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debridement
WOCN program
| Question | Answer |
|---|---|
| what is the role of debridement in wound healing | reduces bioburden, control and potentially prevent wound infection, make wound bed visible, stimulates a pseudo acute wound |
| when should debridement be contraindicated | poor perfusion, stable heel eschar, stable arterial eschar |
| what is the difference between selective and non-selective debridement | selective is removal of nonviable tissue only, nonselective is removal of nonviable and viable tissue |
| identify 4 types of debridement and give an example of each | autolysis (semiocclusive), chemical (enzyme), biosurgical., mechanical (wet to dry, irrigation) sharp (sterile scissors, forceps, or scalpel) |
| when is Maggot therapy considered | as a last resort when the pt is not a surgical candidate |
| name selective debridement methods | autolysis, enzymes, conservative sharp, maggot and ultrasonic mist |
| name nonselective debridement methods | hydrotherapy, wet to dry gauze, surgical sharp |
| when should Dakin's solution be discontinued | after 10 days |
| identify general guidelines for selection of debridement | pt's goals, overall medical condition, urgency of debridement, status of the wound, skill level of the clinician, practice setting |
| when is debridement indicated | if necrotic tissue (slough or eschar) is present, foreign bodies present, or when wound is infected |
| explain autolytic debridement | naturally occurring process of wound healing WBC's and enzymes digest nonvital tissue, must have moist environment and nl abc count Honey, transparent film, polyacrylate & hydrogel are examples. Is NOT indicated for infected wound |
| explain enzymatic debridement | selective, collagenase digest dead tissue can be used with local wound infection, d/c when wound bed clean, can use with other dsgs except iodine, PHMB, zinc and silver, ok for peripheral arterial ulcers and PU's |
| explain biosurgical debridement | maggots- their excretions clean up the wound |
| explain mechanical debridement | wet to dry, conservative sharp debridement, pulsatile lavage, irrigation,hydrotherapy, ultrasonic mist |
| explain sharp debridement | surgical sharp (by MD only.; is nonselective) or conservative sharp (trained clinician, selective) |
| explain high pressure wound irrigation- what equipment is needed | 19 g angiocatheter, 35ml syringe, 4-10 psi |
| chemical debridement | sodium hypochlorite 0.0125% Dakin's solutionwill harm fibroblasts if over 0.0125% |
| dakin's solution | typically used in heavily necrotic wounds with odor. effective against viruses, yeast and bacteria, odor control, debrides, short term, |
| Ultrasound and MIST | Selective, traditional high frequency ultrasound lacks evidence to support but noncontact low frequency (MIST) and ultrasonic low frequency debridement (touches wound bed) does |
Created by:
Beth Perry
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