Wound Care Certified Certification (WCC) Practice Exam

For which of the following wounds would negative pressure wound therapy be contraindicated?

1. A wound with 50% eschar

2. A clean surgical wound

3. A wound with minimal exudate

4. A superficial abrasion

The correct answer is: A wound with 50% eschar

Negative pressure wound therapy (NPWT) utilizes controlled sub-atmospheric pressure to enhance wound healing, promote tissue granulation, and facilitate the formation of a closed environment that can help clear excess exudate. However, the use of NPWT can be contraindicated in certain types of wounds, particularly those with significant necrotic tissue, such as a wound with 50% eschar. When a wound has a high percentage of eschar, it indicates a considerable amount of non-viable tissue. Applying NPWT in such cases can trap bacteria and debris beneath the eschar, leading to infection and further complications, rather than promoting healing. Additionally, eschar needs to be properly debrided before NPWT can be applied effectively, as NPWT works best on clean, healthy granulating tissue. In contrast, clean surgical wounds typically have minimal contamination, while wounds with minimal exudate may still promote healing with NPWT, as it can assist with fluid management without the risks associated with necrotic tissue. Superficial abrasions usually heal straightforwardly and do not require NPWT, but do not present the same risks as wounds laden with eschar. This understanding reinforces why NPWT should be avoided in the case of wounds