Wound Interventions Flashcards
Why would you irrigate a wound?
facilitate debridement
maintain moist wound environment
enhance wound healing
What are the contraindications for irrigating a wound?
- do not immerse or soak recent skin grafts, recent surgical incision sites, diabetic feet
- active profuse bleeding wounds
- dry gangrene
Which irrigation solutions works best with silver dressings?
Sterile water
What contraindications are there for using a whirlpool to irrigate a wound?
- clean and granulating
- edematous, draining, macerated
- active bleeding
- VI
- multi-wounds same area
- uncontrolled seizures
- B&B issues
What are the contraindications for pulse lavage with suction?
- exposed named tissues
- body cavities
- facial wounds
- recent grafts or surgical procedures
- actively bleeding
What is the purpose for debridement?
- decrease bioburden and risk of infection
- increase effectiveness of topicals
- improve bactericidal activity of leukocytes
- shorten inflammatory phase (or turn chronic into acute)
- decrease energy required by the body to heal
- eliminate physical barriers
- decrease odor
What contraindications are there for debridement?
arterial compromise viable tissue granular tissue electrical burns deeper tissues
What is sharp debridement?
What are contraindications for this debridement type?
very fast and selective for of debridement using forceps, scissors, scalpel, or curette and requires a high level of skill
- PT skill level
- Cannot see or identify tissue
- consent
- ischemic ulcers
- hypergranulation
- pyoderma gangrenosum
When should you debride a blister?
if it is larger than a nickel
if area is likely to tear
if worried about possible tissue injury
great medium for bacterial growth
What is mechanical debridement?
a non-selective form of debridement that uses a variety of methods to clean wound that can be less painful than sharp debridement
When should you do wet-to-dry mechanical debridement?
only when tissue is 100% nonviable
What is enzymatic debridement?
selective debridement using a prescription lotion or cream that is pain-free and can be used on infected wounds but cannot be used with silver, hydrogen peroxide, acetic acid or iodine products
should be discontinued when wound is clean
What contraindications are there for enzymatic debridement?
- timeframe (takes too long)
- not for deeper wounds
- facial burns
What is autolytic debridement?
What are the contraindications?
a selective conservative debridement type that is less painful and cheaper than other options but takes longer than most, it maintains favorable wound environment by using occlusive dressings that are moist and warm
contraindications:
- odor upon removal
- time
- infrequent visualization
What are the indications that surgical debridement is necessary?
- complex wound
- gross infection or high risk of it
- extensive undermining
- unknown depth
- involves fistula
- named structures are visible
- bleeding tendency, extreme pain, or trauma
