Wound Care Flashcards
Treadmill Exercise program supervised
x per week speed rest total time a day continue for how many months
3-5x a week At a speed that brings on claudication in 2-5 min pt rests until pain subsides repeat to get 20 minutes of ambulation continue for 6 months!
Treadmill exercise program unsupervised
begin with how much time working up to what modify speed and grade by what? monitor what continue
begin w/35 minutes
increase by 5 minute increments to get up to 50 minutes
modify speed and grade by pain 8/10 VAS
monitor vitals
continue 2-3 months/forever
Exercise number of x per week for how many minutes for how many months for intermittent claudication
3x/wk for >30 minutes
continue for 6 months
True or false: we want all wound beds to be moist?
False: dry gangrene should be kept dry
Wounds open to air?
never
What are you aiming for with a dressing?
homeostatic environment that allows moisture but not too much
Hydrocolloid is what kind of dressing?
semi-occlusive: allows gases to escape but nothing to get in
What kind of compression wrapping do we use a semi-occlusive in?
unna boot uses a hydrocolloid
occlusive dressing means what?
gasses come out but nothing comes in
what is an occlusive dressing you know?
hydrocolloid
are hydrocoloids absorptive, maintaining or adding moisture?
maintaining
what kind of dressing does Pam love?
alginates: absorbs moisture its non-occlusive (need a third thing to hold it on)
Used to absorb exudate!
what topical wound care product is derived from iodine, silver and polyhexethylene?
antimicrobial
if a pt has an infection what kind of wound dressing are you going to put on it?
antimicobial
what is the only kind of wound cellular tissue therapy is reimbursed for?
DFU
Name the four approved medical diagnosis for the use of HBO thearpy that have to do with wounds
1) diabetic wounds: wagner grade 3(already down to bone) or worse) and has failed other treatment
2) compromised skin grafts and flaps
3)chronic refractory osteomyelitis: they’ve already been on antibiotics etc
4) soft tissue
necrotizing fascitits
what stage of healing do most wounds get stuck in?
between inflammatory and proliferation
Four common barriers to wound healing
1) bad microcirculation
2) prolonged pressure from interstitial edema
3) bacterial infection
4) inadequate electrical potential
standard of care in wound care is what?
treat the underlying medical condition that causes the wound as well as the wound
How do you wrap a long stretch bandage?
this is an ACE bandage, NOT figure 8!
compression stockings should be used when?
maintenance part of therapy, after the wound is healed. maintain healthy circulation and control edema
unna boot often used for what kind of things? 2 of them
1) venous leg ulcers
2) venous insufficiencies of the leg
how many mmHg for compression wrapping for treatment and healing?
30-40mmHg
How many mmHg for compressing wrapping for maintenance
22-30mmHg
how often should stockings be replaced?
every 6 months
protocol for vasopneumatic compression
position how long ratio how many x a week what do you do after?
supine w/LE elevated above hip
1hour
3:1 compression relaxation ratio
Semi0rigid dressing after pumping
1-3x a week in OP
gradient compression mimics our system the best filling from distal to proximal
HVPC used mostly for what two types of wounds
pressure injuries and surgical wounds
if the pt is in outpaitne thow many days must the wouund be there to use HVPC?
30 days
apply electrode where
1-5 days _____ polarity
how many minutes per day inpatient vs. outpatient
apply electrode directy on wound or around wound margin
1-5 days or until necrosis is removed) NEGATIVE polarity (6 day or if wound plateus switch daily to positive)
45-60 min /day IP
45-60 min 3x a week OP
What kind of therapy is best for excudate management?
negative pressure therapy
what therapy is contraindicated when more than 20% of the wound is necrotic tissue?
negative pressure therapy
if this is the case, debride the wound first
what is your goal with negative pressure therapy?
prepare the wound for closure! you are NOT healing it
How many hours a day should negative pressure wound therapy be worn?
22hrs/day
Dressing for negative pressure thearpy remains on for how many hours?
72 hours
Preparing the wound bed for secondary closure is a characteristic of what biophysical agent?
negative pressure wound therapy
what treatment actually REDUCES bacteria level?
noncontact low frequency ultra sound
pulling or pushing on cells with US?
pushing breaks bacteria walls
biofilm reduces with what treatment and there is no impact of aerosolization
US
how freuquently do you do US?
2-3x per week
not better after 6tx you have to stop
MIST disrupts biofilm on the wound surface and below in order to advance wound to healing!
the clearest clinical indicator that a biofilm has been disrupted is healing progression!
What kind of treatment is great for deep tissue inuries?
US
what is the most effective and reliable method for off loading DFU?
TCC
