Decubitus Ulcers and Burns - Chapter 40 Flashcards
Decubitus Ulcer
- A pressure sore or bedsore
- Most commonly occur over bony prominences
- Tissue begins to decay from lack of blood circulation
Stages of Wounds
-1, 2, 3, 4
Stage 1 Wounds
- Surface reddening of skin
- Skin is unbroken
- Wound is superficial
Stage 2 Wounds
- Blister, broken or unbroken
- Partial layer of skin is injured
- Goals: cover, protect, and clean the area
Stage 3 Wounds
- Wound extends through all layers of skin
- Risk of serious infection
- Goals: alleviate pressure, cover and protect wound
Stage 4 Wounds
- Extend through the skin and involve underlying muscle, tendon and bone
- Can produce life threatening infection; must treat very quickly and aggressively
Prevention of Decubitus Ulcers
- Most important principle is preventing initial skin damage
- Frequent turning of patients
- Maintain hydration
- Good hygiene
- Applying skin protection
Treatment of Decubitus Ulcers
- Keeping area clean
- Removing dead tissue
- Exudate control
- Using topical treatments for healing of partial-thickness sores
- Possibly surgery
Keeping Area Clean
-Use sterile water or normal saline
Debridement (Removing Dead Tissue)
-collagenase breaks down collagen into gelatin
Exudate Control
- Occlusive, hydrocolloid dressing to promote fibrinolysis, angiogenesis and wound healing without softening or breaking down tissue
- Duoderm, Tegaderm, Aquacel
Topical Antiinfectives
- bacitracin
- gentamicin
- mupirocin
Burns
-A thermal injury or lesion
Burn Classifications
- First degree
- Second degree
- Third degree
- Fourth degree
First Degree Burn
-Minor discomfort, reddening of skin; tissue injury minimal
Second Degree Burn
- Blisters, severe pain, generalized swelling and edema.
- Injury but not destruction of the upper layer of the dermis
Third Degree Burn
-Destruction of the epidermis and dermis
Fourth Degree Burn
-Involves underlying muscles, fasciae, or bone
Burn Complications
- Infection
- Low blood volume
- Hypothermia
- Respiratory problems (related to smoke)
- Scarring
- Bone and joint deformities
Treatment of Infections Due to Burns Examples
- silver sulfadiazine
- silver nitrate
- povidone/iodine
Brand: Flamazine, SSD, Dermazin
Generic: silver sulfadiazine
-Most frequently used
Brand: silver nitrate
Generic: silver nitrate
Brand: Betadine
Generic: povidone/idodine
