Flashcards in Lecture 11 - Basic Wound Care and Skin Grafting Deck (173)
What does DIMES stand for?
debride, infection, moisture, edge protection, and support
What are the types of debridement?
surgical, autolytic, enzymatic, mechanical, and biosurgical
What is surgical debridement?
when devitalized tissues are removed with sharp dissection
What is removed during surgical debridement?
fat, fascia, skin, and muscle
In surgical debridement you want a ______ edge.
What is surgical debridement often combined with?
What is osteostixis/forage?
the use of small pins to penetrate bone that is exposed
What does osteostixis/forage promote?
vascular medullary canal communication with the wound bed
Osteostixis/forage enhances _____.
When is autolytic debridement preferred?
with tissue viability
What type of dressings do you use with autolytic debridement?
hydrophilic, occlusive dressings
What is enzymatic debridement?
enzyme agents are applied topically to dissolve collagenous tissue and cause superficial sloughing of debris
What is enzymatic debridement an adjunct to?
lavage and surgical debridement
What enzymes are used for enzymatic debridement?
trypsin, collagenase, papain, and urea
What is enzymatic debridement used for?
chronic, nonhealing, indolent wounds
If wet-to-dry dressings are done, how long are they usually done for?
Wet-to-dry dressings and enzymatic debridement are both ________ debridement.
What are the risks that accompany wet-to-dry dressings?
they can leave lint/fiber in the wound and they inhibit epithelialization
What are some forms of biosurgical debridement?
maggots and leeches
If you use a maggot for biosurgical debridement, how many do you put per cm squared of wound surface area?
What do you cover the maggots with in biosurgical debridement?
dacron chiffon dressing
What do maggots do in biosurgical debridement?
they secrete enzymes that dissolve necrotic tissue
What can be the negatives to using maggots for biosurgical debridement?
they can destroy healthy epithelium if not careful or be irritating to the patient
What do leeches do in biosurgical debridement?
they can improve skin perfusion
What are leeches used for in biosurgical debridement?
venous insufficiency and to salvage skin flaps and grafts
What is the goal of moist wound healing?
to keep the wound exudate on the wound bed
What type of debridement does moist wound healing allow for?
What does moist wound healing promote?
granulation tissue formation and epithelialization
What does moist wound healing prevent?
desiccation and tissue devitalization