WCC Procedures Practice Questions (90 Flashcards)

Autolytic debridement uses the body's own enzymes (endogenous proteases and matrix metalloproteinases/MMPs) and moisture to liquefy necrotic tissue. The primary cells involved are macrophages and neutrophils, which release these enzymes to digest devitalized proteins. Exam Strategy: NAWCO emphasizes that autolysis is the most selective form of debridement, as it only targets non-viable tissue while sparing healthy granulation. It is the slowest method and requires a functional immune system and a moist environment to be effective.

Dakin's solution is cytotoxic to healthy fibroblasts and endothelial cells at standard concentrations. While it is an effective antimicrobial for heavily infected or malodorous wounds, its use on healthy granulation tissue inhibits wound healing and can cause tissue damage. 2026 Best Practice: Use pH-balanced hypochlorous acid or normal saline for mechanical cleansing unless heavy bioburden or specific infection justifies the short-term use (usually <7 days) of cytotoxic agents.

Pain is usually caused by the increase in wound pH (alkalinity) and the physical movement/spiking of the larvae as they grow and crawl over sensitive nerve endings. Management: Administer prescribed analgesics (NSAIDs or opioids). If pain is unbearable, the larvae must be removed. WCC Tip: Pain is most common in ischemic wounds or those with pre-existing neuropathy. Always assess perfusion before MDT; poor blood flow increases the risk of therapy-induced pain.

A non-adherent, protective barrier (e.g., white foam, petroleum gauze, or a silicone contact layer) must be placed over exposed vessels, nerves, or organs. Rationale: Direct contact with reticulated (black) foam can cause erosion of the vessel wall due to mechanical forces and granulation tissue ingrowth, leading to fatal hemorrhage. NAWCO Focus: Never place black foam directly on vital structures.

1. The wound must be a **Stage III or IV pressure injury**, arterial ulcer, diabetic ulcer, or venous stasis ulcer. 2. **Standard wound care** (moist wound healing, nutrition, offloading/compression) must have been tried for at least **30 days** with no measurable signs of healing. **Exam Strategy:** CMS does not cover ES as an initial therapy; documentation of a failed 30-day trial is a must-know for the WCC. Distractors often suggest 14 days or any wound stage, which is incorrect for reimbursement.