1.20 Other Wound Types

Question 1

categories of wounds

Answer 1

• burns
• traumatic
• decubitus ulcers
• diabetic ulcers
• venous ulcers
• arterial ulcers

Question 2

Why should you not take a knife out of a stab wound?

Answer 2

• it’s occluding a blood vessel

- can typically be sewn together and healed via primary intention

Question 3

All wounds have the capacity to develop ____

Answer 3

infection

Question 4

when a surgically fixed wound pops open

Answer 4

dehiscence

Question 5

Dehiscence is a common problem with this group

Answer 5

amputees

Question 6

problem with dehiscence

Answer 6

• can’t go back and sew up again

- must heal by secondary intention

Question 7

tertiary intention

Answer 7

• heals by secondary intention

- doc sews it back up once it’s healed

Question 8

decubitus ulcers

Answer 8

pressure ulcers

Question 9

How does a pressure ulcer form?

Answer 9

• pressure over a bony landmark
• occludes blood flow
• deeper tissue dies

Question 10

Why do pressure ulcers seem to just appear out of nowhere?

Answer 10

• dermal layer has been dying off for a while

- sometimes dies out and then up (undermining)

Question 11

Which are the two types of wounds with a classification system?

Answer 11

• burns

- decubitus ulcers

Question 12

bony landmarks susceptible to decubitus ulcers

Answer 12

• occiput
• thoracic vertebrae
• acromion, spine of scapula
• olecranon (sometimes)
• sacrum, coccyx (sometimes), ischial tuberosity, greater trochanter
• knees
• heels
• metatarsals

Question 13

Why is the occiput a spot for pressure ulcers?

Answer 13

• often forgotten due to hair
• doesn’t get washed, dreads up
• laying on top of it

Question 14

Why are the thoracic vertebrae a spot for pressure ulcers?

Answer 14

• kyphosis and popping out, especially if old and skinny

- direct pressure

Question 15

Who most commonly gets metatarsal pressure ulcers?

Answer 15

diabetics

Question 16

Stages of decubitus ulcers

Answer 16

• Suspected deep tissue injury
• Stage 1
• Stage 2
• Stage 3
• Stage 4
• Unstageable

Question 17

Stages of decubitus ulcers: suspected deep tissue injury

Answer 17

• tissue doesn’t feel right (boggy, darker than normal skin)
• still blanches, but feels different
• may look bruised

Question 18

Stages of decubitus ulcers: Stage 1

Answer 18

• skin intact, but there’s non-blancheable redness over a bony prominence
• inflammation happening (warm)

Question 19

What to do for stage 1 pressure ulcer

Answer 19

• position them so they keep pressure off for 2 hours

- do NOT massage pressure ulcers

Question 20

Stages of decubitus ulcers: Stage 2

Answer 20

• skin is broken
• partial thickness skin loss (dermis)
• shallow open ulcer with a red/pink wound bed

Question 21

Stages of decubitus ulcers: Stage 3

Answer 21

• full thickness tissue loss (down to sub q fat

- bone, tendon, and muscle are not exposed

Question 22

Stages of decubitus ulcers: Stage 4

Answer 22

• full thickness tissue loss

- exposed bone, tendon, or muscle

Question 23

To stage decubitus ulcers, what must you be able to see?

Answer 23

• where the wound stops

- must SEE the wound bed

Question 24

venous ulcers overall

Answer 24

• blood pooling

- valves not working

Question 25

arterial ulcers overall

Answer 25

lack of blood flow

Question 26

Which ulcer types are the most similar? Why?

Answer 26

• diabetic and arterial

- lack of blood flow

Question 27

outside edge of the wound

Answer 27

periwound

Question 28

For a wound, what should the periwound look like?

Answer 28

• as normal as possible (not desiccated or macerated)
• inflamed, slightly red
• should be uniform

Question 29

Why do we need to make sure the periwound is not macerated or desiccated?

Answer 29

• doesn’t hurt as much

- not able to fight off infection as well

Question 30

What would an infected periwound look like?

Answer 30

• irregular borders of redness

- streaking if close to a vein or artery

Question 31

streaking

Answer 31

• infection follows artery or vein

- becomes systemic as it goes through the heart