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7313/7333 Bringman > 1.26 Wound closure > Flashcards

1.26 Wound closure Flashcards

1
Q

How does an amputation typically heal?

A

primary intention

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2
Q

classifications of dressings for amputations

A
  • rigid dressings
  • semirigid dressings
  • soft dressings
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3
Q

What are the rigid dressings?

A
  • IPOP

- removable rigid dressings

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4
Q

IPOP

A

immediate postoperative prosthesis

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5
Q

What is an IPOP?

A
  • cast around residual limb (shapes perfectly)

- can add a post to the cast so they can use a prosthetic immediately

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6
Q

Who would receive an IPOP?

A
  • usually only for traumatic amputations

- want to get them walking as soon as possible

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7
Q

What are removable rigid dressings?

A
  • hard plastic shell with foam on the inside
  • straps to hold in place
  • education is particularly important here, remind them they need to get help
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8
Q

semirigid dressing

A

Unna dressing for control of edema

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9
Q

What are the soft dressings

A
  • elastic wraps

- shrinkers

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10
Q

soft dressings: elastic wraps

A
  • shape the leg right after surgery

- done so they can use a prosthetic limb

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11
Q

soft dressings: shrinkers

A
  • have some pressure to help shape
  • don’t have to wrap anymore
  • used only once they’ve healed and gotten to the size they’re after
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12
Q

What is a big concern at the surgical site

A

can dehisce and create a wound

  • undermining and infection along length of wound
  • tissue hasn’t grown together
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13
Q

post-surgical management

A
  • will have redness and swelling (measure girth)
  • wrap
  • mobilize
  • I&D
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14
Q

What is I&D?

A

irrigation and debridement

standard surgical procedure (common)

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15
Q

phantom limb issues

A
  • sensation

- pain

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16
Q

phantom limb sensation

A
  • normal feeling sensations about the portion of the limb that’s gone
  • not pain
17
Q

phantom limb pain

A
  • perceiving something as very painful even though it isn’t happening
  • can be continuous, localized, diffuse, and limit ability to function
  • anatomically no longer there, but that portion of the brain is
18
Q

With amputees, the early stages of PT is focused on

A

desensitizing

  • looking at the leg, touching it, thinking about where they’re touching it
  • integration of sensation at the limb
  • may do mirror therapy
19
Q

Does phantom limb ever go away?

A
  • may or may not

- typically trying to get it from continuous to intermittent

20
Q

overall PT goals

A
  • heal the wound
  • edema control
  • ROM and strength
  • gait training
  • transfers
  • sitting and standing balance
  • skin
  • psychosocial aspects of loss
  • HEP
21
Q

What is involved with gait training?

A

crutches and walkers

  • walkers safer
  • crutches typically for younger, healthy people
22
Q

Which is better for an amputee? Rolling or standard walker?

A

rolling: don’t want to have to pick it up every time

23
Q

Gait is mostly

A

momentum

24
Q

Why is gait so challenging for new amputees?

A
  • every motion is a brand new contraction, motion against gravity
  • there’s no momentum to be used with amputees
25
Q

What is an important thing to be able to do for bed mobility?

A

bridging

26
Q

sitting and standing balance: transtib

A

hooking knee on side of bed/chair

27
Q

sitting and standing balance: transfem

A
  • often widen base of support on bed

- harder to balance

28
Q

psychosocial issues

A
  • getting them to talk about the loss

- may need to refer

29
Q

amputee HEP: consider

A
  • What will get tight on transfem/transtib?

- What should be strengthened?

30
Q

Questions to ask for d/c planning?

A
  • Stairs? Rails? Both sides? How far apart?
  • Who lives with them?
  • How tight are doorways?
  • Ramp?
  • Bathroom?
  • Bed height? Consistency?
  • Carpet/tile?
  • Tub? Walkin? Shower? Etc?
31
Q

What is one of the most important things to focus on in PT?

A

fall recovery

32
Q

Amputee wheelchair

A
  • support for residual limb (keep in extension

- balance: COM over base of support

33
Q

wheelchairs and COM

A
  • could tip backward because COM is posterior

- axle needs to be moved back to keep from tipping

7313/7333 Bringman (56 decks)

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