Wk 4 Complications of Wound Healing

Question 1

What is an adhesion?

Answer 1

A band of scar tissue that joins two surfaces of the body that are usually separate

Question 2

What is contraction?

Answer 2

an ongoing process resulting in part from the proliferation of the specialized fibroblasts termed myofibroblasts, which resemble contractile smooth muscle cells. Wound contraction occurs to a greater extent with secondary healing than with primary healing.

Question 3

What is a fistula?

Answer 3

Fistulas form when inflammation causes sores, or ulcers, to form on the inside wall of the intestine or nearby organs. Those ulcers can extend through the entire thickness of the bowel wall, creating a tunnel to drain the pus from the infected area. An abcess, or a collection of pus, can also cause a fistula to form.

Question 4

When is the greatest risk for hemorrhage?

Answer 4

24-48 hours after surgery

Question 5

How might internal bleeding present?

Answer 5

Swelling
Distention in the area
Sanguineous drainage
Initially a subtle change in VS

Question 6

What is the first VS change during a hemorrhage?

Answer 6

Tachycardia

Question 7

What should you do first during wound hemorrhage?

Answer 7

Apply pressure dressing, THEN notify provider and monitor vital signs

Question 8

Separation of a wound, usually a few underlying skin layers

Answer 8

Dehiscence

Question 9

Evisceration is a reason for…

Answer 9

Immediate surgery

Question 10

With an evisceration there will be a significant increase in…

Answer 10

serosanguinous fluid on the wound dressing

Question 11

What is often the case when a patient has an evisceration?

Answer 11

History of sudden straining, will say it felt like wound popped or gave away

Question 12

Visualization of the __ is a manifestation of an evisceration

Answer 12

Viscera

Question 13

What are the risk factors for dehiscence and evisceration?

Answer 13

Chronic disease
Age
Obesity
Invasive abdominal cancer
Vomiting
Infection
Ineffective suturing
Dehydration
Malnutrition
Excessive straining

Question 14

When a patient has an evisceration what should you do?

Answer 14

Notify provider
Stay with patient
Cover wound
Position patient
Stay calm

Question 15

What should you cover an evisceration with?

Answer 15

Sterile towels or dressings soaked with sterile normal saline

Question 16

What position should you place a patient in with an evisceration?

Answer 16

Supine with hips and knees bent to prevent too much stretch in the area

Question 17

If a patient has an evisceration you should keep them…

Answer 17

NPO because they will likely need surgery again

Question 18

When does a wound infection manifest?

Answer 18

2-11 days post op/injury

Question 19

What are the s/s of a wound infection?

Answer 19

Pain
Inflammation
Purulent drainage
Odor
Fever, chills
Tachycardia
Tachypnea
Leukocytosis