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NPTE Integumentary System > Wound Interventions and Dressings > Flashcards

Wound Interventions and Dressings Flashcards

1
Q

What are 2 types of wound debridement?

A

Selective debridement

Non-selective debridement

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2
Q

What is selective debridement?

A

Removal of ONLY non-viable tissue from a wound

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3
Q

What are three types of selective debridement?

A

Sharp debridement
Enzymatic debridement
Autolytic debridement

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4
Q

What is sharp debridement?

A

Use of a scalpel, scissors or forceps to remove non-viable tissue or debris from the wound bed

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5
Q

When is sharp debridement used?

A

When large amounts of thick, adherent, necrotic tissue is present

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6
Q

What is enzymatic debridement?

A

Application of an enzymatic preparation to necrotic tissue to remove necrotic tissue

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7
Q

When is enzymatic debridement used?

A

Used on infected and non-infected wounds with necrotic tissue or when autolytic debridement is not effective

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8
Q

What is autolytic debridement?

A

Use of the body’s own mechanisms to remove nonviable tissue

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9
Q

What are 4 examples of autolytic debridement?

A 
Use of:
Transparent films 
Hydrocolloids 
Hydrogels 
Alginates
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10
Q

What is the purpose of autolytic debridement?

A

Establishes a moist wound environment that rehydrates necrotic tissue and eschar

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11
Q

When is autolytic debridement not used?

A

On infected wounds

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12
Q

What is non-selective debridement?

A

Removal of both viable and non-viable tissues from a wound

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13
Q

What are the 3 most common types of non-selective debridement?

A

Wet-to-dry dressings
Wound irrigation
Hydrotherapy

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14
Q

What is wet to dry dressing application?

A

Refers to the application of a moistened gauze dressing over an area of necrotic tissue

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15
Q

Describe the debridement process via wet to dry dressing application.

A
  1. Apply the moistened gauze over the wound
  2. Let gauze dry completely
  3. Remove gauze (necrotic tissue will be adhered to gauze)
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16
Q

What is wound irrigation?

A

Removal of necrotic tissue from the wound bed using pressurized fluid

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17
Q

What is an example of wound irrigation?

A

Pulsed lavage

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18
Q

What is the most common form of hydrotherapy?

A

Whirlpool

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19
Q

What are 3 potential side effects of hydrotherapy?

A
  1. Maceration of viable tissue
  2. Edema from dependent LE positioning
  3. Hypotension
20
Q

What is negative pressure wound therapy (NPWT)?

A

Non-invasive modality that involves placing a sterile foam dressing over the wound and sealing it with an airtight secondary dressing which is attached to a vacuum pump.

21
Q

When is negative pressure wound therapy indicated?

A

Indicated for wounds that cannot be closed by primary intention

22
Q

What are 5 contraindications to using negative pressure wound therapy? (NPWT)

A
  1. Malignancy within the wound
  2. Insufficient vascularity for wound healing
  3. Large amounts of necrotic tissue
  4. Uncontrolled pain
  5. Untreated osteomyelitis
23
Q

What is hyperbaric oxygen?

A

Refers to the inhalation of 100% oxygen at a pressure greater than 1 atmosphere to reduce edema and hyper oxygenating tissue

24
Q

When is hyperbaric oxygen indicated? (5)

A 
Osteomyelitis 
Diabetic wounds
Crush injuries 
Thermal wounds 
Radiation necrosis
25
Q

What are growth factors?

A

Derived from naturally occurring protein factors. Promote healing by stimulating the activity of specific cell types

26
Q

When is the use of growth factors indicated?

A

To treat neuropathic ulcers extending into or through subcutaneous tissue

27
Q

When is the use of growth factors contraindicated?

A

Contraindicated for wounds closed by primary intention

28
Q

What is the difference between primary and secondary dressings?

A

Primary = dressings that come in direct contact with the wound

Secondary = dressings that are placed directly over the primary dressing for protection/absorption etc.

29
Q

What are 6 types of wound dressings?

A 
Alginates
Foam Dressings 
Gauze 
Hydrocolloids
Hydrogels
Transparent films
30
Q

What are alginates?

A

Dressings derived from seaweed extraction that create a hydrophilic gel and are highly absorptive but highly permeable

31
Q

What type of wound dressings typically require secondary dressings? (3)

A

Alginates
Non-adhesive foam dressings
Hydrogels

32
Q

When are alginates typically used?

A

On partial or full-thickness wounds (typically infected)

33
Q

What are foam dressings?

A

Dressing made of a polyurethane base that contacts the wound surface and a hydrophobic outer layer

34
Q

When are foam dressings typically used?

A

To provide protection and absorption over partial and full-thickness wounds with varying levels of exudate.

35
Q

What is the most readily available dressing in an inpatient environment?

A

Gauze

36
Q

What are hydrocolloids?

A

Gel forming polymers backed by a strong film or foam adhesive that do not attach to the wound itself but to the intact surrounding skin.

37
Q

What is a contraindication to hydrocolloids?

A

It cannot be used on infected wounds

38
Q

What are hydrogels?

A

Water and gel forming materials used on superficial and partial thickness wounds

39
Q

What is one disadvantage of hydrogels?

A

Cannot be used on wounds with significant drainage

40
Q

What are transparent films?

A

Thin membranes made from transparent polyurethane that are permeable to vapor/oxygen and nonpermeable to water/bacteria

41
Q

What do hydrocolloids, hydrogels and transparent film dressing have in common?

A

They cannot be used on infected wounds

42
Q

What type of dressing can be used as a coupling agent for ultrasound?

A

Hydrogels

43
Q

What types of wound dressing CANNOT be used on infected wounds?

A

Hydrocolloids
Hydrogels
Transparent film

44
Q

What does occlusion mean in terms of wound dressings?

A

Refers to the ability of a dressing to transmit moisture, vapor or gases between the wound bed and the atmosphere.

45
Q

List the wound dressings in order of most occlusive to non-occlusive. (7)

A
  1. Hydrocolloids
  2. Hydrogels
  3. Semipermeable foam
  4. Semipermeable film
  5. Impregnated gauze
  6. Alginates
  7. Traditional gauze
46
Q

List the wound dressings from most to least moisture retentive.

A 
Alginates
Semipermeable foams
Hydrocolloids 
Hydrogels
Semipermeable films
47
Q

What is dehiscence?

A

The separation, rupture or splitting of a wound closed by primary intention

NPTE Integumentary System (5 decks)

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