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NURS 220 > LEC 1: Wound Care Basics > Flashcards

LEC 1: Wound Care Basics Flashcards

1
Q

What is the function of the skin?

A
  • The skin protects against disease-causing organisms
  • Senses pain, temperature, and touch
  • Synthesizes vitamin D
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2
Q

What are the two layers of the skin?

A
  1. Epidermis
  2. Dermis
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3
Q

Epidermis

A

The superficial, thinner layer of skin (epithelial tissue), composed of keratinized stratified squamous epithelium.

  • The epidermis skin layer is avascular
  • Is the 1st layer of skin
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4
Q

Dermis

A

A layer of dense irregular connective tissue containing collagen and elastic fibers that lay deep in the epidermis.

  • Is the 2nd layer of skin.
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5
Q

How does the epidermis help with wound healing?

A

The epidermis functions to resurface the wound and restore the barrier against invading organisms

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6
Q

How does the dermis help with wound healing?

A

The dermis functions to restore the structural integrity (collagen) and the physical properties of the skin

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7
Q

What are the two types of wound classifications?

A
  1. Acute wound
  2. Chronic wound
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8
Q

What do wound classification systems describe?

A
  • The status of the skin integrity
  • Cause of the wound
  • Severity/ extent of the wound
  • Descriptive qualities of the wound, such as colour, smell, edema, etc.
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9
Q

Acute Wound

A

A wound that heals in a timely manner

  • Healing is quicker - Simple wound
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10
Q

Chronic Wound

A

Wound that fails to heal in a timely manner

  • Complex wound
  • The more layers that are involved, the longer it will take to heal
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11
Q

What causes an acute wound?

A
  • Trauma
  • Surgical incision
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12
Q

What are the implications for healing regarding acute wounds?

A
  • Wounds are easily cleaned and repaired
  • Wound edges are clean and intact
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13
Q

What causes a chronic wound?

A
  • Vascular compromise
  • Chronic inflammation
  • Repetitive insults to the tissue
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14
Q

How long can you expect an acute wound to heal?

A

Expect to heal within two months or less

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15
Q

How long can you expect a chronic would to heal?

A

A chronic wound will take greater then two months to heal

  • Can last for ever
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16
Q

What are the implications for healing regarding chronic wounds?

A

Continued exposure to insult impedes wound healing

17
Q

What are the three processes of wound healing?

A
  1. Primary intention healing
  2. Secondary intention healing
  3. Tertiary intention healing
18
Q

Primary Intention Healing

A
  • Wound with minimal or no tissue loss
  • Skin edges are approximated/ closed
  • Risk of infection is low
  • Minimal scar formation
  • Healing occurs quickly
19
Q

What causes primary intention wounds?

A

Surgical incisions, wound that is sutured or stapled

20
Q

What are the implications for primary intention wound healing?

A

Healing occurs by epithelialization

  • Heals quickly with minimal scar formation
21
Q

Epithelialization

A

Healing by the growth of epithelium over a denuded surface. The formation of granulation tissue into an open wound allows the re-epithelialization phase to take place, as epithelial cells migrate across the new tissue to form a barrier between the wound and the environment.

22
Q

Secondary Intention Healing

A
  • Wound with loss of tissue
  • Wound is left open until it becomes filled by scar tissue; must heal from bottom up
  • Takes longer to heal
  • Chance of infection is greater
23
Q

What causes secondary intention wounds?

A
  • Pressure ulcers
  • Surgical wounds that have tissue loss
24
Q

What are the implications for secondary intention wound healing?

A

Wound heals by:

  • Granulation tissue formation
  • Wound contraction
  • Epithelialization
25
Q

Tertiary Intention Healing

A

Wound is left open for several days then closed surgical

26
Q

What causes tertiary intention wounds?

A

Wounds that are contaminated and require observation for signs of inflammation

27
Q

What are the implications for tertiary intention wound healing?

A

Closure of wound is delayed until risk of infection is resolved

28
Q

What are the four phases in the pathophysiology of wound healing?

A
  1. Homeostasis
  2. Inflammatory
  3. Proliferative (Granulation)
  4. Maturation (Remodelling)
29
Q

Homeostasis Phase

A
  • Occurs within minutes of initial injury
  • The body sends platelets to the site of the injury to aggregate and vasoconstrict blood vessels
  • At the same time it starts the clotting cascade to stabilize the clot

*Body will stop bleeding in that area

30
Q

Inflammatory Phase

A
  • The body’s protective response to injury
  • Last 2 to 4 days and can restart at any point
  • Histamine released causing vasodilation and WBCs migration
  • Leukocytes and macrophages ingest bacteria, dead cells, and debris
31
Q

Proliferative Phase

A
  • Lasts 3 to 24 days
  • New blood vessels form
  • Newly formed collagen starts to contract, decreasing wound bed size and speeds healing
  • Epidermal cells migrate over the granulation tissue (epithelialization)
32
Q

Maturation/ Remodelling Phase

A
  • Can last up to 2 years
  • The surface of the wound may look healed but the internal structures are still gaining strength/ healing
  • Collagen production continues, thickening the epithelium and contacting to form a scar
  • Scar tensile strength increases to 80% of the original tissue, but has limited elasticity
33
Q

What are factors that affect wound healing?

A
  • Lifespan considerations
  • Nutrition
  • Lifestyle
  • Medications
  • Contamination, colonization, and infection

NURS 220 (41 decks)

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