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Integumentary Care > Week 1 Debridement Part 2 > Flashcards

Week 1 Debridement Part 2 Flashcards

1
Q

what is mechanical debridement

A

non selective, and soft abrasion or scrub, hydrotherapy, or even wet to dry, and low frequency ultrasound

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2
Q

is mechanical debridement painful

A

yes, because it does not discriminate between viable and non-viable tissues

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3
Q

the is wet to dry indicated

A

when 100% not viable

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4
Q

is enzymatic debridement selective? and what is it

A

yes, selective, and it is pain free way to debride, and easy to apply

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5
Q

can we do enzymatic debridement on infected wounds

A

yes, in combination with polymyxin B power

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6
Q

can we use enzymes with silver or iodine products

A

no

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7
Q

what is a name of an enzymatic treatment we use

A

collagenase santyl

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8
Q

how does enzymatic treatment work

A

the denatured collagen filaments anchor debris to the wound bed, and the collagenase digests the collagen filaments

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9
Q

what are the 4 dressing types we can never use enzymatic with

A

silver
iodine
hydrogen peroxide
acetic acid

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10
Q

how much do we apply at a time

A

thickness of a nickel

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11
Q

what do we cover the enzyme with

A

saline moist gauze

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12
Q

what happens if it is not clean in 2 weeks

A

switch to another method

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13
Q

enzymatic is frequently used for

A

burns

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14
Q

can we use enzymes on the face

A

no

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15
Q

what are adverse effects of enzymes

A

burning/stinging
allergic reaction
peri-wound irritation

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16
Q

contraindications for enzymatic

A

takes too long
not for deeper wounds with tracts, in cavities, or with named tissue
not for the face

17
Q

what is autolytic debridement

A

selective and conservative and least painful way to debride its also cheap but takes a while

18
Q

what is the least painful type of debridement

A

autolytic

19
Q

how does autolytic favor a good wound environment

A

the dressing is kept moist and warm, and cooks the wound. with hydrocolloid, transparent films, foams and hydrogels.

20
Q

when is autolytic indicated

A

pain, palliative care, or can’t sit still (like PD)

21
Q

what are contraindications for autolytic

A

infection or gangrene, or deep cavities, or when other things are more appropriate

22
Q

what are the disadvantages of autolytic

A

odor the removed, time and can’t see the wound

23
Q

when do you change autolytic

A

when you see strike through or that it is soiled

24
Q

what can you combine autolytic with

A

cross hatching

25
Q

what 3 things are combined in a combo debridement

A

sharp (to remove loose tissue, and cross hatch thicker areas)
enzymatic to non-viable areas
autolytic (warm and well insulated and which

26
Q

what can we educate the patient on

A

rest, nutrition, habits and lifestyle

27
Q

what is biological/biosurgical debridement

A

using maggots or larva to quickly and selectively get non-viable tissues. also, helps to decrease odor

28
Q

what do maggots and larva do to tissues

A

releases an enzyme to degrade non-viable tissues and biofilm

29
Q

what kind of effect does biologic debridement have

A

antimicrobials, MRSA, STREP, pseudomonas, biofilm, changes the pH and kills and ingests bacteria.

30
Q

what do biologic excretions help with

A

stimulate the granulation tissue growth

31
Q

what are sterile biologic

A

from Irvine CA, 300 for 98$, and you can only use 10 per cm2 area. NO REPRODUCTING

32
Q

what are free range or contained

A

need air, and they cannot be sealed off, so they have a mesh cover over them, and you need to cover them with dry gauze to not kill them

33
Q

in what kind of population can we use biologic

A

osteoporosis with infection around the hardware
poor candidate for surgery
can’t handle other forms of debridement

34
Q

where is biosurgical contraindicated

A 
eyes, GI, respiratory tracts 
ALLERGY to fly larva or yeast or soy
exposed vessels, connecting to organs 
decreased perfusion 
malignant wounds
35
Q

what are precautions with biosurgical

A

maggots can drown or get squished and patient with bleed disorder

36
Q

what are indications for surgical debridement

A 
complex wound
gross infection or high risk infection 
too much nonviable tissue 
lots undermining 
unknown depth or abscess 
fistula 
named structures 
bleeding tendency, high pain or trauma
37
Q

how do you determine the type of debridement

A

what works best for them, makes most sense? safety? cost? risks? combination? can I do it, am I comfortable?

38
Q

what is ultrasound based debridement

A

low frequency tissue vibration that has antimicrobial effects. it lifts the dead tissue.

Integumentary Care (26 decks)

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