Burns and Wounds Flashcards
What are the 5 stages of wound healing?
- Hemostasis - immediate skin response
- Vasoconstriction - blood vessels clump together, blood clot form, fibrin crosslink
- Inflammation - sends signal to fight pathogen, macrophages eat bacteria through phagocytosis, produce GF for healing
- Vasodilation, expansion of constricted BV to allow WBC to travel to site.
- Proliferative - 2-3 days after fibroblast enter wound, process of collagen deposition
What is a pressure injury?
Localized damage to skin and underlying soft tissue over bony prominence, by prolonged pressure and shear.
What is the Braden Scale?
Scale to measure elements of risk contributing to high intensity and duration of pressure. Low is risk.
Why is the ear important for pressure wounds?
Requiring oxygen for tubes over ears - higher likelihood of skin breakdown.
What are the 3 parts of the skin?
Epidermis - barrier
Dermis - tough CT, hair follicles, sweats glands, nerves
Hypodermis - fat, CT, BVs
What are the 4 stages of pressure ulcers?
Non-blanchable erythema, Partial thickness skin loss with exposed dermis, full thickness of skin loss, full thickness skin and tissue loss.
What is a non-blanchable erythema?
Intact skin, erythema (redness of skin), localized redness, painful, firm, soft, warmer, cooler.
NOT purple or maroon.
What is partial thickness skin loss with exposed dermis?
Shallow open ulcer, pink wound bed, moist, intact or ruptured blister, adipose/ deep tissue is NOT visible.
What are the 4 types of skin wound not classified in stage 2?
Incontinence related dermatitis, maceration, scratches, skin tear
What is full thickness skin loss?
Adipose fat visible, eschar, slough present. Epibole present. Undermining and tunneling occurs.
What is undermining and tunneling?
Undermining - wider area of tissue, one or more direction
Tunneling - channels from wound, one direction
What is epibole?
Rolling of tissue around the wound. Indicate its chronic.
What is full thickness skin and tissue loss?
Exposed bone, tendon, muscle present.
What is unstageable or unclassified?
Obscured full thickness of what the wound is, by slough or eschar.
What is suspected deep tissue injury?
Deep purple and maroon discoloration, pain/temperature changes precedes skin color changes. Results from pressure at bone-muscle interface.
What are the 4 sources of burns?
Thermal, chemical, electrical, radiation.
What is 1st degree burn? How to treat it?
Superficial, only epidermis, red, dry, no blisters.
Soak area in cool water, wrap with dry bandage, painkillers.
What is 2nd degree burn? How to treat it?
Partial thickness, from epidermis to dermis, red, moist with blisters, swollen.
Soak in water for several minutes, no support for topical antibiotics.
What is 3rd degree burn? How to treat it?
Beyond dermis into hypodermis, patchy white or brown, dry leathery, little to no pain.
Immediate medical care, elevate burn above heart level.
What is 4th degree burn?
Beyond hypodermis into muscle or bones, brown, dry, charred. Painless.
How long for skin replacement to heal?
7-10 days to heal and graft site, dressing is left on for 2-5 days to keep new skin in place before changed.
What is a hypertrophic scarring?
Lots of tension around wound, 3 Rs (red, raised, rigid). Imbalance in collagen at wound site, longer wound healing, more likely to develop. Dry, itchy, sensitive.
What is a keloid scar?
Infiltrate surrounding tissue, firm tender tumor with hyperpigmentation. Does not regress.
Keloid composed of type 1 and 3 collagen irregularly branched, without nodules, excess myofibroblasts.
What is a contracture? How to treat contracture?
Tightening of skin after 2-3rd degree burn, loss of ROM.
Scar massages, stretches, silicone gel, splints, can help prevention.
