ppt 13 Wounds Flashcards
What are the types of open wounds?
- Incision
- Avulsion
- Abrasion
- Laceration
- Puncture
Describe a surgical incision.
- cut or a wound intentionally produced by cutting with a sharp instrument
- produced with wound healing in mind
- clean
Describe an avulsion wound.
How to treat partial vs. total.
wound where skin is “torn” partially or fully away
-tends to bleed
- partial avulsions are debrided and sutured in place, if viable
- total avulsions are generally not replaceable, except as a skin graft after the fat is removed
- if an avulsed part contains an adequate single artery and a vein (>0.5mm) it may possibly be replanted microsurgically
Describe a puncture wound.
Treatment?
- wound or hole in the skin and deeper tissue layers caused by a sharp object such as a nail, stick, or piece of metal
- should not be closed
- management consists of assessing for damage to underlying vital structures and examining for a foreign body
Describe an abrasion.
Treatment?
- superficial loss of the epithelial tissue layer
- usually only cleaning of the wound is required because the remaining epithelial cells regenerate and migrate to close the wound
- careful cleaning to prevent traumatic tattooing
- pain medication/sedation or general anesthesia may be needed to clean for large abrasions
- antibacterial ointment (e.g., bacitracin, Neosporin, silvadene)
Describe a laceration.
Treatment?
- wound caused by a sharp object producing edges that may be jagged, dirty, or bleeding.
- lacerations most often affect the skin, but any tissue may be lacerated, including subcutaneous fat, tendon, muscle, or bone
- treatment may be primary or secondary closure
Describe a crush injury.
What are the associated wounds/injuries that usually present?
- occurs when a body part is subjected to a high degree of force or pressure, usually after being squeezed between two heavy or immobile objects
- associated injuries include laceration, bruising, fractures, compartment syndrome
What is a contusion?
Treatment?
- area of soft tissue swelling and hemorrhage without violation of the skin (bruise)
- evacuation of a hematoma with aspiration may be required
-management consists of application of cold compresses early to minimize swelling, followed by the application of warm, moist compresses for the absorption of blood
What are the stages of pressure ulcers?
I II III IV Unstageable
Describe a stage I ulcer.
intact skin with non-blancheable redness of a localized area usually over a bony prominence, darkly pigmented skin may not have visible blanching; its color may differ from the surrounding area
Describe a stage II ulcer.
partial thickness loss of dermis presenting as a shallow open ulcer with a red pink wound bed, without slough -may also present as an intact or open/ ruptured serum-filled blister
Describe a stage III ulcer.
- full thickness tissue loss
- subcutaneous fat may be visible but bone, tendon or muscle are not exposed
- slough may be present but does not obscure the depth of tissue loss
- may include undermining and tunneling
Describe a stage IV ulcer.
- full thickness tissue loss with exposed bone, tendon or muscle
- slough or eschar may be present on some parts of the wound bed
- often include undermining and tunneling
Describe an unstageable ulcer.
full thickness tissue loss in which the base of the ulcer is covered by slough (yellow, tan, gray, green or brown) and/or eschar (tan, brown or black) in the wound bed
What are the types of wound closures?
Primary - closure by active, direct approximation
Secondary - spontaneous wound closure from edges; close wound later with a skin graft
Tertiary - wound is closed by active means after a delay; often used with grossly contaminated wounds
