Wound Care Flashcards
What are the three types of wound closure?
primary intention
secondary intention
tertiary intention
What is primary intention in wound closure?
clean, straight line, edges well approximated with sutures, rapid healing, usually best cosmetic outcome
What is secondary intention for wound closure?
larger wounds with tissue loss, edges not approximated, heals from the inside out, granulation tissue fills in the wound, longer healing time, larger scars
What is tertiary intention in wound closure?
tertiary (delayed primary)– delay is typically 3-5 days before injury is sutured, used to managed infected unhealthy wounds, larger scar
What is the wound healing chronology?
inflammation= 0-3 days
proliferation =4-30or weeks days
maturation = anywhere between 30-100 days
What is the inflammatory phase?
starts immediately with hemostasis and includes the innate immune system
exposed collagen activates clotting cascade
cytokines/chemokines and growth factors are released by resident cells and cell that migrate to area of wound
neutrophils, monocytes, and macrohphages
what you’ll notice: ocal erythema, edema and tenderness
main function is to remove debris, start healing cascade and prepare wound for regeneration
What is the proliferative phase of wound healing?
day 4 through weeks
fibroblasts are most important cell type
angiogenesis– capillaries bud from nearby vessels and grow into wound
epithelization– epitherlial cells from wound marins migrate across wound surface
wound contraction– pulling of edges toward center making wounds smaller
growth of blood vessels, deposition of collagen, formation of granulation tissue, epithelialization, wound contraction
granulation tissue
epithelializing tissue
What is epitheliazation
epithelial cells migrate across the nw tissue to form a barrier between the wound and the environment
basal epithelial cells at the wound margin
basal cells behind margin undergo vertical growth (differentiation)
What is the remodeling phase in wound healing?
collagen type III replaced by Type I
disorganized collagen fibers are rearranged, cross linked, and aligned along tension lines
wound may increase in strength for up to 2 years after injury
What arre local factors in Wound healing?
psychological function
hypergranulation
tobacco
use
high bacterial burden
biofilms
edema
pressure/friction/shear
maceration/motion
hyperkeratosis
cellulitis
nonviable tissue
lack of growht factors
cytokines
What are systemic factors in wound healing
Nutirion/hydration
diabetes
peripheral vacular disease
GERD
collagen disease
ESRD
immunosupproesion
aging
medication
infection
paresthesia
perfusion
incontinence
What is a chronic wound?
those wounds that fail to progress through a norma, orderly, and timely sequence of reppair or wounds that pass through the repair process without restoring anatomix and functional results
How to diagnose a wound by tissue involvment?
superficial/erosion
partial thickness
full thickness
How do you diagnose a wound by etiology?
arterial
venous insuffiiency
neuropathic
pressure
atypical
What are the methods for determining size of a wound?
perpendicular
clock
volumetric
tracing
phots
