Wound Care 101

Question 1

What are the two primary layers of the skin?

Answer 1

Dermis and epidermis

Question 2

What are the primary roles of the epidermis?

Answer 2

Protection, moisture retention

Question 3

What is the epidermis primarily comprised of?

Answer 3

Dead avascular cells

Question 4

What are the primary roles of the dermis?

Answer 4

Add structural integrity to the skin, provides nutrition and hydration to the epidermis, regulates body temp.

Question 5

What does the dermis contain?

Answer 5

• Blood vessels
• Nerves
• Collagen
• Lymphatics
• Elastin
• Sebaceous glands
• Sweat glands

Question 6

What is the Rate Peg Region?

Answer 6

-Between epidermal and dermal ridges and valleys, increases the surface areas between these two layers, acts as extra skin to protect against additional forces.

Question 7

What comprises the subcutaneous layer?

Answer 7

Connective tissue, adipose tissue, blood vessels, lymphatics, nerves

Question 8

What is the role of the subcutaneous layer?

Answer 8

Provides blood supply for skin, provides insulation/cushioning.

Question 9

What is under the subcutaneous layer?

Answer 9

Muscles, fascia, bone.

Question 10

What are the general roles of the skin (integument)?

Answer 10

Thermoregulation, sensation, protection, elimination of waste, synthesis of Vit D, maintaining homeostasis, storage of nutrients.

Question 11

What are some sources of damage to the integument?

Answer 11

Impaired circulation, trauma, burns, pressure, friction, shear, radiation, edema, infection, loss of sensation, loss of moisture, skin disease

Question 12

What is the difference between an intrinsic and extrinsic factor impacting skin integrity?

Answer 12

Intrinsic: related to medical conditions

Extrinsic: related to the environment.

Question 13

Examples of intrinsic factors:

Answer 13

Age, disease, oxygenation/blood volume, perfusion, immunosuppression, neuropathy, SCI

Question 14

Examples of extrinsic factors:

Answer 14

Medications, nutrition, hydration, radiation and chemotherapy, stress, infection.

Question 15

Define superficial wound

Answer 15

Invovles epidermis, is closed.

Question 16

Define partial thickness wound

Answer 16

Involves dermis, characterized by loss of dermis

Question 17

Define full thickness wound

Answer 17

Includes all layers of dermis and extends to underlying tissues

Question 18

How do superficial wounds heal

Answer 18

Inflammatory response

Question 19

How do partial thickness wounds heal

Answer 19

Epithelialization

Question 20

What characterizes full thickness wounds?

Answer 20

Large gaps, edges that are unable to be approximated

Question 21

How do full thickness wounds heal?

Answer 21

Intention/proliferation

Question 22

What is primary intention healing?

Answer 22

Edges are approximated and sutured via surgery

Question 23

What is secondary intention healing?

Answer 23

Contraction and granulation in open thickness wounds

Question 24

What is tertiary healing?

Answer 24

Deeper layers closed, subcutaneaous left open. Treated and then eventually closed.

Question 25

What defines a "chronic wound"?

Answer 25

Wounds that fail to decrease by 50% in 1 month, so closure could not occur by 12 weeks.

Question 26

How long does the inflammatory phase last?

Answer 26

2-24 hours up to 2 weeks

Question 27

How long does the epithelialization phase last?

Answer 27

2-4 weeks

Question 28

How long does the proliferative phase last?

Answer 28

2-6 weeks

Question 29

How long does the remodeling phase last?

Answer 29

End of proliferative phase to 2 years

Question 30

Describe inflammatory phase

Answer 30

- Essential for timely healing - Immune reaction homeostasis - Growth factors stimulated - Controlled tissue degradation occurs

Question 31

Inflammation vs Infection characteristics?

Answer 31

Inflammation: tenderness, changes in skin color, slight edema, heat. Infection: red streaks extending from wound, intense pain, drainage (brown, yellow, green, bad odor.

Question 32

Why does epithelialization occur?

Answer 32

Protect body from invasion.

Question 33

How does epithelialization occur?

Answer 33

Tissue migrates across wound in multiple directions. Thin pink sheet at first. May be bypassed if skin graft used, wound too large.

Question 34

What is epiboly?

Answer 34

Edges roll

Question 35

Describe the proliferative phase

Answer 35

Granulation tissue rises, yellow fibrous membrane. Contraction occurs.

Question 36

Rank from quickest to slowest healing: circular, square, linear

Answer 36

Linear, square, circular

Question 37

Describe remodeling phase

Answer 37

Scar tissue rebuilt to increase tensile strength, maximum of 80% of pre-injury strength when complete. Scar tissue replaced with less vascular tissue, eventually increases in flexibility.