CHS CHS Wound Care & Tissue Healing 2 — Questions and Answers
Question 1: Necrotizing fasciitis is a UHMS-approved indication for HBOT. What is the primary rationale for using HBOT as an adjunct in this condition?
- HBOT replaces surgical debridement as the primary treatment
- Elevated tissue pO2 enhances leukocyte bactericidal activity against anaerobic organisms (Correct answer)
- HBOT reduces the need for antibiotic therapy
- HBOT seals the fascial planes to stop spread
Correct answer: Elevated tissue pO2 enhances leukocyte bactericidal activity against anaerobic organisms
HBOT raises local tissue oxygen levels, restoring the oxidative killing capacity of neutrophils against anaerobic and mixed-flora bacteria involved in necrotizing fasciitis.
Question 2: When assessing a wound for HBOT candidacy using TCOM, a reading that increases to above 200 mmHg in 100% O2 at 1 ATA indicates what?
- The wound will not respond to HBOT
- Adequate vascular supply exists and HBOT is likely to be beneficial (Correct answer)
- The wound is fully healed and no further treatment needed
- The patient has oxygen toxicity
Correct answer: Adequate vascular supply exists and HBOT is likely to be beneficial
A TCOM that rises above 200 mmHg with supplemental oxygen at normobaric conditions demonstrates responsive vasculature capable of delivering hyperbaric oxygen benefits.
Question 3: Which statement best describes the role of HBOT in treating compromised skin grafts and flaps?
- HBOT directly injects oxygen into graft tissue bypassing capillaries
- HBOT reduces edema and supports angiogenesis to improve graft survival in at-risk tissue (Correct answer)
- HBOT is contraindicated in all post-surgical graft patients
- HBOT cures graft failure after it has fully occurred
Correct answer: HBOT reduces edema and supports angiogenesis to improve graft survival in at-risk tissue
HBOT decreases post-ischemic edema, supports new capillary growth into the graft, and provides oxygen to marginally perfused tissue to rescue compromised grafts and flaps.
Question 4: A patient undergoing HBOT for a chronic non-healing wound is also receiving radiation therapy. Why might the irradiated tissue respond poorly to conventional wound care?
- Radiation increases collagen overproduction causing fibrosis only
- Radiation causes obliterative endarteritis resulting in chronic tissue hypoxia and impaired healing (Correct answer)
- Radiation directly kills all bacteria preventing infection
- Radiation accelerates wound healing by stimulating stem cells
Correct answer: Radiation causes obliterative endarteritis resulting in chronic tissue hypoxia and impaired healing
Ionizing radiation damages small blood vessels (obliterative endarteritis), creating a hypoxic-hypovascular-hypocellular wound environment that impairs healing.
Question 5: What is the term for the HBOT-approved condition characterized by bone death due to radiation damage?
- Avascular necrosis
- Osteoradionecrosis (Correct answer)
- Osteomyelitis
- Stress fracture
Correct answer: Osteoradionecrosis
Osteoradionecrosis is the death of bone resulting from radiation-induced vascular insufficiency, and it is a UHMS-approved indication for HBOT.
Question 6: Which wound measurement tool uses light reflection to provide a three-dimensional assessment of wound volume and surface area?
- Transparent acetate tracing
- Structured light or stereophotogrammetry imaging system (Correct answer)
- Standard wound ruler
- Visual analog scale
Correct answer: Structured light or stereophotogrammetry imaging system
Structured light and stereophotogrammetry systems capture 3D wound geometry non-contact, providing accurate volume and area measurements for tracking HBOT response.
CHS CHS Wound Care & Tissue Healing 2
Necrotizing fasciitis is a UHMS-approved indication for HBOT.
What is the primary rationale for using HBOT as an adjunct in this condition?