Tissue Healing, Scars & Wounds Flashcards
What is a wound?
A disruption of the unity of the skin
Some parts of our body can regenerate after wounds, what are they?
Bone, epidermis, epithelium in GI track, liver, peripheral nerve
Factors influencing wound healing ?
Blood supply/type Heredity Age Smoking Alcohol Infections Systematic disease Diabetes Nutrition Pressure of mechanical disruption. (Moveable joint) Medications
Types of wound healing ?
Primary Closure/Intention
Secondary Closure/Intention
Tertiary/Delayed Primary Closure
Primary Closure/Intention
Sutures, adhesives, staples-wound edges are clean and little to no tissue loss - Keep Dry
Secondary Closure/Intention
Left open to heal via body’s processes, scar formation - KEEP MOIST. (Avulsion/pressure injury).
Wound edges can’t be approximated
Tertiary/Delayed Primary Closure
Poor vascular supply, infection, bleeding does not allow for immediate closure.
Phrases of Wound Healing
Hemostasis
Inflammatory Stage
Proliferation Phase/Fibroplastic
Remodeling or Maturation
What is happening at the Hemostasis Phase?
STOP BLEEDING
Vasoconstriction.
Combination of platelets with collagen forming a cloth.
What is happening at the Inflammation Phase?
CLEAN UP AND REMOVAL ANY DEBRIS AND BACTERIAL PRESENT
To prevent infection and optimize the healing.
White blood cells to the rescue as a clean up crew.
Change from vasoconstriction to vasodilation
What is happening at the Proliferation Phase?
FILL IN THE DEFECT WITH SCAR TISSUE
Building of the new tissues called “GRANULATION”
Fragile stage of healing need to be protected from trauma/ temperature changes and chemicals.
What is happening at the Maturation Phase?
SCAR FORMATION AND INCREASING TISSUE TENSILE STRENGTH.
Increasing tensile strength so it does not open.
From type 3 colleges to type 1
Abnormal scarring happens due to?
Excessive collagen production problems?
What is Hypertrophic scar?
Are raised and thick but stay within the wound borders.
Occur in early maturation due to an overgrowth of type 3 collagen
What is Keloid scar?
Grow outside of the borders of the wound and occur in late maturation due to an overgrowth of type 1 collagen.
How do Pressure Ulcers Happen?
Positioning make these variable
Pressure over time combination
Shearing/friction
Pressure injuries can relate to what?
Pressure, friction, or shear
Risk factors related to pressure injuries are?
Immobility, inactivity Nutrition Incontinence Decreased sensation/cognition Body type
What areas of the body are likely to develop pressure injuries?
Heels, ischial tuberosities, sacrum, coccyx, greater trochanters, elbows, occiput
What are less likely areas that can have pressure injuries ?
Ears, vertebral processes, iliac crests, knees, malleoli, toes, tibial crest
Pressure injury: Stage I
Skin is intact
Sun burn /readiness can be present
Pressure injury: Stage II
Partial thickness.
A shallow open area without slough/Escher or granulation tissues over a bony prominence.
Dermis is exposed
Can be fluid filled blister
Pressure injury: Stage III
Full thickness
Deeper open area (into or through the dermis) with granulation tissue over a bony prominence that may contain slough or Escher, undermining or tunneling
Pressure injury: Stage IV
Deepest type - bone, muscle, tendon, ligament visible in the wound bed, high risk for osteomyelitis
Pressure injury: Unstageable
Depth obscured by slough or eschatology, an open wound
Deep tissue injury ?
Intact area of skin that has change in color to purple/maroon and possible change in texture. Can be blood filled blister
Which layer of the skin is avascular?
The Epidermis
What is Slough?
Is the result of the build up of dead neutrophils and derbies in the wound.
It is yellowish, brown, stringy material that can be in one area or can cover the whole wound bed.
It can be dry and thick or wet and gooey
What is Eschar?
Is dead tissue that is typically black or dark brown and dry
