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WEB WOC Wound Care Exam Study Guide.
TIMERS - answer✔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 - answer✔TIMERS
Goal of tissue management - answer✔to remove non-viable, necrotic tissue as well as non-
functional tissue such as hypergranulation
goal of inflammation or infection control - answer✔eliminate infection and control bioburden
goal of moisture balance - answer✔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 - answer✔keep wound edged open, address epibole and
undermining, remove callous, protect periwound skin
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goal of regeneration/repair of tissue - answer✔cellular products, tissue based products,
advanced therapies such as hyperbaric treatment of NPWT
goal of social/patient related factors - answer✔develop a patient-centers POC, patient
engagement, holistic assessment
why use debridement? - answer✔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 - answer✔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 - answer✔painless, easily done with moisture retentive
dressings, aides in combination debridement methods
disadvantages of autolytic debridement - answer✔takes times, may be aesthetically displeasing
to the patient if using a transparent dressing
contraindications to autolytic debridement - answer✔neutropenic patients, those with diabetes
mellitus (higher risk for infection)
surfactant debridement - answer✔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 - answer✔stagnant wounds, local wound infections,
burns
benefits of surfactant debridement - answer✔cleanses wound without the use of cytogenic
agents, reduces inflammation, reduces biofilm, allows for daily visualization of wound
disadvantages of surfactant debridement - answer✔can be expensive, dressing must be
changed daily
contraindications for surfactant debridement - answer✔sensitivity to chemical properties
enzymatic debridement - answer✔a type of non-instrumental debridement that uses
collagenase to dissolve collagen anchors between necrotic tissue and the wound bed
benefits of enzymatic debridement - answer✔faster than autolysis, good option for those at
high risk for bleeding, safe in infected wounds
disadvantages of enzymatic debridement - answer✔costly, daily application, can sting, takes
longer than sharp or mechanical debridement
contraindications of enzymatic debridement - answer✔not compatible with metal products,
some antiseptic cleansers reduce its activity/effectiveness
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chemical debridement by sodium hypochlorite - answer✔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 - answer✔grossly necrotic or
infected wounds
benefits of chemical debridement by sodium hypochlorite - answer✔reduces wound odor,
cheap, non-cytotoxic
disadvantages of chemical debridement by sodium hypochlorite - answer✔use is controversial,
is cytotoxic to fibroblasts
contraindications of chemical debridement by sodium hypochlorite - answer✔do not use in
clean wounds
chemical debridement by silver nitrate - answer✔a type of non-instrumental debridement
using silver nitrate to reduce fibroblast proliferation and overgrowth
*silver nitrate is a non-selective, caustic, chemical which burns and contacted tissues
benefits of chemical debridement by silver nitrate - answer✔removes excess granulation tissue,
removes necrotic tissue, can open up epibole, reduces bioburden
disadvantages of chemical debridement by silver nitrate - answer✔use is controversial, painful,
can stain skin, absorption of toxic silver is possible
contraindications of chemical debridement by silver nitrate - answer✔avoid use in pediatric
patients as it can cause silver toxicity and is painful
biosurgical debridement - answer✔a type of non-instrumental debridement using medical
grade maggots to liquify necrotic tissue through proteolytic enzymes
disadvantages of biosurgical debridement - answer✔distasteful to most patients/caregivers,
bleeding, pain, crawling sensation
contraindications or biosurgical debridement - answer✔poorly perfused wounds, exposed
blood vessels, necrotic bones, limb-threatening infections
mechanical debridement by wet-to-dry dressing - answer✔a type of non-instrumental
debridement done by using damp gauze in the wound bed that is allowed to dry out to trap
tissue which is then pulled off during dressing changes
benefits of mechanical debridement by wet-to-dry dressing - answer✔cheap, dressing change is
easy to perform, use in heavily necrotic or infected wounds without granulation tissue
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