Wound Care Basics

Question 1

What are the keys to wound healing

Answer 1

• Moisture: essential for epithelial cell migration, dry cells are dead cells
• Bioburden must go: slough, appearance as yellow/black/brown

Question 2

What are the 5 types of debridement for bioburdens

Answer 2

• Mechanical
• Sharp/surgical
• Autolytic
• Enzymatic
• Biological

Question 3

Wound evaluation using the acronym ASSESSMENT

Answer 3

• Anatomic Location of Wound
• Size & Shape: length x width x depth
• Sinus Tracts, Undermining, Tunnels
• Exudate
• Sepsis
• Surrounding Skin
• Margins: Edge attached?
• Erythema, Epithelilization
• Necrotic Tissue
• Tissue Bed, Tenderness to Touch

Question 4

What are the layers of the epidermis

Answer 4

• Stratum Corneum
• Stratum Lucidum
• Stratum Granulosum
• Stratum Spinosum
• Stratum Basale

Question 5

Wound healing of the epidermis

Answer 5

• 2-3 wks for cells to move from Stratum Basale to Stratum Corneum
• Melanocytes
• Merkel Cells
• Epidermal cells originate in the Stratum Basale

Question 6

What are the layers of the dermis

Answer 6

• BMZ = basement membrane zone (b/w epidermis & dermis)
• Papillary dermis
• Reticular dermis: dermal appendages (AKA hair follicles)

Question 7

What are the phases of wound healing

Answer 7

• Inflammation: hemostasis
• Proliferation
• Remodeling

Question 8

Describe hemostasis

Answer 8

• Clotting factors produce provisional matrix
• Multiple growth factors released & drawl in neutrophils and monocytes (chemotaxic signals)
• Begins inflammation

Question 9

Describe inflammation

Answer 9

• 24 hrs to 2 wks
• Key cells: neutrophils, monocytes, & macrophages
• Clean up duties & regulation
• Activate fibroblasts & promote angiogenesis

Question 10

Cellular activity occurring during inflammation phase of healing

Answer 10

• Adherence
• Chemotaxis
• Phagocytosis
• Oxidative burst

Question 11

Describe the proliferation phase of wound healing

Answer 11

• Fibroblasts: produce disorganized extracellular matrix
• Angiogenesis: produces granular appearance
• Epithelization: from the basalar Keratinocytes

Question 12

Describe the remodeling phase of wound healing

Answer 12

• Granulation tissue matures into scar tissue
• Reorganization of collagen fibers (Type III to Type I) = increased tissue strength
• Wound contraction: fibroblasts (FB) and MFB’s

Question 13

Keys to wound healing for systemic effects on prognosis

Answer 13

• Nutrition & absorption: measured by labs - Albumin, PreAlbumin
• Diabetes: HGbA1C
• Immunosuppression, Radiation, or Chemotherapy
• Self-induced: smoking, ETOH, and drug abuse
• Destructive force: abnormal pressure