Wound Care Flashcards
Signs of Impaired Healing 1-4 days
Persistent drainage >24 hrs after wound has been closed, no inflammation
Why is inflammation important in wound healing?
Because inflammation is the begging of the body’s healing process
Signs of normal healing 1-4 days
inflammation,redness,in-duration (hardening), warmth, tenderness & pain
Sign of normal healing 7-10 days
there will be a healing ridge
Signs of Impaired Healing 7-9 days
lack of a healing ridge
Chemo, radiation therapy, immunosuppressants, anticoagulants, smoking & steroid all impede what?
the healing process
Wound that goes to Pink –> bright red indicates what?
that blood vessels are reforming well within tissue
What do you look at when assessing a wound?
Location, size, shape, sinus tracts, tunneling, necrotic tissue, exudate, inflammation, pain
Do you base treatment on culture swab alone?
No. Treatment is based on culture & assessment
Deep tissue injury
purple localized color on intact skin,
Stage I ulcer is what?
intact skin with non blanchable redness of a localized area, usually over a bone
Stage I ulcer will feel..
warm or cool, firm or soft & may be painful
Stage II ulcer
Partial thickness skin loss involving the epidermis, dermis or both
Stage III ulcer
Full thickness loss extending into subcutaneous tissue; does not go thru fascia. Bone, tendon or muscle are not exposed
What does a stage II ulcer look like?
intact or not intact blister, shiny or dry
