13 SKIN AND WOUND MANAGEMENT

Question 1

SKIN

Answer 1

Skin is the largest organ in the body.
Capable of repair
Less than 2 mm thick in most places.

Question 2

SKIN FUNCTIONS

Answer 2

Excretion of moisture and body fluids.
Protection.
Regulates body temperature.
Provides sensory input.
Gives identity.

Question 3

EPIDERMIS

Answer 3

Outer layer of the skin.
Replaces every 6-8 weeks.

Question 4

DERMIS

Answer 4

Thicker than the epidermis.

Houses:
Smooth muscle.
Blood vessels.
Lymphatic vessels.
Nerves.

Question 5

SUBCUTANEOUSE TISSUES

Answer 5

Located deep to dermis.

contains:
adipose tissue
muscles
tendons
ligaments
bones

Question 6

HEALING OF SKIN

Answer 6

Inflammation.
Cellular Proliferation and Repair.
Remodeling.

Question 7

DELAYED HEALING

Answer 7

Age.
Poor blood supply.
Infection.
Medications.
Eschar, dead tissue.
Poor nutrition.
Smoking.

Question 8

BURNS DEPENDENT ON

Answer 8

Time of exposure.
Temperature.
Type of insult.
Anatomical thickness.
Rule of nines.

Question 9

RULE OF NINES

Answer 9

Head 9%
Arms 9% each
Trunk: front 18%, back 18
Leg: 18% each

Question 10

DEGREE OF BURNS

Answer 10

1st degree: damage to epidermis.
2nd degree: damage to epidermis and dermis.
3rd degree: damage to subcutaneous layer.
4th degree: damage to fat, muscle, bone.

Question 11

WHEN TO SEEK ATTENTION FOR BURNS

Answer 11

Burn is more than 3 inches in diameter on face, hands, feet, or a joint.
Burns from electrical or chemical means.
Pus leaking from burn.
Skin burnt away.
Pain gets worse with time.

Question 12

PHYSIOTHERAPY TREATMENT WITH BURNS

Answer 12

Apply dressing.
Monitor for signs of infection.
Facilitate skin graft healing.
Prevent respiratory complications.
Maintain ROM.
The position of comfort is the position of dysfunction.

Question 13

ULCERS & WOUNDS

Answer 13

Stage 1: redness does not disappear within 30 minutes.
Stage 2: blister formed.
Stage 3: open wound/ulcer.
Stage 4: deep through subcutaneous tissues, expose fascia, tendons, muscle, bone.

Question 14

CONSIDERATIONS FOR ULCERS

Answer 14

Ulcer bed, wound itself.
Location, pressure.
Drainage.
Tunnelling.
Infection.

Question 15

ESCHAR VS SCAB

Answer 15

Eschar: dead skin.
Scab: dried blood.

Question 16

SIGNS OF INFECTION

Answer 16

Fever.
Discharge or Pus.
Increased redness.
Increased warmth.
Increased pain.
Increased swelling.

Question 17

PHYSIOTHERAPY INVOLVEMENT WITH ULCERS

Answer 17

Cleanse.
Debride.
Dress and ointment.
Electrotherapy agents to promote healing.
Encourage function withing limits of ulcer.
Education.
ROM.
Positioning.

Question 18

AMPUTATIONS

Answer 18

60-70% Vascular Disease.
30-40% Trauma.

Question 19

TYPES OF AMPUTATION

Answer 19

Toe amputation.
Partial foot amputation.
Transmalleolar/Ankle disarticulation.
Transtibial/Below knee amputation.
Knee disarticulation.
Transfemoral.

Question 20

PHYSIOTHERAPY TREATMENT FOR AMPUTATIONS

Answer 20

Stump care.
Stump exercises.
Pain management.
Balance.
Gait training/strength.
Prevention of other conditions.

Question 21

SKIN INSPECTIONS

Answer 21

Critically important.
Education.
Inspect incision, shape, colour.

Question 22

PRESSURE AREAS FOR TRANSTIBIAL PROSTHETIC

Answer 22

Pressure Sensitive Areas: Fibular Head, Anterior Border (tibia), Distal End, Hamstring Tendons, Medial/Lateral Femor condyles.

Pressure Tolerant Areas: Patellar Tendon, Gastrocnemius, Medial/Lateral Flare.