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

When is debridement of an arterial ulcer contraindicated?

1. In case of a necrotic ulcer

2. In dry, uninfected wounds until blood flow is adequate

3. In any ulcer with bacterial infection

4. In ulcers greater than 3 cm in diameter

The correct answer is: In dry, uninfected wounds until blood flow is adequate

Debridement of an arterial ulcer is contraindicated in dry, uninfected wounds until blood flow is adequate because the primary concern with arterial ulcers is the compromised blood supply. Debridement can exacerbate tissue ischemia by removing viable tissue that might otherwise benefit from improved perfusion if blood flow were to be restored. In cases where blood flow is insufficient, the risk of causing further harm or delaying healing increases significantly. It is essential to ensure adequate blood supply before proceeding with debridement to promote healing and prevent complications. Other options do not present a clear contraindication. For instance, debridement might be necessary in the case of a necrotic ulcer to remove dead tissue, even though careful consideration is required if blood flow is still inadequate. Similarly, while bacterial infections demand careful management, they do not universally contraindicate debridement since infection may necessitate the removal of necrotic tissue to facilitate healing, provided that adequate blood flow is present. The size of an ulcer, such as being greater than 3 cm in diameter, does not inherently contraindicate debridement either; the decision should depend more on the overall condition of the ulcer and the patient.