A patient is admitted to the emergency department with a burn. Following the treatment and procedures used for healing the wound, identify the type of therapy shown in the following image for healing?

1. A

   Negative Pressure wound therapy (NPWT)

2. B

   Positive pressure wound therapy

3. C

   Hyperbaric oxygen therapy

4. D

   Recording the muscles electrical activity

Appeared in: AIIMS Delhi NO - 2018

Explanation

• The image shows a complete Negative Pressure Wound Therapy (NPWT) system, which includes sealed occlusive dressings on the patient's leg and foot, tubing, and a portable vacuum pump.
• NPWT, also known as vacuum-assisted closure (VAC), applies sub-atmospheric (negative) pressure to a wound to promote healing.
• The primary mechanisms of NPWT are the removal of wound exudate, reduction of tissue edema, and promotion of granulation tissue formation.
• This therapy is commonly used for various acute and chronic wounds, including burns, to accelerate the healing process.

Why Other Options Were Wrong

• Option B: This is the opposite of the correct mechanism. NPWT uses negative (sub-atmospheric) pressure to create suction, not positive pressure to push air or fluid into the wound.
• Option C: Hyperbaric oxygen therapy is a systemic treatment where the patient breathes 100% oxygen in a pressurized chamber. It does not involve a localized dressing, tubing, or a portable pump as shown in the image.
• Option D: This describes Electromyography (EMG), which is a diagnostic test used to measure the electrical activity of muscles. It is not a therapeutic intervention for wound healing.

Related Visual

Clinical Relevance

• Nursing practice connection: Prioritize focused assessment, early escalation, and real-time monitoring when managing Identification and principles of Negative Pressure Wound Therapy (NPWT) in acute care settings.
• Nurses play a critical role in managing NPWT, including assessing the wound at each dressing change, ensuring the occlusive dressing maintains an airtight seal, and monitoring the pump settings and drainage in the canister.
• Patient education is key. The nurse must teach the patient and family how to manage the portable pump, respond to alarms, and identify signs of complications like infection or bleeding.
• What if? If the NPWT pump alarm sounds, it often indicates an air leak. The nurse's first action is to assess the dressing seal, checking for any loose edges or wrinkles in the drape, and reinforce it to restore the negative pressure.

How to Approach the Question

• First, carefully analyze the image provided. Identify the key components of the equipment shown: there are dressings on the patient's leg and foot, tubes coming from the dressings, and a small electronic device connected to the tubes.
• Recognize the setup as a medical suction device. The sealed dressings and tubing leading to a pump suggest that something is being drawn out of the wound.
• Consider the term 'negative pressure,' which is synonymous with suction or vacuum. This directly relates to the function you've observed.
• Evaluate the given options. 'Negative Pressure wound therapy (NPWT)' accurately describes a system that uses suction to heal wounds.
• Eliminate the other options based on their definitions. 'Positive pressure' is the opposite. 'Hyperbaric oxygen therapy' is a different procedure involving a pressurized chamber. 'Recording electrical activity' describes a diagnostic test (EMG), not a therapy.

Concept Tested & Keywords

• Concept Tested: Identification and principles of Negative Pressure Wound Therapy (NPWT).
• Stem keywords: burn, healing, wound, therapy, image
• Lead-in keywords: identify
• Clinical cues: The care setting changes urgency, monitoring level, and the expected nursing action.

Question ID

QHBJmaJh8huVdMe_7VbLVr

Copy ID

Reference Book

E6 Nursing Fundamentals Potter Perry 12e Part 6 p. 98-100

E6 Obstetrics Williams p. 64-86