factor)

Question 11

Exercise for Healing

Answer 11

-increase healing
-reduce inflammation
-reduce edema
-regulate glucose