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

If a wound is covered with eschar, what must be done before enzymatic debridement?

1. Apply antimicrobial dressings

2. Crosshatch or apply at the periphery

3. Remove the entire eschar manually

4. Leave the eschar intact for better healing

The correct answer is: Crosshatch or apply at the periphery

When addressing a wound covered with eschar, it is essential to prepare the area to facilitate effective enzymatic debridement. Crosshatching or applying the enzymatic agent at the periphery of the eschar enhances the effectiveness of the debridement process. This practice creates a pathway for the enzymes to penetrate the eschar more effectively, allowing them to break down necrotic tissue and promote healing. Enzymatic debridement relies on the action of topical agents that digest the non-viable tissue; however, without proper preparation of the eschar, these agents may not adequately penetrate and work effectively. By creating crosshatch patterns or applying the enzymatic agent along the edges, you optimize the conditions for the enzyme to act, ensuring that the necrotic tissue is more readily removed and the underlying healthy tissue can be restored. The other options, while they may seem plausible in different contexts, do not directly support the enzymatic debridement process as effectively as crosshatching. For instance, applying antimicrobial dressings may be useful for infection control but does not aid the enzymatic process. Removing the eschar manually could lead to trauma to the wound bed and potential complications, while leaving the eschar intact does not facilitate healing and