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Medical Conditions II > Wound Care > Flashcards

Wound Care Flashcards

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USMLE® Step 1 flashcards
1
Q

Intrinsic factors of wound healing

A
  • age
  • chronic diseases present
  • perfusion/oxygenation
  • immunosuppresison
  • neurologically impaired skin
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2
Q

Extrinsic factors of wound healing

A
  • medications
  • nutrition
  • irradiation and chemo
  • psych stressors
  • wound ‘bioburden” and infection
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3
Q

Bioburden

A
  • Whatever is colonized on a wound

- pathogens

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4
Q

Iatrogenic Factors for healing

A
  • local ischemia due to pressure/other forces
  • inappropriate wound care
  • trauma
  • wound extent and duration
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5
Q

Zones of Wound Healing

A
  • zone of hyperemia
  • zone of stasis
  • zone of coagulation
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6
Q

Zone of coagulation

A
  • area of necrosis

- will not heal

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7
Q

Zone of Hyperemia

A
  • inflammatory response surrounding the wound
  • normal tissue going through normal response
  • redness of skin
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8
Q

Zone of Stasis

A
  • part that may or may not heal
  • important to protect this zone so it can heal
  • hanging in the balance
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9
Q

Re-epithelialization

A
  • recreation of a permeable barrier
  • skin reinstituted as functional barrier
  • epithelial cell migration from nearby tissues begins within hours of injury
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10
Q

Granulation Tissue

A
  • new or budding tissue
  • composed of capillaries and collagen
  • fills defects of full-thickness wounds
  • bleeds easily, relatively fragile
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11
Q

Demarcation

A

-clear differentiation between viable and non-viable tissue

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12
Q

Excoriated Tissue

A
  • epidermal tissue abrasion
  • to chafe, tear or wear off the skin
  • often linear
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13
Q

Sinus Tract

A
  • channel or passageway extending into viable tissues with one entrance only
  • travels under skin
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14
Q

Tunneling

A

-narrow channel or passageway with openings on both ends

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15
Q

Abscess

A

-localized collection of pus

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16
Q

Induration

A
  • palpably hard tissue
  • often at edge of wound
  • can indicate abscesses (must determine cause)
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17
Q

Drainage

A
  • Exudate or transudate

- indicates inflammatory response

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18
Q

Exudate

A
  • found in inflammatory stage of wound healing
  • contains cells, proteins and other solid materials
  • 2 kinds: purulent or serous
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19
Q

Purulent

A
  • milky/cloudy appearance but can be any color

- indicate infection

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20
Q

Serous

A
  • thin, clear usually amber color
  • mostly contains serum
  • (Serosanguinous-thin with some RBC)
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21
Q

Transudate

A
  • thin, cloudy drainage found in the proliferation stage of wound healing
  • like exudate but has fewer cellular componenets
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22
Q

Dehiscence

A
  • splitting of open wound
  • separation of layers of surgical wound (partial, superficial or complete)
  • bad
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23
Q

Risk Factor of Dehiscence

A
  • obesity

- because adipose is less vascularized

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24
Q

Necrosis

A
  • tissue death

- residual dead tissue can impede normal healing

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25
Q

Slough

A
  • Yellow and thin covering of wound

- stringy appearance

26
Q

Eschar

A
  • more advanced necrosis
  • soft or hard (leathery)
  • represents full-thickness destruction of tissue
  • black/dark colored
27
Q

Necrotic tissue tends to become more______

A

-adherent to wound bed as level of damage increases

28
Q

As necrotic tissue worsens, the color may____

A

-progress from white-grey to yellow to brown/black

29
Q

Methods of Wound Closure

A
  • first intent
  • secondary intent
  • third intent
30
Q

First Intent Closure

A

-close the wound and done

31
Q

Second Intent Closure

A

-larger wound must fill in on it’s own

32
Q

Third Intent

A

-intentionally left open to get rid of infection first

33
Q

Debridement

A
  • removal of dead tissue

- 4 types

34
Q

4 Types of Wound Debridement

A
  • Mechanical
  • Sharp
  • Enzymatic
  • Autolytic
35
Q

Mechanical Debridement

A
  • PT

- Pulsed lavage, whirlpool/flow-over hydrotherapy etc

36
Q

Sharp Debridement

A

-with scalpel

37
Q

Enzymatic Debridement

A

-put stuff on the wound to break down necrosis

38
Q

Autolytic Debridement

A
  • scab, body creates temporary roof
  • healing under scab and scab falls off
  • body does it on it’s own
39
Q

Ulcer

A
  • loss of epidermis and dermis

- most are preventable

40
Q

Common Locations of Decubitus Ulcers

A
  • bony prominences

- ischium, sacrum, coccyx, olecranon, heels, occiput, scapulae, lateral malleoli, trochanters, acromion

41
Q

Decubitus

A

lying down position

42
Q

5 Risks/Causative factors for Decubitus Ulcers

A
  • interface pressure (externally)
  • Friction (skin on other surface)
  • Shearing
  • Maceration (softening due to excessive moisture)
  • decreased skin resilience (dehydration)
43
Q

Maceration

A

-softening due to excessive moisture

44
Q

Grading decubitus ulcers

A
  • grade I-IV
  • IV is the worst
  • stage I-skin is still intact
  • don’t massage area or use donut cushions
45
Q

Osteomyelitis

A

-Bone infection

46
Q

Signs of Infection

A
  • redness
  • fever
  • increased temp
  • discoloration
  • drainage (smelly)
47
Q

Prevention of Decubitus Ulcers

A
  • MOBILITY
  • assessment of surfaces in contact
  • vigilance in the presence of incontinence
  • multidisciplinary consultation (RN, NA, Family, Physicians)
48
Q

Other Ulcer Types

A
  • Arterial
  • Venous
  • Neuropathic
49
Q

Modalities for Wound Care

A
  • ESTIM
  • US (pulsatile)
  • SWD
  • Whirlpool
50
Q

Whirlpool

A
  • softens eschar and other necrotic tissue
  • turbulence provide mechanical debridement
  • flow over therapy is better
51
Q

Flow-Over Hydrotherapy

A
  • wound cleansing with immediate flushing away of potentially infectious material
  • more sanitary than whirlpool
52
Q

Grade I Pressure Ulcer

A
  • skin intact
  • warmer/cooler than other skin
  • firm or boggy consistency
  • pain/itching sensation
  • redness
53
Q

Grade II Pressure Ulcer

A
  • Partial thickness skin loss of epidermis and/or dermis

- superficial

54
Q

Grade III Pressure Ulcer

A
  • full thickness damage/necrosis to subq layer to fascia
  • deep crater
  • with/without undermining of adjacent tissue
55
Q

Grade IV Pressure Ulcer

A
  • Full thickness with necrosis or damage to muscle, bone or supporting structures (tendon, joint capsule)
  • undermining and sinus tracts
56
Q

Unstageable Pressure Ulcer

A
  • wound covered with eschar
  • or more than 50% necrotic tissue
  • or filled with granulation tissue
57
Q

Deep Tissue Injury (grade of pressure ulcer)

A

-pressure related injury to subq tissues under intact skin

58
Q

Neuropathic ulcers

A
  • weight bearing surfaces
  • well-defined margins
  • no undermining
  • graunlation tissue present
  • no pain
59
Q

Arterial Ulcers

A
  • deep pale base
  • well defined edges
  • black necrotic tissue
  • dry
  • cool leg
  • painful
60
Q

Venous Ulcers

A
  • uneven edges
  • ruddy granulation tissue
  • warm leg, edema
  • wet
  • some pain

Medical Conditions II (34 decks)

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