Wound Interventions and Dressings

Question 1

What are 2 types of wound debridement?

Answer 1

Selective debridement

Non-selective debridement

Question 2

What is selective debridement?

Answer 2

Removal of ONLY non-viable tissue from a wound

Question 3

What are three types of selective debridement?

Answer 3

Sharp debridement
Enzymatic debridement
Autolytic debridement

Question 4

What is sharp debridement?

Answer 4

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

Question 5

When is sharp debridement used?

Answer 5

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

Question 6

What is enzymatic debridement?

Answer 6

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

Question 7

When is enzymatic debridement used?

Answer 7

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

Question 8

What is autolytic debridement?

Answer 8

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

Question 9

What are 4 examples of autolytic debridement?

Answer 9

Use of:
Transparent films 
Hydrocolloids 
Hydrogels 
Alginates

Question 10

What is the purpose of autolytic debridement?

Answer 10

Establishes a moist wound environment that rehydrates necrotic tissue and eschar

Question 11

When is autolytic debridement not used?

Answer 11

On infected wounds

Question 12

What is non-selective debridement?

Answer 12

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

Question 13

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

Answer 13

Wet-to-dry dressings
Wound irrigation
Hydrotherapy

Question 14

What is wet to dry dressing application?

Answer 14

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

Question 15

Describe the debridement process via wet to dry dressing application.

Answer 15

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

Question 16

What is wound irrigation?

Answer 16

Removal of necrotic tissue from the wound bed using pressurized fluid

Question 17

What is an example of wound irrigation?

Answer 17

Pulsed lavage

Question 18

What is the most common form of hydrotherapy?

Answer 18

Whirlpool

Question 19

What are 3 potential side effects of hydrotherapy?

Answer 19

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

Question 20

What is negative pressure wound therapy (NPWT)?

Answer 20

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.

Question 21

When is negative pressure wound therapy indicated?

Answer 21

Indicated for wounds that cannot be closed by primary intention

Question 22

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

Answer 22

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

Question 23

What is hyperbaric oxygen?

Answer 23

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

Question 24

When is hyperbaric oxygen indicated? (5)

Answer 24

Osteomyelitis 
Diabetic wounds
Crush injuries 
Thermal wounds 
Radiation necrosis

Question 25

What are growth factors?

Answer 25

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

Question 26

When is the use of growth factors indicated?

Answer 26

To treat neuropathic ulcers extending into or through subcutaneous tissue

Question 27

When is the use of growth factors contraindicated?

Answer 27

Contraindicated for wounds closed by primary intention

Question 28

What is the difference between primary and secondary dressings?

Answer 28

Primary = dressings that come in direct contact with the wound Secondary = dressings that are placed directly over the primary dressing for protection/absorption etc.

Question 29

What are 6 types of wound dressings?

Answer 29

``` Alginates Foam Dressings Gauze Hydrocolloids Hydrogels Transparent films ```

Question 30

What are alginates?

Answer 30

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

Question 31

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

Answer 31

Alginates Non-adhesive foam dressings Hydrogels

Question 32

When are alginates typically used?

Answer 32

On partial or full-thickness wounds (typically infected)

Question 33

What are foam dressings?

Answer 33

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

Question 34

When are foam dressings typically used?

Answer 34

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

Question 35

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

Answer 35

Gauze

Question 36

What are hydrocolloids?

Answer 36

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.

Question 37

What is a contraindication to hydrocolloids?

Answer 37

It cannot be used on infected wounds

Question 38

What are hydrogels?

Answer 38

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

Question 39

What is one disadvantage of hydrogels?

Answer 39

Cannot be used on wounds with significant drainage

Question 40

What are transparent films?

Answer 40

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

Question 41

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

Answer 41

They cannot be used on infected wounds

Question 42

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

Answer 42

Hydrogels

Question 43

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

Answer 43

Hydrocolloids Hydrogels Transparent film

Question 44

What does occlusion mean in terms of wound dressings?

Answer 44

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

Question 45

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

Answer 45

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

Question 46

List the wound dressings from most to least moisture retentive.

Answer 46

``` Alginates Semipermeable foams Hydrocolloids Hydrogels Semipermeable films ```

Question 47

What is dehiscence?

Answer 47

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