Chap 83 Wound Care Flashcards
List causes of non-healing wounds and name one method of investigation for each.
Venous hypertension–Plethysmography/Doppler
Arterial insufficiency–NIVs (macro), tcPO2/biopsy (micro)
Bacterial colonization–wound culture or biopsy
Malignancy–biopsy
Lymphatic obstruction–clinical, lymphangiography
Hematological disorders–B/W
Collagen vascular disorders–serum markers
Excessive pressure—vibratory sensation (>25mV)
What are the stage of normal wound healing.
inflammatory
proliferative
epithelialization and remodelling
Describe the inflammatory phase.
Mediated by Mast cells, neutrophils, macrophages
Release cytokines that recruit fibroblast and epithelial cells
Within 24hours
Describe the proliferative phase.
Macs—growth factors that begin angiogenesis
Finroblast and cytokines synthesize collagen and proteoglycans—granulation tissue
Describe the Epithelialization and remodelling phase
Epithelial cells migrate into the wounds, secret MMP to degrade nonviable tissue
Remodeling long-term procee where type III collagen replaces type I
List mechanisms of abnormal wound healing
Inflammation
Inflam cause up regulation of cytokins and MMP which has a detrimental effect because they are present persistently
Cytokines
Upregulation of THN-alpha, IL-1, IL-6
Cell senescence
Cells have diminished response to agonist-induced proliferation
What is the National Pressure Ulcer Advisory Panel Staging of ulcers?
Stage I Non-blacheable erythema
Stage II partial thickness (partial dermis)
Stage III Full thickness skin loss
Stage IV full thickness tissue loss (bone, tendon, muscle)
Unstageable–until eschar comes off)
List forms of non-vaible tissue.
callus
eschar
fibrinous material
slough
List methods of debridement and examples.
mechanical–surgical, best
chemical-collagenase
larval-maggots
US
When to treat bacterial colonization?
when counts are > 10 5th power counts per cubic millimeter
Give an example, advantages/disadvantage and e.g. of when to use gauze.
kerlix
debridement
absorptive
cheap
may dehydrate wound
damage granulation tissue
frequent changes
infected wounds
Give an example, advantages/disadvantage and e.g. of when to use film.
tegaderm
opsite
semipermeable
retains moisture
waterproof
visualization of wound
can’t use on infected wounds
may tear skin
post-surgical wounds
Give an example, advantages/disadvantage and e.g. of when to use hydrogel.
nu-gel
rehydrate wound
extends time b/w dressing changes
fills dead spar
may be difficult to secure secondary dressing
may macerate skin
diabetic foot ulcers
minimally exudative wounds
Give an example, advantages/disadvantage and e.g. of when to use hydrocolloid.
duoderm
tagasorb
impremeable to bacteria
facilitates autolytic debridement
self-adhesive
not for infected or exudative wounds
may cause skin tears
patialthickness wounds
low-exudative pressure ulcers
Give an example, advantages/disadvantage and e.g. of when to use foam.
allevyn
highly absorptive
protective
may macerate
secondary dressing
not effective for dry wounds
highly exudative wounds
venous ulcers
