Ch. 8 - Wound Care

Front 1

Reasons why literature is poor for modalities?

Back 1

1) Poorly defined parameters
2) Small sample size
3) Only done on chronic wounds
4) Failure to describe the type of wound

Front 2

Indications for wound irrigations?

Back 2

Acceptable for all type of wounds

Front 3

Contraindications for wound irrigation?

Back 3

Profuse bleeding

Front 4

When should one irrigate?

Back 4

On initial exam and with each dressing change

Front 5

Ideal force of irrigation?

Back 5

10-15PSI

Front 6

Benefits of whirlpool?

Back 6

1) Loose debridement
2) Increases ROM
3) Decreases pain
4) Helps loosen bandages
5) Promotes circulation
6) Hydrates the wound
7) Softens necrotic tissue and eschar.

Front 7

Indications of whirlpool?

Back 7

1) Infected wounds
2) Non-draining woudns
3) Thick necrosis/eschar

Front 8

Contraindications?

Back 8

1) Ulcers d/t VI, Edema or Lymph-
2) B&B incontinence
3) Profuse bleeding
4) Granulating woiunds

Front 9

Why are chemical additives a bad idea?

Back 9

Cytotoxic to all human cells. Only really used in isolated cases

Front 10

Disadvantages of whirlpool?

Back 10

1) Maceration
2) Can't calibrate agitation force
3) Cross-contam.
4) Time
5) Cost

Front 11

Standard of care for wound irrigation?

Back 11

Pulsed lavage

Front 12

When is pulsed lavage most beneficial?

Back 12

During the inflammatory stage to remove necrotic tissue

Front 13

When is pulsed lavage with suction the most beneficial?

Back 13

During the proliferative phase to increase granulation.

Front 14

Pulsed lavage contraindications?

Back 14

1) Exposed aa., nn., tt., capsules or bones.
2) Active bleeding

Front 15

7 possible ways that e-stim aids in wound healing?

Back 15

1) Restores current of injury
2) Galvonataxis
3) Increases circulation
4) Increases cell proliferation
5) Autolytic debridement
6) Reduces Edema
7) Increases bactericidal abilitites.

Front 16

Indications for e-stim?

Back 16

Chronic or recalcitrant wounds (clean or infected).

Front 17

Contraindications of e-stim?

Back 17

1) Simple, uncomplicated wounds
2) Bleeding
3) Osteomylitis
4) In combination with topical agents containing heavy metal ions

Front 18

3 techniques of e-stim?

Back 18

1) Direct
2) Immersion
3) Periwound

Front 19

Parameters for e-stim?

Back 19

Frequency = 80-125 Hz
Interpulse interval = 50-100ms
Intensity = 75-200v
SUBMOTOR INTENSITY
35-60min 1-2x/d.

Front 20

3 disadvantages of e-stim?

Back 20

1) Time consuming (current literature says no less than 30min)
2) Risk of cross-contamination
3) Not good for extensive wounds

Front 21

Suggested parameters for ultrasound?

Back 21

1) Low frequency - 25-40Hz with saline mist

Still need more research to hammer out more specific parameters.

Front 22

Contraindications of US?

Back 22

1) Severe arterial insuffeciency
2) Osteomylitis
3) Profuse bleeding
4) Simple, uncomplicated wounds
5) Untreated acute infections

Front 23

Parameters for non low-frequency US?

Back 23

1) 1or 3 MHz depending on depth
2) pulsed @ 20-25%
3) .5-1.0 W/CM2
4) divide into zones 1.5x US head
5) 3min per zone

Front 24

Parameters for low-frequency mist US?

Back 24

1) 25-40 KHz
2) Hold 15mm above wound
3) 15-20s/cm with minimum of 4 minutes for wounds less than 15cm

Front 25

Advantages of US?

Back 25

1) Universally available
2) Less time (setup, applicaiton and cleanup)

Front 26

Disadvantages of US?

Back 26

1) little research support
2) Cross-contamination
3) Painful for direct or peri-wound application