Modalitites

Question 1

Define chronic wounds and explain why they may require adjunctive wound modalities.

Answer 1

• Chronic wounds fail to respond to standard care and show stalled healing for over 30 days.
• Adjunctive modalities can help reduce bioburden and necrotic tissue.

Question 2

What are the main challenges in research supporting wound modalities?

Answer 2

Challenges include:

• Patient-related variables
• Wound-related variables
• Treatment-related variables
• Research-related problems
• Manufacturer-sponsored research

Question 3

List general indications for adjunctive wound modalities and considerations for selection.

Answer 3

• Adjunctive modalities are indicated for chronic wounds needing enhanced healing.
• Consider patient characteristics, wound location, treatment setting, and equipment.

Question 4

What is the purpose of wound irrigation, and what pressures are recommended?

Answer 4

• Removes debris, bacteria, and exudate
• Recommended pressures are 4-15 psi

Question 5

List the indications, contraindications, and common methods for wound irrigation.

Answer 5

• indicated for all wound types
• contraindicated in profuse bleeding
• methods include syringe or pressurized saline

Question 6

Describe the effects of whirlpool therapy and list its common indications.

Answer 6

• softens necrotic tissue, promotes circulation, and reduces pain
• indicated for infected wounds, thick eschar, and pain relief

Question 7

What are the contraindications and disadvantages of whirlpool therapy?

Answer 7

• Contraindicated in clean, granulating wounds and hydrophobic or seizure-prone patients.
• Disadvantages include risk of maceration and cross-contamination.

Question 8

What are the effects and recommended irrigation pressures for pulsed lavage?

Answer 8

• facilitates debridement and improves granulation
• 4-15 psi
• includes suction to remove contaminants

Question 9

List indications, precautions, and key setup considerations for pulsed lavage.

Answer 9

• Indicated for wounds needing debridement
• Precautions include exposed deep tissues and anticoagulant use
• Requires clean room and PPE

Question 10

What are the general purposes of electrical stimulation (ES) in wound care, and which types of wounds are typically treated?

Answer 10

• ES promotes healing, manages inflammation, and enhances wound contraction
• Suitable for all wound depths

Question 11

Compare effects of the negative pole (cathode) vs. the positive pole (anode) in ES.

Answer 11

• Cathode: decreases edema, promotes granulation, bactericidal.
• Anode: promotes healing, coagulates protein, attracts macrophages.

Question 12

What are contraindications for ES in wound care?

Answer 12

Untreated osteomyelitis, malignancy, heavy metal-based topical agents, pacemakers, and reflex center wounds.

Question 13

Describe the method and common settings for ES, including polarity changes.

Answer 13

Frequency: 120 Hz,

Intensity: 75-200 V, submotor;

Change polarity every 1-3 days; 45-60 mins, 3-5 days/week.

Question 14

What are the main purposes of high-frequency vs. low-frequency US in wound care?

Answer 14

High-frequency: improves collagen deposition and contraction.

Low-frequency: debridement, reduces wound bioburden.

Question 15

Describe the indications, methods, and precautions for traditional high-frequency US.

Answer 15

• Indicated for recalcitrant wounds;
• Methods include direct or immersion;
• Precautions include osteomyelitis and DVT.

Question 16

Explain diathermy’s mechanism and effects on wound healing.

Answer 16

Uses RF energy for heating; increases circulation, fibroblast function, and nitric oxide release; contraindicated on moist wounds.

Question 17

Compare the effects and indications of UVB vs. UVC light in wound healing.

Answer 17

UVB induces inflammation and granulation

UVC is bactericidal, enhances granulation, and inactivates microorganisms.

Question 18

What are common delivery methods and contraindications for UV therapy?

Answer 18

- Delivered via LEDs or lasers;

- Contraindicated:

• malignancy
• DVT
• deep vein thrombosis

Question 19

List the main purposes and effects of NPWT.

Answer 19

• reduces edema
• increases granulation
• maintains moist environment
• promotes wound contraction
• decreases bioburden.

Question 20

Describe Negative Pressure Wound Therapy:

• indications = ?
• contraindications = ?
• common settings = ?

Answer 20

• Indicated for chronic and postsurgical wounds
• contraindicated in necrotic or eschar wounds and exposed organs;
• Pressure: 50-175 mmHg

Question 21

What are the setup steps and common disadvantages of NPWT?

Answer 21

• Steps: irrigate, debride, apply foam, connect tubing, cover with drape.
• Disadvantages: pain, mobility restriction, air-tight seal issues.

Question 22

What are the purposes and effects of HBO on wound healing?

Answer 22

Increases oxygen gradient, reduces bacteria, enhances angiogenesis, reduces edema; useful in ischemic wounds.

Question 23

List indications, contraindications, and general treatment protocol for HBO.

Answer 23

• indications: gas gangrene, ischemia, osteomyelitis
• contraindications: DVT, CHF, pregnancy; 2x/day–3x/week, 10-60 sessions.

Question 24

Explain the mechanisms of ESWT and CAP in wound healing.

Answer 24

• Extracorporeal Shock Wave Therapy (ESWT): enhances microcirculation and metabolism.
• Cold atmospheric plasma (CAP): promotes fibroblast proliferation, keratinocyte growth, and angiogenesis.

Question 25

List the main criteria for selecting a wound modality for a specific patient.

Answer 25

Consider patient characteristics, wound type, treatment setting, availability, and modality pros/cons.

Question 26

What should be monitored when using adjunctive wound therapies, and when should a therapy be discontinued?

Answer 26

Monitor wound progress; discontinue if no improvement within 2 weeks.

Question 27

Explain the role of the clinical setting and available resources in wound modality choice.

Answer 27

Availability, equipment access, and patient tolerance all influence modality choice and practicality.

Question 28

Summarize the importance of modality effects, contraindications, and overall goal for wound adjunct therapies.

Answer 28

Understand effects, recognize contraindications, and aim to promote safe, effective healing by choosing suitable adjuncts.