Certified Wound Care Nurse (CWCN) Practice Exam

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Which procedure may be useful when routine pouching systems fail to contain fistulas within wound depressions?

  1. Charcoal procedure

  2. Fibrin glue application

  3. Negative pressure therapy

  4. Skin grafting

The correct answer is: Charcoal procedure

The charcoal procedure, while sometimes used to manage unpleasant odors associated with wounds or fistulas, is not specifically designed to address the containment of fistulas within wound depressions where traditional pouching systems fail. In this context, fibrin glue application is a method that actively assists in sealing fistulas by promoting tissue adhesion and healing. It works by applying a fibrin-based product that mimics the final stages of the clotting process, creating a barrier that helps to contain the output from the fistula, thus preventing leakage and protecting the surrounding tissue. Fibrin glue can be particularly effective in managing complex wounds with fistulas, as it provides a moist environment that encourages healing and minimizes the risk of infection. It is also beneficial because it can be applied in outpatient settings and does not require extensive surgical intervention, making it a practical choice when routine pouching systems are inadequate. Negative pressure therapy and skin grafting are additional strategies that may be effective in managing wounds but are not specifically tailored for fistula containment. Negative pressure therapy helps promote healing by drawing out excess fluids and can assist with wound closure but does not close fistulas. Skin grafting is a surgical technique used to cover defects or aid in wound closure but is more invasive than what might be needed