WEB WOC Wound Care, Complete Verified
Solution 2023
TIMERS
Tissue management
Inflammation/infection control
Moisture balance
Edge/epithelial advancement
Regeneration/repair of tissue
Social/patient related factors
Framework used to provide an optimal physiologic wound environment that is
conducive to healing
TIMERS
Goal of tissue management
to remove non-viable, necrotic tissue as well as non-functional tissue such as
hypergranulation
goal of inflammation or infection control
eliminate infection and control bioburden
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 advancement
keep wound edged open, address epibole and undermining, remove callous, protect
periwound skin
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 debridement
takes times, may be aesthetically displeasing to the patient if using a transparent
dressing
contraindications to autolytic debridement
neutropenic patients, those with diabetes mellitus (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
indications for surfactant debridement
stagnant wounds, local wound infections, burns
benefits of surfactant debridement
cleanses wound without the use of cytogenic agents, reduces inflammation, reduces
biofilm, allows for daily visualization of wound
disadvantages of surfactant debridement
can be expensive, dressing must be changed daily
contraindications for surfactant debridement
sensitivity to chemical properties
enzymatic debridement
a type of non-instrumental debridement that uses collagenase to dissolve collagen
anchors between necrotic tissue and the wound bed
benefits of enzymatic debridement
faster than autolysis, good option for those at high risk for bleeding, safe in infected
wounds
disadvantages of enzymatic debridement
costly, daily application, can sting, takes longer than sharp or mechanical debridement
contraindications of enzymatic debridement
not compatible with metal products, some antiseptic cleansers reduce its
activity/effectiveness
chemical debridement by sodium hypochlorite
a type of non-instrumental debridement using sodium hypochlorite (diluted bleach) to
dissolve collagen anchors between necrotic tissue and the wound bed
indications for chemical debridement by sodium hypochlorite
grossly necrotic or infected wounds
benefits of chemical debridement by sodium hypochlorite
reduces wound odor, cheap, non-cytotoxic
disadvantages of chemical debridement by sodium hypochlorite
use is controversial, is cytotoxic to fibroblasts
contraindications of chemical debridement by sodium hypochlorite
do not use in clean wounds
chemical debridement by silver nitrate
a type of non-instrumental debridement using silver nitrate to reduce fibroblast
proliferation and overgrowth
Solution 2023
TIMERS
Tissue management
Inflammation/infection control
Moisture balance
Edge/epithelial advancement
Regeneration/repair of tissue
Social/patient related factors
Framework used to provide an optimal physiologic wound environment that is
conducive to healing
TIMERS
Goal of tissue management
to remove non-viable, necrotic tissue as well as non-functional tissue such as
hypergranulation
goal of inflammation or infection control
eliminate infection and control bioburden
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 advancement
keep wound edged open, address epibole and undermining, remove callous, protect
periwound skin
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 debridement
takes times, may be aesthetically displeasing to the patient if using a transparent
dressing
contraindications to autolytic debridement
neutropenic patients, those with diabetes mellitus (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
indications for surfactant debridement
stagnant wounds, local wound infections, burns
benefits of surfactant debridement
cleanses wound without the use of cytogenic agents, reduces inflammation, reduces
biofilm, allows for daily visualization of wound
disadvantages of surfactant debridement
can be expensive, dressing must be changed daily
contraindications for surfactant debridement
sensitivity to chemical properties
enzymatic debridement
a type of non-instrumental debridement that uses collagenase to dissolve collagen
anchors between necrotic tissue and the wound bed
benefits of enzymatic debridement
faster than autolysis, good option for those at high risk for bleeding, safe in infected
wounds
disadvantages of enzymatic debridement
costly, daily application, can sting, takes longer than sharp or mechanical debridement
contraindications of enzymatic debridement
not compatible with metal products, some antiseptic cleansers reduce its
activity/effectiveness
chemical debridement by sodium hypochlorite
a type of non-instrumental debridement using sodium hypochlorite (diluted bleach) to
dissolve collagen anchors between necrotic tissue and the wound bed
indications for chemical debridement by sodium hypochlorite
grossly necrotic or infected wounds
benefits of chemical debridement by sodium hypochlorite
reduces wound odor, cheap, non-cytotoxic
disadvantages of chemical debridement by sodium hypochlorite
use is controversial, is cytotoxic to fibroblasts
contraindications of chemical debridement by sodium hypochlorite
do not use in clean wounds
chemical debridement by silver nitrate
a type of non-instrumental debridement using silver nitrate to reduce fibroblast
proliferation and overgrowth
