Wound Cleaning and Debridement Flashcards
What is Wound Irrigation?
Use of pressurize fluid to cleanse a wound, with a force between 4-15 psi. REmoves loosely adherent contaminants
Contraindication to Wound Debridement?
- Dry Gangrene
- Stable Eschar
- Wet Gangrene
- Osteomyelitis
- Electrical Burns
Forms of Selective Debridement?
Sharp
Autolytic
Enzymatic
Biological
Forms of Non-Selective Debridement?
Mechanical
Surgical
Will result in damage or removal of viable tissue along with NVT.
What is Sharp Debridement?
Use of scalpel, forceps, curette or scissors ro remove NVT
- fastest and most aggressive (other than surgical)
Indications of Sharp Debridement?
- Scoring and/or excision of leathery eschar
Contraindication to Sharp Debridement?
- Advancing cellulitis with sepsis
- individuals on anticoagulant therapy
What is Autolytic Debridement?
Use of bodies own endogenous enzymes, neutrophils and macrophages to break down NVT.
with the use of moisture-retentive dressings
Indications for Autolytic Debridement?
Really any wound
- those unable to tolerate other forms
Contraindications for Autolytic Debridement?
Presence of infection or deep cavities
What is Enzymatic Debridement?
The application of exogenous enzymes, promoting selective emulsification of NVT
- can be used in conjunction with sharp debridement (cross hatching)
Indications for Enzymatic Debridement?
Patients who cannot tolerate or fail to respond to other forms of debridement
Contraindications to Enzymatic Debridement?
- Exposed deep structures
- wounds open to body cavities
- heavily draining wounds
What is mechanical debridement?
Non-selective, forceful removal of both viable and NVT
- Scrubbing
- Irrigation
- Pulsatile Lavage
- Whirlpool
Is pulsatile lavage effective on hard eschar?
NO
