Venous Insufficiency and Surgical Wounds - Class 4 Flashcards

1
Q

venous insufficiency ulcers are caused by

A

unrelieved venous hypertension in LEs

–> d/t incompetent perforator valves

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2
Q

venous insufficiency ulcers are usually located

A

medial ankle

gait area

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3
Q

venous insuff LE presents w/

A

firm edema

dilated superficial veins

possible dermatitis

hyperpigmentation

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4
Q

venous insufficiency ulcers are

A

highly draining

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5
Q

venous ulcers present as

A

superficial wound

irregular margins

ruddy granular

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6
Q

venous ulcers –> exudates

A

usually w/ heavy exudates

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7
Q

venous ulcers –> pain

A

no pain

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8
Q

tests for venous vasculature

A

venous doppler

Trendelenburg test

percussion test

cuff test

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9
Q

venous insufficiency intervention

A

reduce venous hypertension

compression therapy

leg elevation

re-establishing calf-muscle pump

exercise activity

local wound care to absorb heavy exudates

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10
Q

venous insufficiency interventions –> compression therapy

A

obtain ABI

–> if <0.8 –> no compression tx

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11
Q

acute surgical wound

A

incision

heal w/in a specific time frame

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12
Q

types of surgical wound closure

A

primary (acute surgical wound)

secondary (left open)

tertiary (delayed primary) (cut them, let infection resolve, let soft tissue edema resolve then close them)

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13
Q

assessment of acute surgical wound

A

suture/wound

surrounding skin tissue

as it related to the 3 phases of healing

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14
Q

how do we asses an acute wound

A

measurement of incision

wound tissues

wound closure

exudate

palpation of suture line

palpation and color of surrounding tissue

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15
Q

exudate –> assessment

A

amount and type

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16
Q

palpation of suture line –> assessment

A

presence of healing ridge

raised tissue firmness from collagen deposition

17
Q

inflammatory phase of incisional wound

A

first 3-4 days

18
Q

inflammatory phase will be accompanied by

A

normal signs of inflammation

warmth, redness, edema, pain

19
Q

what does absence of inflammation point to –> inflammatory phase

A

trouble

20
Q

inflammatory phase –> wound edges

A

approximation of wound edges

-epithelialization
-no tenson on sutures

21
Q

type of draining –> inflammatory phase

A

sanguineous to serosanguinous

22
Q

incisional wound in the proliferative phase

A

presence of healing ridge

draining

asses for swelling and induration

asses skin color for erythema ecchymosis

23
Q

presence of healing ridge –> proliferative phase

A

firmness along incision extending 1 cm on either side from deposition of new collagen

24
Q

when does the presence of a healing ridge appear

A

post op day 5-9

25
Q

proliferative phase –> drainage

A

should be serosanguinous –> serous –> nil

asses for nearly draining incision once closed

26
Q

how long does the remodeling phase occur

A

1-2 years

27
Q

incision color –> remodeling phase

A

changes from red/pink silvery –> gray to white

28
Q

remodeling phase –> healing ridge

A

gradually softens

29
Q

remodeling phase –> wound strength

A

80% of pre wounded stage

30
Q

what should we asses for in the remodeling phase

A

signs of abnormal scarring

keloid or hypertrophic

31
Q

keloid scarring

A

raised

goes beyond borders of initial wound

32
Q

hypertrophic scarring

A

raised

stays w/in wound borders

33
Q

wound management for acute surgical wound

A

primary dressing

secondary dressing

34
Q

primary dressing

A

absorbent of wound exudate

protects incision from further trauma

non-adherent to wound

maintains sterile wound environment

limits frequent dressing changes

35
Q

secondary dressing

A

absorbs excess drainage wicked away by primary dressing

secures primary dressing in place