Bioburden

Question 1

bioburden definition

Answer 1

microbial burden in the wound
microorganisms present in the wound

Question 2

what is biofilm scientifically

Answer 2

extracellular polysaccharide matrix

Question 3

what is biofilm in basic terms

Answer 3

protective coating produced by colonies of microorganisms

Question 4

what types of wounds does biofilm cover

Answer 4

chronic wounds

Question 5

after debreiment of microfilm, what is effective within what time frame

Answer 5

topical agents - within 24 hours

Question 6

after debreiment of microfilm, what is not effective within what time frame

Answer 6

topical agents - after 72 hours

Question 7

how do topical agents affect a wound

Answer 7

they kill non-dormant microbes that are metabolically active

Question 8

how to microbial colonies communicate? who do they communicate with? why?

Answer 8

other microbial colonies via chemical messages

planned dormancy across a wound to ensure non-effectiveness of topical agents

Question 9

examples of bioburden formations

Answer 9

eschar
slough
necrotic tissue

Question 10

what are the types of deberiment?

Answer 10

slow and fast

Question 11

examples of slow debreiment

Answer 11

autolytic
enzymatic

Question 12

how is autolytic vs enzymatic debreiment different

Answer 12

autolytic - use of the body’s own enzymes under the cover of dressing

enzymatic - added solution containing enzymes

Question 13

what medical professionals can perform sharp debreiment

Answer 13

PT and MD

Question 14

what is mechanical debreiment

Answer 14

person performed clearing of the wound using manual techniques

Question 15

what is something to keep in consideration of bioburden

Answer 15

can communicate a planned spread of the injury to nonaffected areas

Question 16

how is a biofilm formed

Answer 16

microorganisms will
contaminate the wound surface
attach to the surface
alter genetic code
exude extracellular polymeric substance

Question 17

what is biofilm resistant to

Answer 17

antibiotics
antimicrobials

Question 18

how is biofilm removed

Answer 18

sharp
maggot
ultrasonic
– debreiment techniques

Question 19

what controls the risk of infection in the body

Answer 19

individuals immune system
environment in the wound
type of organisms looking to attack

Question 20

virulent

Answer 20

rapidly producing microorganisms
- will take over tissue easily

Question 21

what environment is best for avoidance of infection

Answer 21

moist and warm
balanced pH
sufficient oxygen supply

Question 22

how does diversity of microbes affect the wound care plan

Answer 22

more diversity (aerobic and anaerobic) microbes cause topical agents to be less effective

– will need very strong topical agents that could in turn damage healthy cells

Question 23

contamination

Answer 23

organism present on wound surface

Question 24

colonization

Answer 24

organisms multiply on wound surface

early reversible adherence
irreversible adherence of organisms in the tissue

Question 25

s/s associated with contamination

Answer 25

none

Question 26

s/s associated with colonization

Answer 26

none

Question 27

what is another name for biofilm

Answer 27

critical colonization

Question 28

s/s of biofilm

Answer 28

delayed healing local infection

Question 29

infection definition

Answer 29

organisms invade tissue systemic response occurs

Question 30

organism # related to infection

Answer 30

100,000/gm

Question 31

induration of ___ cm indicates infection

Answer 31

within 2 cm of wound edge

Question 32

compare local vs systemic infections and the relation of each to the wound

Answer 32

local - within the margins of the wound up to 2cm outside the wound systemic - extend beyond the margins of the wound

Question 33

examples of systemic infections

Answer 33

cellulitis osteomyelitis meningitis endocarditis bacteremia sepsis

Question 34

what is an indirect result of endocarditis

Answer 34

cardiac tamponade

Question 35

if bone is seen in a wound, what should you be concerned with? what is the plan of action from there?

Answer 35

osteomyelitis MRI

Question 36

what # of symptoms do you need on a clinical signs and symptoms checklist to rule in an infection

Answer 36

3

Question 37

what are the clinical signs and symptoms frameworks

Answer 37

NERDS STONEES

Question 38

what is NERDS

Answer 38

n - non healing e - increased exudate r - red/bleeding granular tissue d - debris / eschar in wound s - smell

Question 39

what is STONEES

Answer 39

S - size T - temperature increase O - exposure to bone N - new areas of breakdown E - exudate changes E - erythema / edema S - smell

Question 40

management of bioburden

Answer 40

cleanse wound / periwound skin irrigation/pulsating lavage debride necrotic tissue antimicrobial dressings

Question 41

time table of antimicrobial dressings

Answer 41

work for up to 7 days

Question 42

methods of wound culture

Answer 42

cleanse thoroughly pick healthiest wound tissue - no necrotic tissue take sample

Question 43

what are the types of culture taking techniques

Answer 43

z - culture spin culture

Question 44

how often is sharp debreiment repeated

Answer 44

every 7 days

Question 45

NPWT

Answer 45

negative pressure wound therapy

Question 46

examples of topical agents

Answer 46

cadexomer iodine silver sulfadizaine honey chlorhexidine

Question 47

explain how iodine kills microbes

Answer 47

nondiscriminatory

Question 48

how does honey kill microbes

Answer 48

cuts off their oxygen supply

Question 49

how does cadexomer iodine kill microbes

Answer 49

modifies the iodine compound and releases iodine on a timed basis

Question 50

compare iodine and antimicrobial agents

Answer 50

iodine - kills everything antimicrobial - discriminates the cells killed

Question 51

low toxicity antiseptics

Answer 51

saline tap water PHMB chlorhexidine povidone-iodine

Question 52

high toxicity antiseptics

Answer 52

hydrogen peroxide socium hypochlorite ammonia dyes iodine

Question 53

what is cadexomer put on

Answer 53

granular / new tissue