Wound Care Certification Lower Extremity Wound Management Flashcards
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Which compression system is considered the gold standard for venous leg ulcer treatment?
Answer: Four-layer compression bandage system (Charing Cross regimen)
The four-layer compression bandage system delivers sustained 40 mmHg compression at the ankle and has the strongest evidence base for venous leg ulcer healing.
Compression therapy is CONTRAINDICATED in which clinical scenario?
Answer: ABI of 0.45 with a venous leg ulcer and significant edema
Compression is contraindicated when ABI is below 0.5–0.6 because the arterial perfusion pressure is too compromised; added external pressure would critically worsen ischemia.
What is the primary therapeutic mechanism of compression therapy in venous leg ulcer management?
Answer: Counteracting venous hypertension by promoting venous return and reducing edema
Compression therapy directly addresses the underlying pathophysiology by countering venous hypertension, improving venous return, and reducing edema that impairs wound healing.
Which wound characteristic best differentiates a diabetic neuropathic ulcer from an arterial ulcer?
Answer: Located on the plantar surface at bony pressure points with surrounding callus
Neuropathic diabetic ulcers characteristically occur on plantar pressure points and are surrounded by callus from undetected repetitive trauma due to loss of protective sensation.
The Semmes-Weinstein 5.07 (10-gram) monofilament test is used to assess which clinical finding in diabetic patients?
Answer: Presence or absence of protective sensation
The 5.07 monofilament test detects loss of protective sensation (LOPS); inability to feel the 10-gram filament identifies patients at high risk for neuropathic ulcers.
Which dressing strategy is most appropriate for a venous leg ulcer with moderate exudate?
Answer: Absorbent foam dressing under compression bandaging
Foam dressings effectively manage moderate exudate, are compatible with compression bandaging, and together the combination addresses both wound moisture balance and venous hypertension.
Regular callus debridement around a diabetic neuropathic ulcer is performed primarily to:
Answer: Redistribute pressure, stimulate wound edge healing, and remove healing barriers
Callus debridement redistributes concentrated plantar pressure, converts the chronic wound edge to an acute state to enable epithelial migration, and removes physical barriers to healing.