1.20 Other Wound Types Flashcards
categories of wounds
- burns
- traumatic
- decubitus ulcers
- diabetic ulcers
- venous ulcers
- arterial ulcers
Why should you not take a knife out of a stab wound?
- it’s occluding a blood vessel
- can typically be sewn together and healed via primary intention
All wounds have the capacity to develop ____
infection
when a surgically fixed wound pops open
dehiscence
Dehiscence is a common problem with this group
amputees
problem with dehiscence
- can’t go back and sew up again
- must heal by secondary intention
tertiary intention
- heals by secondary intention
- doc sews it back up once it’s healed
decubitus ulcers
pressure ulcers
How does a pressure ulcer form?
- pressure over a bony landmark
- occludes blood flow
- deeper tissue dies
Why do pressure ulcers seem to just appear out of nowhere?
- dermal layer has been dying off for a while
- sometimes dies out and then up (undermining)
Which are the two types of wounds with a classification system?
- burns
- decubitus ulcers
bony landmarks susceptible to decubitus ulcers
- occiput
- thoracic vertebrae
- acromion, spine of scapula
- olecranon (sometimes)
- sacrum, coccyx (sometimes), ischial tuberosity, greater trochanter
- knees
- heels
- metatarsals
Why is the occiput a spot for pressure ulcers?
- often forgotten due to hair
- doesn’t get washed, dreads up
- laying on top of it
Why are the thoracic vertebrae a spot for pressure ulcers?
- kyphosis and popping out, especially if old and skinny
- direct pressure
Who most commonly gets metatarsal pressure ulcers?
diabetics
Stages of decubitus ulcers
- Suspected deep tissue injury
- Stage 1
- Stage 2
- Stage 3
- Stage 4
- Unstageable
Stages of decubitus ulcers: suspected deep tissue injury
- tissue doesn’t feel right (boggy, darker than normal skin)
- still blanches, but feels different
- may look bruised
Stages of decubitus ulcers: Stage 1
- skin intact, but there’s non-blancheable redness over a bony prominence
- inflammation happening (warm)
What to do for stage 1 pressure ulcer
- position them so they keep pressure off for 2 hours
- do NOT massage pressure ulcers
Stages of decubitus ulcers: Stage 2
- skin is broken
- partial thickness skin loss (dermis)
- shallow open ulcer with a red/pink wound bed
Stages of decubitus ulcers: Stage 3
- full thickness tissue loss (down to sub q fat
- bone, tendon, and muscle are not exposed
Stages of decubitus ulcers: Stage 4
- full thickness tissue loss
- exposed bone, tendon, or muscle
To stage decubitus ulcers, what must you be able to see?
- where the wound stops
- must SEE the wound bed
venous ulcers overall
- blood pooling
- valves not working
arterial ulcers overall
lack of blood flow
Which ulcer types are the most similar? Why?
- diabetic and arterial
- lack of blood flow
outside edge of the wound
periwound
For a wound, what should the periwound look like?
- as normal as possible (not desiccated or macerated)
- inflamed, slightly red
- should be uniform
Why do we need to make sure the periwound is not macerated or desiccated?
- doesn’t hurt as much
- not able to fight off infection as well
What would an infected periwound look like?
- irregular borders of redness
- streaking if close to a vein or artery
streaking
- infection follows artery or vein
- becomes systemic as it goes through the heart
