Wound Care Certification Wound Bed Preparation Techniques Flashcards
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A patient requires wound bed preparation before split-thickness skin grafting. Which wound bed characteristic is MOST predictive of graft success?
Answer: Clean, well-vascularized granulation tissue covering >95% of the wound bed
Successful graft take requires a well-vascularized, clean granulation tissue bed covering nearly the entire wound surface.
Which of the following BEST describes the concept of 'wound bed preparation 2.0' as it has evolved beyond the original TIME framework?
Answer: Addition of host factors including patient-centered concerns, biofilm management, and advanced therapies
Wound Bed Preparation 2.0 expanded TIME to include patient-centered care, biofilm as a primary barrier, and integration of advanced therapies.
A clinician documents 'epibole' during wound assessment. What does this term describe?
Answer: Rolled, thickened wound edges where epithelium has turned down into the wound
Epibole refers to rolled or curled wound edges where epithelial cells have migrated down into the wound rather than across it.
Which topical agent is MOST appropriate to apply to hypergranulation tissue to reduce it and allow re-epithelialization?
Answer: Silver nitrate or foam dressing with compression
Silver nitrate sticks chemically cauterize hypergranulation tissue, and compressive foam dressings reduce it mechanically to allow epithelial migration.
When evaluating wound exudate as part of wound bed preparation, which exudate characteristic suggests wound infection rather than normal healing?
Answer: Cloudy, malodorous, purulent exudate
Purulent, malodorous, cloudy exudate is a hallmark of wound infection requiring bioburden reduction strategies.
A wound care nurse is choosing between conservative sharp debridement and surgical debridement. Which criterion MOST strongly indicates the need for surgical debridement?
Answer: Large, deep wound with extensive necrosis and signs of spreading infection
Surgical debridement is indicated when there is extensive necrosis with spreading infection that conservative methods cannot adequately or rapidly address.
In wound bed preparation, which factor is MOST responsible for converting a chronic wound environment to an acute wound environment?
Answer: Effective debridement that removes senescent cells and reduces bioburden
Effective debridement removes senescent cells, reduces bioburden, and resets the wound biochemistry toward an acute, healing-responsive state.