A patient is referred to wound clinic with a lower extremity wound with well demarcated, undermined, and angry purple edges.  In addition, the patient has pronounced pain. You suspect that this patient likely has pyoderma gangrenosum.  Which of the following treatment interventions are contraindicated? 

A patient presents to you in the outpatient wound clinic with a wound on the dorsal aspect of the right 3rd MTP.  The wound appears to be dry and necrotic, has minimal drainage.  The patient has moderate edema in the foot and ankle.  You cannot palpate pedal pulses.  Which of the following items would be MOST important to complete this session?

Your patient is a 55 year old with h/o rheumatoid arthritis .  He presents with a lateral forearm wound sustained while gardening one week ago.  The wound measures 1.0 x 0.5 with a 2 cm area of surrounding erythema.  The wound is 50% granular and 50% slough.  While probing, you find a 3.1 cm tunnel at the 12:00 The periwound area is indurated, warm to touch, and painful to palpation. When would you tell you patient to see further care for infection?

For the patient in the previous question above, what do you first need to rule out before you can do that treatment? 

Which of the following tests or lab values would contraindicate the use of compression wraps to treat a patient with edema?

What dressings are used in the case of a MRSA infected wound?

Which dressing/product can be used for autolytic debridement (i.e. the body’s natural healing process to remove dead tissue from a wound)?

For the above right heel pressure injury.  Which is the most important treatment intervention you can provide? 

A patient presents to the hospital with a lower leg wound he sustained from an alligator bite while golfing. He did not seek medical attention at first because he thought it would heal on its own, but now it is painful, has diffuse redness around the periwound, and has an odorous smell coming from it. It was discovered through culture results that the wound is infected with MRSA.  Which of the following would be antimicrobial dressings that could help the patient to heal?

You have evaluated a patient with a right medial lower extremity wound today. The wound bed is 80% granular, 20% yellow slough. There is moderate wound odor, and copious blue-green drainage on the dressings. The border is irregular and macerated.  The periwound is moderately edematous, with moderate distal hemosiderin deposition.  The patient states that his leg swells up throughout the day and weeps into his sock and shoe. You diagnose the underlying etiology as venous insufficiency and this is confirmed by the vascular surgeon, having tested the patient with a venous duplex scan with poor results, and a normal ABI bilaterally.  What form of debridement would you do/recommend?