Wound Care Flashcards
What are the three stages of wound healing?
Inflammation 1-4 days
Proliferation (Repair) 3-21 days (14 days tensile strength matches suture strength)
Maturation (Remodeling) (Days 21-year)
What occurs during the inflammation phase of healing?
The inflammatory phase lasts 1-4 days and involves initial vasoconstriction followed by eventual vasodilation.
Neutrophils arrive first followed by macrophages.
What occurs during the proliferative/repair phase of healing?
Days 3-21
Collagen synthesis begins to provide tensile strength within the wound. This tensile strength reaches the strength of the suture at 14 days.
In what stage of healing do chronic wounds stop progressing?
The proliferative stage!
What is santyl?
Collagenase: An enzymatic debrider that digests collagen in necrotic tissue
What is Regranex?
Platelet derived growth factor
Potent activator for cells of mesenchymal origin. PDGF stimulates chemotaxis, proliferation, and new gene expression in monocytes-macrophages and fibroblasts in vitro, cell types considered essential for tissue repair.
Where is Regranex made?
Puerto Rico
This is why there is a shortage!!
What is the normal serum albumin level?
3.4-5.0 g/dL
What is a low serum albumin level associated with?
Associated with decreased wound healing and nutritional status!
Think edema, impaired cellular immunity, decreased collagen synthesis, decreased fibroblast proliferation etc.
What is the minimum ABI needed for wound healing in diabetics?
0.45
What is the minimum ABI needed for wound healing in non-diabetic patients?
0.35
.045 in diabetic patients!
Using transcutaneous oximetry what is the minimum pressure necessary for wound healing in non-diabetic patients?
30 mm Hg
Using transcutaneous oximetry what is the minimum pressure necessary for wound healing in a diabetic patient?
40 mm Hg
How does wound vac/negative pressure wound therapy assist in wound closure?
NPWT applies mechanical shear stress to the wound site.
This is believed to promote granulation by decreasing bacterial bioburden, reducing edema, and inducing capillary budding.
How does hyperbaric oxygen therapy assist wound closure?
The thouht is that it increases the partial pressure of O2 in the arterial circulation which increases diffusion of O2 at the wound site.
This is believed to increase growth factors promoting angiogenesis and collagen synthesis.
