Module 9- Wound Types (neuropathic, arterial, venous) Flashcards
wound type that is present for at least 6 weeks
chronic wounds
These are some characteristic of what type of wound
-necrotic tissue
-bioburben
-chronic inflammatory
-impaired hemodynamics
-senescent fibroblasts and keratinocyctes
-chronic wound fluid with growth inhibiting proteases
-overgrowth of epithelium with lack of underlying connective tissue
chronic wounds
What are the 4 categorize of chronic wounds
- arterial
- venous insufficiency
- neuropathic/diabetic
- pressure
name the type of wound category
-ischemia
-micro or macro vascular disease
-smoking
arterial
name the type of wound category
-deep vein thrombosis
-recent surgery, ankle fusion
-prolonged standing, pregnancy
-congestive heart failure
venous insufficiency
name the type of wound category
-diabetes
-peripheral vascular disease
-hansen’s disease
neuropathic/diabetic
-pressure/shear
-immobility, moisture
-decreased sensation
-poor nutrition
pressure
_____ wounds
-occur on the foot usually plantar surface of toes
-causes by mechanical forces or minor trauma
neuropathic wounds
Pt with ____ wounds typically have sensory, autonomic and motor neuropathies
neuropathic
____ wounds are caused by ischemia
arterial
___ wounds typically occur in the peripheral extremities
caused by macro- or microvascular disease
arterial
_____: obstruction of the larger named arteries by PAOD, embolus, thrombus, trauma
_____: disease of the small unnamed arterioles and capillaries usually associated with diabetes or small emboli
Arterial wounds
macro:
Micro:
Neuropathic wounds pain typically relieved with ambulation—T or F
true
Both neuropathic and arterial wounds occur mainly on the foot and toes T or F
true
How does the appearance of the foot differ in neuropathic and arterial injuries
neuropathic- architectural changes in the foot
arterial- normal looking foot
appearance of wounds:
pink, moist callus formation, plantar surface, skin usually warm
neuropathic
appearance of wound:
pale dry well defined margins, limb color pale, skin cool to touch
arterial
Which has a normal ABI neuropathic or arterial injuries?
neuropathic
what are the grades of the diabetic foot classification
grade 0- intact skin
grade 1- superficial ulcer
grade 2- deep ulcer
grade 3- ulcer with bone involvement
grade 4- forefoot gangrene
grade 5- full-foot gangrene
what are the 3 critical phases of peripheral vascular disease?
- collateral circulation insufficient for metabolic needs
- claudication- pain with activity
- rest pain- requires revascularization surgery
in arterial wounds: will ABI and pulses be diminished?
yes
what is the normal time during a capillary refill exam
less than 3 sec
which are more common venous or arterial wounds?
venous
What are 3 causes of chronic venous insufficiency?
- reflux as a result of incompetent valves in the perforator, superficial, or deep veins
- obstruction- chronic deep vein thrombosis
- lack of venous pump activation during the gait cycle
Chronic venous insufficiency can result in venous _____-tension and excessive moisture in the interstitial tissue
hypertension
chronic venous insufficiency prevents adequate ____ and ____ from reaching the skin
oxygen and nutrients
what are some risk factors for chronic venous insufficiency?
Hx of DVT
Hx of hip/knee/calf surgery
ankle hypo-mobility
employment involving prolonged standing
morbid obesity
pregnancy
heart failure
Heavy, aching feelings in legs
telegentsia or reticular veins
varicose veins
edema without ulceration
skin changes without ulceration
skin changes with ulceration
is the progression of ____ disease
venous
where are venous wounds located
in the gaiter area
a wound has irregular wound borders, full-thickness, minimal exudate, cool and pale LE
presentation isnt clean for one or the other what is the gold standard test to determine?
ABI
What is the ABI range for a mixed ulcer
0.6-0.8
If an ABI is <0.6 what is the first mode of treatment
revascularize, prevent occurrence
no compression for mixed ulcer
mixed wounds account for ___% of LE ulcers origin is primarily due to chronic venous insufficiency with poor healing with co-exisiting arterial insufficiency
10
No peripheral arterial obstruction is found from a ABI and ultrasound examination what do you suspect
venous injury/wound
