WEB WOC Wound Care Exam comprehensive
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TIMERS Tissue management
Inflammation/infection control
Moisture balance
Edge/epithelial advancement
Regeneration/repair of tissue
Social/patient related factors
Framework used to provide an TIMERS
optimal physiologic wound
environment that is conducive to
healing
Goal of tissue management to remove non-viable, necrotic tissue as well as
non-functional tissue such as hypergranulation
goal of inflammation or infection eliminate infection and control bioburden
control
goal of moisture balance not too wet and not too dry
provide moist wound therapy, absorb excess
drainage, control odor, fill dead space, control
swelling, protect periwound
goal of epithelial/edge keep wound edged open, address epibole and
advancement undermining, remove callous, protect periwound
skin
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goal of regeneration/repair of tissue cellular products, tissue based products, advanced
therapies such as hyperbaric treatment of NPWT
goal of social/patient related factors develop a patient-centers POC, patient
engagement, holistic assessment
why use debridement? to remove necrotic tissue or debris, remove and
reduce biofilm, remove infected tissues, in
palliative care to control odor, to facilitate wound
visualization, in chronic wounds to convert to acute
wound to promote healing
autolytic debridement a type of non-instrumental debridement that uses
the body's own WBCs, enzymes, and moisture to
re-hydrate, soften, and liquify hard eschar and
slough
benefits of autolytic debridement painless, easily done with moisture retentive
dressings, aides in combination debridement
methods
disadvantages of autolytic takes times, may be aesthetically displeasing to the
debridement patient if using a transparent dressing
contraindications to autolytic neutropenic patients, those with diabetes mellitus
debridement (higher risk for infection)
surfactant debridement a type of non-instrumental debridement that uses
concentrated nonionic surfactant dressings (CSDs)
which can soften and loosen wound debris,
breakdown biofilms, and prevent redevelopment of
biofilms
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