Chapter 5 - Integumentary Flashcards
What ointments are used immediately following a burn injury?
- Bacitracin
- Polymyxin B
- Neomycin
What are the contraindications for silver sulfadiazine?
- at term pregnancy
- on infants less than 2 months
- those with sulfa drug allergy
What are the contraindications for sulfamylon?
penetrates through eschar; avoid with sulfa drug allergies
What are examples of temporary grafts?
- allograft
- xenograft
What are examples of permanent grafts?
- biosynthetics
- cultured skin
- autograft (split-thickness or full-thickness)
Z-plasty
surgical excision of scar contracture
What factors are associated with healing of burn injuries?
- nutrition
- infection
- associated illnesses
- cytotoxic treatments
What are the examples of wound debridement?
- autolytic
- surgical/sharp debridement
- enzymatic
- mechanical
What is the most common position for contracture of the hand?
claw hand (intrinsic minus position); stress wrist extension to 15˚, MCP flexion (70˚), PIP, and DIP extension
What is the most common position for contracture of the foot?
the deformity is plantar flexion; ankle stress DF with foot-ankle in neutral with splint or plastic ankle-foot orthosis..
Stage I pressure injury
nonblanchable erythema of intact skin. May include changes in skin temperature (warm or cool), tissue consistency (firm or boggy), and/or sensation (pain, itching)
Stage 2 pressure injury
partial-thickness skin loss: involves the epidermis, dermis, or both. The ulcer is superficial. Presents clinically as an abrasion, blister, or shallow crater.
Stage 3 pressure injury
full-thickness skin loss: involves damage to or necrosis of subcutaneous tissue. May extend down to, but not through, underlying fascia. Presents clinically as a deep crater.
Stage 4 pressure injury
Full-thickness skin loss: involves extensive destruction, tissue necrosis, or damage to muscle, bone, or supporting structures. Undermining and sinus tracts may be present.
Unstageable
tissue depth is obscured due to slough or eschar and extent of damage cannot be determined
Deep Tissue Injury
discolored area of tissue (e.g. bruise) that is not reversible and will likely progress to a full-thickness injury
How often should wounds be cleansed?
At the initial evaluation and with each dressing change
It is recommended that most wounds be cleaned with:
Normal saline: 0.9% NaCl solution
Why should povidone-iodine solution, sodium hypochlorite, Dakin’s solution, acetic acid solution, and hydrogen peroxide not be used in wound care?
They are toxic to healing granulation tissues
What are the mechanical delivery systems from most gentle to harshest?
- minimal mechanical force: cleansing with gauze, cloth, or sponge
- irrigation: recommended pressures range from 4-15 psi
- whirlpool therapy
What are the different types of irrigation?
- squeeze bottle, bulb syringe, or piston syringe
- pulsed lavage: delivery of irrigating solution under pressure that is produced by an electrically powered device. Pulsed lavage with vacuum assists in removal of wound debris.
An ideal wound dressing does what?
- maintains a moist environment
- allows gas exchange
- controls exudate
- insulates and prevents contamination
- is non-traumatic to the wound
What is normal albumin? Why is that important for wound healing?
3.5 - 5.5 mg/dl; less than 3.5 mg/dl is indicative of malnutrition and poor wound healing
T/F: Individuals with wounds require 5 liters or more water per day
False. Individuals require 3 or more liters per day; patients on air-fluidized beds will require greater hydration (40-60 ml/kg per day)
