Module 3- PT role in wound care

Question 1

Venous leg ulcers have a ____month healing rate of 45-70% and 23-70% chance of reoccurance in 5 years

Answer 1

6 month

Question 2

Patients >45 y/o have a ____% prevalence of PAD

Answer 2

15%

Question 3

Primary intention

Answer 3

clean, straight line, edges well approximated with sutures, rapid healing, usually best cosmetic outcome

Question 4

Secondary intention

Answer 4

larger wound with tissue loss
edges not approximated
heals from the inside out
granulation tissue fills in the wound, longer healing time, larger scars

Question 5

Tertiary intention (delayed primary)

Answer 5

delay is typically 3-5 days before injury is saturated, used to manage infected or unhealthy wound, larger scar

Question 6

Homostasis

Answer 6

prevention of bleeding- formation of a clot to stop body from bleeding

Question 7

What stage of wound healing involves hemostasis and includes the innate immune system

Answer 7

inflammatory phase

Question 8

What do you notice on the skin during the inflammatory phase

Answer 8

local erythema, edema and tenderness

Question 9

What is the main goal of the inflammatory phase

Answer 9

remove debris, start healing cascade and prepare wound for regeneration

Question 10

During day 4- 2weeks of the wound healing phase you have fibroblast producing collagen to fill the wound and provide support
there is growth of blood vessels, deposit of collagen, formation of granulation tissue, epithelialization and wound contraction

Answer 10

proliferative phase

Question 11

what do you see during the proliferative phase

Answer 11

granulation tissue
epitheliazing tissue

Question 12

during this stage epithelial cells migrate across the new tissue to form a barrier between the wound and the environment

Answer 12

epithelialization

Question 13

during this phase collagen type III fibers are replaced by type I
disorganized collagen fibers are rearranged, cross linked and aligned along tension lines

wound may increase in strength for up to 2 years after injury

Answer 13

remodeling phase

Question 14

inflammatory phase

Answer 14

begins with the wound develops lasts 4-6 days
edema, erythema, inflammation and pain
healing process triggered
immune system works to prevent microbial colonization

Question 15

proliferative phase

Answer 15

lasts 4-24 days
granulation tissue fills in the wound
fibroblasts lay collagen in the wound bed, strengthening new granulation tissue
wound edges begin to contract
epithelial cells migrate form the wound margins

Question 16

Maturation phase

Answer 16

can last 21-2 years
length of time depends on patient and wound related complicating factors
filled in wound is covered and strengthened
scar tissue forms

Question 17

what are some systemic factors that can impact wound healing

Answer 17

nutrition
diabetes
peripheral vascular disease
collagen disease
end stage renal disease
immunosuppression
aging
medication
social/health habits
functional status and activity level
infection
paresthesia

Question 18

what are some local factors that impact wound healing

Answer 18

psychological factors
hypergranulation
tabacco use
high bacterial burden
biofilms
edema
pressure/friction/shear
cellulitis
nonviable tissue
lack of growth factors