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debridement

WOCN program

QuestionAnswer
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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