Dermatology

Question 1

1 Primary intention

Answer 1

(surgical) • When wound edges are brought together so that they are adjacent to each other (re-approximated)
• Minimizes scarring
• Most surgical wounds heal by primary intention healing
• Wound closure is performed with sutures (stitches), staples, or adhesive tape

Question 2

2 Secondary intention

Answer 2

• The wound is allowed to granulate
• Surgeon may pack the wound with a gauze or use a drainage system
• Granulation results in a broader scar
• Healing process can be slow due to presence of drainage from infection
• Wound care must be performed daily to encourage wound debris removal to allow for granulation tissue formation

Question 3

Tertiary intention

Answer 3

1 + 2 (left open - close surgically at a later date)
(Delayed primary closure or secondary suture):
• The wound is initially cleaned, debrided and observed, typically 4 or 5 days before closure.
• The wound is purposely left open

Examples: healing of wounds by use of tissue grafts

Question 4

parkland formula

Answer 4

Answer 5

Stage I pressure Ulcer

intact skin over bony prominence- persistent, non-blanchable redness may fee warm or cool to the touch, tissue is swollen and congested; pt may report discomfort

Question 6

Answer 6

Stage II pressure Ulcer

partial-thickness skin loss involving the epidermis and dermis: ulcer is visible and superficial - may appear as an abrasian, blister or shallow crater; edema perists and the ulcer may become infected; pt may report pain and there may be a small amount of drainage

Question 7

Answer 7

Stage III pressure ulcer

full-thickness tissue loss with damage to or necrosis of subcutaneous tissue - may extend to underlying fascia - appears as a deep crater with or without undermining of adjacent tissue and w/out exposed muscle or bone - drainage and infection are common

Question 8

Answer 8

Stage IV pressure ulcer

full-thickness tissue loss- destruction, tissue necrosis, damage to muscle, bone or supporting structures, possible sinus tracts, dee pockets of infection, tunneling and undermining; may have eschar (black scab) or slough (yellow/green scab)

Question 9

Ulceration, bleeding, exudation and increasing size indicate

Answer 9

malignancy