Certified Wound Care Nurse (CWCN) Practice Exam

What is considered the standard of care after a clean wound bed has been established in a necrotizing fasciitis patient?

1. Shear

2. Collagenase

3. Enzymatic debridement

4. Hydrocolloid dressing

The correct answer is: Enzymatic debridement

The standard of care after establishing a clean wound bed in a patient with necrotizing fasciitis is enzymatic debridement. This method utilizes enzymes to break down necrotic tissue while preserving viable tissue, allowing for effective and selective debridement. Enzymatic debridement is typically used when there is a need to manage large amounts of necrotic tissue without the risks associated with more invasive methods like surgical debridement. This approach is particularly important in cases of necrotizing fasciitis, where timely removal of dead tissue is crucial to prevent further infection and promote healing. Enzymatic agents can be applied directly to the wound, offering a controlled method of debridement that can be especially beneficial in fragile or compromised patients who may not tolerate surgical procedures well. The other treatment options, while potentially relevant in different contexts, do not align with the standard of care for managing the aftermath of necrotizing fasciitis. Shear is not a therapeutic method and can instead contribute to tissue damage. Collagenase can act similarly to other enzymatic agents but is not specifically recognized as the standard after establish a clean wound bed in this scenario. Hydrocolloid dressings are useful for superficial wounds but may not be effective in