Wound, Ostomy and Continence Nurses Society (WOCN) Practice Exam

What should be done if vasocongestion is observed in a myocutaneous flap?

1. Apply direct heat to the area

2. Monitor without intervention

3. Manage with leeches or HBOT

4. Administer pain relief and massage

The correct answer is: Manage with leeches or HBOT

In the case of vasocongestion in a myocutaneous flap, the most appropriate action is to manage the condition with leeches or hyperbaric oxygen therapy (HBOT). Vasocongestion refers to the accumulation of blood in the vessels of the flap, which can lead to complications such as tissue necrosis if not addressed effectively. Leeches can effectively help reduce venous congestion by acting as biological pumps, facilitating blood drainage from the flap area. They secrete anticoagulants that improve blood flow while also providing analgesic effects. On the other hand, hyperbaric oxygen therapy enhances oxygen delivery to the tissues, promoting healing and potentially reversing tissue ischemia. Both options are proactive and targeted methods of managing vasocongestion. Other approaches, such as applying direct heat or simply monitoring the flap without intervention, do not directly address the underlying issue of congestion. Administering pain relief and massage, while potentially providing comfort, does not tackle the vascular complications present in the flap and may exacerbate the situation. Therefore, the choice of leeches or HBOT remains the most effective and clinically relevant intervention for managing vasocongestion in this context.