Lecture 11 - Basic Wound Care and Skin Grafting Flashcards Preview

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Flashcards in Lecture 11 - Basic Wound Care and Skin Grafting Deck (173)
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1

What does DIMES stand for?

debride, infection, moisture, edge protection, and support

2

What are the types of debridement?

surgical, autolytic, enzymatic, mechanical, and biosurgical

3

What is surgical debridement?

when devitalized tissues are removed with sharp dissection

4

What is removed during surgical debridement?

fat, fascia, skin, and muscle

5

In surgical debridement you want a ______ edge.

bleeding

6

What is surgical debridement often combined with?

autolytic debridement

7

What is osteostixis/forage?

the use of small pins to penetrate bone that is exposed

8

What does osteostixis/forage promote?

vascular medullary canal communication with the wound bed

9

Osteostixis/forage enhances _____.

healing

10

When is autolytic debridement preferred?

with tissue viability

11

What type of dressings do you use with autolytic debridement?

hydrophilic, occlusive dressings

12

What is enzymatic debridement?

enzyme agents are applied topically to dissolve collagenous tissue and cause superficial sloughing of debris

13

What is enzymatic debridement an adjunct to?

lavage and surgical debridement

14

What enzymes are used for enzymatic debridement?

trypsin, collagenase, papain, and urea

15

What is enzymatic debridement used for?

chronic, nonhealing, indolent wounds

16

If wet-to-dry dressings are done, how long are they usually done for?

1-2 days

17

Wet-to-dry dressings and enzymatic debridement are both ________ debridement.

nonselective

18

What are the risks that accompany wet-to-dry dressings?

they can leave lint/fiber in the wound and they inhibit epithelialization

19

What are some forms of biosurgical debridement?

maggots and leeches

20

If you use a maggot for biosurgical debridement, how many do you put per cm squared of wound surface area?

5-10 larva

21

What do you cover the maggots with in biosurgical debridement?

dacron chiffon dressing

22

What do maggots do in biosurgical debridement?

they secrete enzymes that dissolve necrotic tissue

23

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

24

What do leeches do in biosurgical debridement?

they can improve skin perfusion

25

What are leeches used for in biosurgical debridement?

venous insufficiency and to salvage skin flaps and grafts

26

What is the goal of moist wound healing?

to keep the wound exudate on the wound bed

27

What type of debridement does moist wound healing allow for?

autolytic debridement

28

What does moist wound healing promote?

granulation tissue formation and epithelialization

29

What does moist wound healing prevent?

desiccation and tissue devitalization

30

What does moist wound healing limit?

infection