Wound care

Question 1

Phases of wound healing?

Answer 1

1. Inflammatory
2. Proliferative
3. Remodeling (maturation)

Question 2

Inflammatory phase?

Answer 2

3 stages
Vascular
Exudate
Repairative

Limits tissue damage by removing injured cells and sending signals out via chemotaxis (chemical mediators sent out to attract immune and other cells)
Chemotaxis causes vasoconstriction and platelet coagulation occurs.
Then vasodilation occurs to bring wbcs/macrophages into the wound bed.

0-72hrs long

Question 3

Exudate stage (inflam phase)

Answer 3

Can exhibit the following appearances:

Serous-clear/yellowish like in a blister.
Prurulant-(pus) Thick and opaque.
Blood-bleeding
Fibrinous-scab/clot

Question 4

Repairative stage (inflam phase)

Answer 4

WBCs and macrophages clean up woundbed. Overlapped by the proliferative phase.

Question 5

Vascular stage (inflam phase)

Answer 5

Limits tissue damage by removing injured cells and sending signals out via chemotaxis (chemical mediators sent out to attract immune and other cells)
Chemotaxis causes vasoconstriction and platelet coagulation occurs.
Then vasodilation occurs to bring wbcs/macrophages into the wound bed.

Question 6

Proliferative phase (healing)

Answer 6

Granulation and epithelialization occur. 
4 stages
-angiogenesis
-granulation
-wound contracture
-epithelialization

48hrs-6wks long

Question 7

Granulation stage (pro phase)

Answer 7

Creates a matrix of fibrous tissue in the wound bed.

Question 8

Angiogenesis (pro phase)

Answer 8

Capillary buds grow in to supply the wound with nutrients.

Question 9

Wound contracture stage (pro phase)

Answer 9

Myofibroblasts (cells similar to mms) line the edge of the wound and contract to pull skin together.

Question 10

Epithelialization stage (pro phase)

Answer 10

Epithelial cells and keratinocytes grow in with angio buds. The migrate along granular tissue. They can only move from the outside in and only grow on viable tissue.

Question 11

Remodling stage (pro phase)

Answer 11

Also called maturation

Organizes collagen to restructure wound. Scarring occurs in this phase. Lasts 4wks to 2years

Question 12

Collagen types

Answer 12

Early
Type III Granulation tissue
Becomes
Type I non elastic-scar
Type III elastic
Depending on the area

Question 13

Burn types (6)

Answer 13

Dry heat
moist heat
chemical
electrical
freeze
superficial (sunburn)

Question 14

Rule of 9s

Answer 14

Head 9%
Arms 9% each
Torso 18% 9 front 9 back
Legs 18% each
Genital 1%

Question 15

5 ways to prevent pressure ulcers

Answer 15

1. Proper skin care (clean, dry, moist)
2. Aleviate pressure
3. Frequent repositioning
4. Proper nutrition
5. Increase activity to increase blood flow

Question 16

Difference between arterial and venous ulcers?

Answer 16

Location  
Art
lower 1/3 of leg, toes, webbing,dorsal foot, lat maleolus
Ven
Proximal to medial maleolus

Appearance
Art
Smooth edges, well defined, 0 granulation, deep
Ven
Irregular shape, shallow

Pain
Art
Severe
Ven 
Mild

Pedal pulse
Art weak
Ven Normal

Edema
Art normal
Ven increased

Skin temp
Art cool
Ven normal

Tissue changes
Art 
Thin shiny skin, 0 hair, yellow nails
Ven
Flaky, dry skin; brownish

Misc
Art
Leg elevation increases pain
Ven
Leg elevation decreases pain

Question 17

Colors of tissue in a burn
Granulation
Epethelial
Eschar
Slough

Answer 17

Gran-red
Epith-pink
Eschar-black (dead)
Slough-yellow (dead)

Question 18

Pressure ulcer staging

I-IV

Answer 18

I-skin intact red and won’t blanch, hot, stiff, or painful
II partial thickness-Damage to the epidermis or dermis
III-full thickness: Damage down to but not through sub Q layer (undermining and tunneling)
IV-full thickness with exposed bone or tendon