Wound Care

Question 1

Treadmill Exercise program supervised

x per week 
speed
rest 
total time a day
continue for how many months

Answer 1

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!

Question 2

Treadmill exercise program unsupervised

begin with how much time
working up to what 
modify speed and grade by what?
monitor what 
continue

Answer 2

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

Question 3

Exercise number of x per week for how many minutes for how many months for intermittent claudication

Answer 3

3x/wk for >30 minutes

continue for 6 months

Question 4

True or false: we want all wound beds to be moist?

Answer 4

False: dry gangrene should be kept dry

Question 5

Wounds open to air?

Answer 5

never

Question 6

What are you aiming for with a dressing?

Answer 6

homeostatic environment that allows moisture but not too much

Question 7

Hydrocolloid is what kind of dressing?

Answer 7

semi-occlusive: allows gases to escape but nothing to get in

Question 8

What kind of compression wrapping do we use a semi-occlusive in?

Answer 8

unna boot uses a hydrocolloid

Question 9

occlusive dressing means what?

Answer 9

gasses come out but nothing comes in

Question 10

what is an occlusive dressing you know?

Answer 10

hydrocolloid

Question 11

are hydrocoloids absorptive, maintaining or adding moisture?

Answer 11

maintaining

Question 12

what kind of dressing does Pam love?

Answer 12

alginates: absorbs moisture its non-occlusive (need a third thing to hold it on)

Used to absorb exudate!

Question 13

what topical wound care product is derived from iodine, silver and polyhexethylene?

Answer 13

antimicrobial

Question 14

if a pt has an infection what kind of wound dressing are you going to put on it?

Answer 14

antimicobial

Question 15

what is the only kind of wound cellular tissue therapy is reimbursed for?

Answer 15

DFU

Question 16

Name the four approved medical diagnosis for the use of HBO thearpy that have to do with wounds

Answer 16

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

Question 17

what stage of healing do most wounds get stuck in?

Answer 17

between inflammatory and proliferation

Question 18

Four common barriers to wound healing

Answer 18

1) bad microcirculation
2) prolonged pressure from interstitial edema
3) bacterial infection
4) inadequate electrical potential

Question 19

standard of care in wound care is what?

Answer 19

treat the underlying medical condition that causes the wound as well as the wound

Question 20

How do you wrap a long stretch bandage?

Answer 20

this is an ACE bandage, NOT figure 8!

Question 21

compression stockings should be used when?

Answer 21

maintenance part of therapy, after the wound is healed. maintain healthy circulation and control edema

Question 22

unna boot often used for what kind of things? 2 of them

Answer 22

1) venous leg ulcers

2) venous insufficiencies of the leg

Question 23

how many mmHg for compression wrapping for treatment and healing?

Answer 23

30-40mmHg

Question 24

How many mmHg for compressing wrapping for maintenance

Answer 24

22-30mmHg

Question 25

how often should stockings be replaced?

Answer 25

every 6 months

Question 26

protocol for vasopneumatic compression

position
how long
ratio
how many x a week 
what do you do after?

Answer 26

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

Question 27

HVPC used mostly for what two types of wounds

Answer 27

pressure injuries and surgical wounds

Question 28

if the pt is in outpaitne thow many days must the wouund be there to use HVPC?

Answer 28

30 days

Question 29

apply electrode where

1-5 days _____ polarity

how many minutes per day inpatient vs. outpatient

Answer 29

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

Question 30

What kind of therapy is best for excudate management?

Answer 30

negative pressure therapy

Question 31

what therapy is contraindicated when more than 20% of the wound is necrotic tissue?

Answer 31

negative pressure therapy

if this is the case, debride the wound first

Question 32

what is your goal with negative pressure therapy?

Answer 32

prepare the wound for closure! you are NOT healing it

Question 33

How many hours a day should negative pressure wound therapy be worn?

Answer 33

22hrs/day

Question 34

Dressing for negative pressure thearpy remains on for how many hours?

Answer 34

72 hours

Question 35

Preparing the wound bed for secondary closure is a characteristic of what biophysical agent?

Answer 35

negative pressure wound therapy

Question 36

what treatment actually REDUCES bacteria level?

Answer 36

noncontact low frequency ultra sound

Question 37

pulling or pushing on cells with US?

Answer 37

pushing breaks bacteria walls

Question 38

biofilm reduces with what treatment and there is no impact of aerosolization

Answer 38

US

Question 39

how freuquently do you do US?

Answer 39

2-3x per week

not better after 6tx you have to stop

Question 40

MIST disrupts biofilm on the wound surface and below in order to advance wound to healing!

Answer 40

the clearest clinical indicator that a biofilm has been disrupted is healing progression!

Question 41

What kind of treatment is great for deep tissue inuries?

Answer 41

US

Question 42

what is the most effective and reliable method for off loading DFU?

Answer 42

TCC