11-Wound Care Flashcards
What are the stages of wound healing?
- inflammatory phase
- proliferative (repair) phase
- remodeling (maturation) phase
in what stage of healing do chronic wounds stop progressing?
proliferative (repair) phase
what occurs during inflammatory phase?
time scale
- (days 1-4)
- initial vasoconstriction followed by vasodilation
- neutrophils and macrophages are recruited
what occurs during proliferative (repair) phase? time scale?
- (days 3-21)
- collagen synthesis provides tensile strength of wound at 14 days
- tensile strength of wound equals that of suture
what is the time scale for remodeling (maturation) phase?
days 21 up to one year
What is Santyl?
collagenase- enzymatic debrider that digests collagen in necrotic tissue
what is Regranex?
PDGF-1 (platelet derived growth factor)
What is a normal value for serum albumin?
3.4-5.0 g/dL
what is low serum album (<3.5 g/dL) associated with?
- decreased wound healing
- edema
- impaired cellular immunity
- decreased collagen synthesis
- decreased fibroblast proliferation
what minimum ABI is necessary for wound healing?
- non-diabetic: 0.35
- diabetic: 0.45
Using transcutaneous oximetry (TcO2), what min. pressure is necessary for wound healing?
- non-diabetic: 30 mmgHg
- diabetic: 40 mmHg
how does negative pressure wound therapy (NPWT) (e.g. wound VAC) assist wound closure?
- NPWT applies mechanical shear stress to the wound site.
- This is believed to promote granulation by decreasing bacterial bioburden, reducing edema, and inducing capillary budding.
how does hyperbaric oxygen therapy assist wound closure?
- increases partial pressure of O2 in arterial circulation, which increases diffusion of O2 at the wound site.
- this is believed to increase growth factors promoting angiogenesis and collagen synthesis.
What is Integra?
bilayer graft composed of bovine (Cow) tendon collagen with chondroitin-6-sulfate and a silicone layer to control moisture loss
what is Oasis?
extracellular graft matrix derived from porcine, small intenstinal submucosa
what is Apligraf?
bilayer graft derived from nenonatal foreskin with dermal and epidermal layers
what is graft jacket?
extracellular graft matrix derived from human tissue with intact vascular channels
what is tissue mend?
acellular collagen matrix derived from fetal bovine dermis
(STRYKER)
where is Regranex made?
puerto rico
what is Theraskin
Real human skin allograft containing growth factors, cytokines and collagens
(MISONIX)
what is Epifix?
Dehydrated Human Amnion/Chorion Membrane (dHACM) Allograft is a placental-based tissue product that acts as a semi-permeable protective barrier that supports the healing cascade
(MIMEDX)
what is Revita?
Dehydrated full-thickness placental membrane allograft intended for use as a wound covering and barrier membrane
what is Dermagraft?
FDA-approved, bioengineered human fibroblast-derived dermal substitute for the healing of diabetic foot ulcers; polyester-based;
*constructed by growing human neonatal foreskin fibroblasts to confluence on a mesh of polyglactin-910 (Vicryl)
what is Kerecis Omega3?
Intact fish skin sheets containing fat, protein, elastin, glycans and other natural skin elements
