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PT 854 Integument > Principles of Wound Healing part 2 > Flashcards

Principles of Wound Healing part 2 Flashcards

1
Q

How does pressure mapping help the clinician?

A

Helps them obtain objective, real-time levels of pressure under the foot

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2
Q

What type of conditions can you use pressure mapping in?

A

In the shoe
Prosthetic
Wheelchair seating system
Standing

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3
Q

What is hyperbaric wound therapy and what is the point?

A

Place patient in 100% oxygen environment below sea-level to improve oxygen levels in the body

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4
Q

What limits hyperbaric wound therapy?

A

RBC only have so many bonding sites for O2

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5
Q

What are the hyperbaric wound indications (14)

A 
Air or gas embolism
Carbon monoxide poisoning
Gas Gangrene
Crush injury, compartment syndrome, and other acute traumatic ischemia
Decompression Sickness
Arterial insufficiencies
Severe Anemia
Intracranial Abscess
Necrotizing Soft Tissue infections
Osteomyelitis (refractory)
Delayed radiation injury (soft tissue & bony necrosis)
Compromised graft and flaps
Acute thermal burn injury
Idiopathic Sudden Sensorineural Hearing Loss
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6
Q

What type of wound therapy removes fluid from open wound through sealed dressing and tubing connected to a collection container?

A

Negative Pressure Wound therapy

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7
Q

How does negative pressure wound therapy work?

A

Vacuum suction creates pressure on the tissues

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8
Q

What is dermal closure?

A

Anchors placed in the skin around the wound with a tensioning cable to improve tissue extensibility on a subnormal level

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9
Q

What type of closure is used with dermal closure?

A

Tertiary Closure (once skin is stretched enough)

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10
Q

How can you provide some edema management?

A

Provide external support to vascular structures
Increase extracellular pressure which can force fluid back into vasculature
Works best with assistance of muscle pump

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11
Q

What is LA Place’s Law?

A

(tension)(#of layers)(Constant)
________________________
(circumference of limb)(bandage width)
More layers and tension increase compression
Bigger the leg/wider the bandage decrease compression

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12
Q

What are some systematic questions you want to know with edema management?

A

CHF
Renal Status
Respiratory status

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13
Q

What are some temporary compression options?

A

Unnaboot
Multi-layer compression bandaging
Elastic Compression Bandages
Elastic Compression Tubing

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14
Q

What is a Unnaboot and what does it do??

A

Type of multilayer wrap

Applies approximately 20-30 mmHg pressure

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15
Q

What is the 1st layer of a unnaboot composed of?

A

Impregnated gauze layer
(forms soft cast around the foot, second skin that isn’t rigid, but doesn’t expand)
Has zinc oxide or calamine lotion on it

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16
Q

What is the top layer of a unnaboot?

A

Conan or ACE wrap

can put a layer of cotton padding between if needed

17
Q

What type of patients does a unnaboot work best with?

A

Active patients

  • Higher active pressure
  • Lower resting pressure
18
Q

How tight do you want the unnaboot?

A

Make sure there is still a capillary refill of at least 3 seconds

19
Q

What are they types of Multi-layer compression bandages?

A

2-layerd (coban 2, coban2lite, ProGuide)
3-layered (dyne-flex)
4-layered (profore)

20
Q

What does pressure depend on with multi-layered compression?

A

Amount of layers & amount of tension

more layers more compression

21
Q

What type of patients does multi-layered work best for?

A

Less active patients

have a higher resting pressure

22
Q

What are the types of stretch an elastic compression bandage can have? (3)

A 
Variable = (long stretch, ACE bandage)
Measured = (have indicators markings to assist clinician, Setopress and Surepress)
Short = Less elastic with better memory (higher resting pressure)
23
Q

What are some characteristics of variable stretch bandages?

A
  • Should be limited if used for extremely short term use in non complicated wounds
  • Only used to manage edema on patients with good blood flow
  • Extra care taken to prevent a tourniquet-like effect and skin damage
24
Q

What are some characteristics of short stretch elastic compression?

A
  • Apply higher resting pressure
  • Less elastic with better memory
  • Treatment often used with lymphedema
  • Protective padding placed below short stretch wraps to protect skin and improve comfort
25
Q

What is elastic compression tubing good for?

A

Holding dressings in place and applying a small amount of compression
(not a form of gradient compression)
Can apply multiple layers (more strength)

26
Q

What are some definitive compression options? (4)

A

Graduated compression socks
TED Hose
Velcro Closure Garments
Pneumatic pressure pumps

27
Q

What is the CCL?

A

Compression Class Level

8-20 mmHg =

28
Q

What CCL do you want to use for long term management of Venous Stasis Ulcers?

A

CCL 2 or higher

29
Q

How often do Graduated Compression Socks need to be replaced?

A

Every 6-8 Months

30
Q

How does graduated compression socks help?

A

Higher pressure at ankle and foot vs calf
Promotes blood flow out of distal extremity
Assists in calf muscle pump

31
Q

Name some characteristics of a TED Hose?

A

Anti-embolism stockings apply minimal to no graduated compression
Designed to prevent clots in an inactive person
Minimal compression 8-15 mmHg
Not an excellent long term option for managing edema

32
Q

What are some characteristics of Velcro Closure Garments?

A

Allow for some flexibility in girth from day to day
Applies a high resting pressure
Easy application for patient/family
Longer lasting

33
Q

What can be used in adjunct with definitive stocking or independently to help stimulate lymph channels for fluid mobilization?

A

Pneumatic Pressure Pumps

34
Q

How long do you want to have a pneumatic pressure pump on the patient?

A

1 hour 2 times a day

35
Q

Name some factors in deciding the type of compression needed.

A

Affordability
Ease of application
Looks/esthetics
What does the patient need (CCL level)

36
Q

What factors do you want to take into account when choosing a type of compression?

A

What patient will be able to do (afford, able to apply, and looks)
What the patient needs (CCL level)

PT 854 Integument (11 decks)

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