1. Section Editor(s): Hess, Cathy Thomas BSN, RN, CWOCN

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How much do you know about wound debridement?


1. Which of the following statements about the purpose of debridement is correct?


a. Debridement is not essential for wound healing.


b. Debridement removes debris so cell movement is enhanced.


c. Debridement removes necrotic tissue to enhance the wound's biologic burden.


d. Debridement reduces the need for moist wound healing.



ANSWER: b. A is incorrect; most wounds need debridement to heal. C is incorrect because necrotic tissue increases the wound's biologic burden. D is incorrect because wounds need moist healing.


1. Which of the following signs in a stable necrotic heel would signal a need for debridement?


a. edema


b. eschar


c. yellow slough


d. thick, leathery black skin



ANSWER: a. Edema is a sign of infection. Other signs are erythema, fluctuance, and drainage.


1. Which of the following is an example of mechanical debridement?


a. collagenase


b. maggots


c. film dressings


d. pulsed lavage



ANSWER: d. Collagenase is an enzymatic debriding agent. Maggots secrete natural collagenase to debride wounds. Dressings are used for autolytic debridement.


1. A resident of a long-term-care facility is taking war-farin and needs debridement for a chronic ulcer on his forearm. Which of the following methods of debridement would beleastindicated?


a. surgical


b. enzymatic


c. mechanical


d. autolytic



ANSWER: a. Because this resident is taking warfarin, which can cause bleeding, surgical debridement would be least indicated. In addition, appropriate personnel and equipment for surgical debridement may not be available at a long-term-care facility.


1. Which method of debridement would be best for initially debriding an infected sacral pressure ulcer in a hospitalized patient?


a. surgical


b. enzymatic


c. mechanical


d. autolytic



ANSWER: a. Time is of the essence, and surgical debridement is the quickest method that can be used with infected wounds. Because the patient is hospitalized, the appropriate personnel and equipment are available.


Source: Ayello EA, Baranoski S, Kerstein MD, Cuddigan J. Wound debridement. In: Baranoski S, Ayello EA, editors. Wound Care Essentials: Practice Principles. Springhouse, PA: Lippincott Williams & Wilkins; 2004. p 117-26.