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Wound Care + Dressings lec Flashcards

1
Q

define wounds

A

any damage leading to break in continuity of skin

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2
Q

what is meant by classifying wound according to aetiology?

A

what is the cause of the wound

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3
Q

give some different wound aetiologies

A

trauma
surgical
ischaemic
pressure
burns
malignant
diabetic

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4
Q

what are the two different timescales that wounds can be classified by?

A

acute and chronic

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5
Q

true or false, all chronic wounds begin as acute wounds?

A

true

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6
Q

chronic wounds do not follow the correct healing stages and hence lengthens recovery true or false?

A

true

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7
Q

what are the 2 types of closure that wounds cam be classed as?

A

primary and secondary intention

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8
Q

what is meant by primary intention closure?

A

wound edges brought together by stitches etc and wound healing occurs by connective tissue formation

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9
Q

what is meant by healing by secondary wound intention?

A

wound left open to heal base up by layering of granulation tissue and wound contraction
healing for most chronic wounds

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10
Q

the healing process can be classified, list the 4 different terms that are associated with the proliferation stage of healing?

A

granulation
contraction
epithelialisation
slough

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11
Q

outline the main steps of the healing process that aims to heal a wound?

A

haemostasis
inflammation
proliferation
remodelling

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12
Q

what is meant by haemostasis ?

A

wound closed by clotting

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13
Q

different steps of haemostasis?

A
  • blood vessels contract to restrict blood flow
  • platelets stick together to seal break in BV wall
  • coagulation reinforces platelet plug with fibrin
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14
Q

what is the second stage of wound healing?

A

inflammation

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15
Q

what controls bleeding and prevents infection?

A

inflammation

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16
Q

fluid engorgement allows healing and promotes cells to move to the site of the wound, true or false?

A

true

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17
Q

when does inflammation become a problem?

A

if its prolonged or excessive

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18
Q

what happens in proliferation?

A

wound rebuilt of tissue with collagen and extracellular matrix

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19
Q

in proliferation wound contracts and new blood vessels constructed so tissue can recieve? 2

A

oxygen and nutrients

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20
Q

remodelling/maturation is when the wound fully closes and collagen matures from type 3 to type ?

A

1

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21
Q

cells no longer needed to repair wound are removed, then collagen is laid down, what happens do it during maturation phase?

A

aligned along tension line, water reabs, fibres crosslink to reduce scar thickness

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22
Q

what is meant by necrotic?

A

dead tissue

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23
Q

what type if tissue is devitalised and contains white blood cells and debris?

A

sloughy

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24
Q

true or false sloughly tissue can not be easily removed but must be to allow healing?

A

true

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25
what colour is used to describe a sloughy wound?
yellow
26
describe granulating tissue
newly formed capillary loops that grow into damaged tissue to form new tissue, characteristically red
27
final stage of wound healing is epithelisation, describe what it would look like?
keratinocytes migrate from wound margins or hair follicles and sebaceous glands to cover wound surface, pink
28
list 5 different factors that can affect healing?
age nutrition comorbidities medications lifestyle
29
what effect does ageing have on healing?
collagen production decreases and weaker so increases risk
30
in terms of nutrition why carbs better for wound healing
body burns aa's and proteins for energy, needed for repair depletion -> impaired inflamm, poor immune response
31
tissues need O2 to survive, amny disease affecting tissues and O2 -> poor wound healing give examples
COPD peripheral vasc disease anaemia
32
high dose X can affect wound healing due to suppression of the immune system
steroids
33
what effect can abuse of alcohol and smoking have on healing?
impairs
34
give 2 causes for diabetic foot ulcers?
peripheral diabetic neuropathy and peripheral arterial disease
35
what causes the initial foot damage in diabetic patients?
lack of nerve sensation in feet
36
what exmaination checks for peripheral pulses in feet?
doppler
37
peripheral arterial disease is a result of X, less blood flow to lower limbs -> diab foot ulcer
atherosclerosis
38
what would be the purpose of angiography
check for peripheral circ and rectify blockages w angioplasty/ stenting
39
what may cause a diabetic foot ulcer
poor fitting shoes rubbing stone in shoe step on sharp walk on hot sand step in hot bath
40
in what different ways can leg ulcers be classified? 5
venous arterial mixed diabetic autoimmune
41
why do venous leg ulcers occur?
failure of calf muscle to pump blood effectively
42
risk factors for venous leg ulcers
dvt varicose veins lower limb surgery trauma
43
patients with brachial arterial diease have a ABPI below 1, what is indicated by a lower number?
more significant damage and atherosclerosis
44
how is ABPI calc?
highest ankle systolic over highest brachial systolic
45
tx of venous ulceration normal abpi
graduated compression hosiery inc pressure gradient from ankle to knee = assisted venous return
46
what is a pressure ulcer?
damage to skin and deeper layer of tissue under skin due to pressure applied to same area for period of time that cuts off blood supply eg sat for long time wheelchair etc
47
early signs of pressure ulcers
discoloured skin, red or purple patches, warm spongy or hard patch, pain
48
what grade of pressure ulcer is non blanchable erythema of intact skin?
1
49
what grade of pressure ulcer is partial thickness skin involving epidermis dermis or both?
2
50
what grade of pressure ulcer is it where there is full thickness skin loss involving damage to or necrosis of sb tissue that may extend down to fascia?
3
51
what grade of damage would a pressure ulcer where there is full thickness skin loss with extensive destruction, tissue necrosis, or damage to muscle bone and supporting structures?
4
52
pressure ulcers more common in what areas of body
bony parts: heels elbows hips spine gradually develop sometimes quick if px in poor state of health
53
list some different properties of an ideal dressing?
control moisture around wound protect from microorganisms and infection mechanical protection easy to use non toxic cost effective
54
what 2 things to think about before choosing dressing
is wound wet/ dry is dressing complete
55
list 2 different simple dressings?
low adherence dressings and absorbent dressings
56
list 3 different advanced wound dressings?
hydrogels, films and foams
57
what are sorbsan and algosteril examples of?
alginates
58
alginates are obtained from seaweed and absorb exudate. They are suitable for wounds with what properties?
moderate to heavily exuding wounds
59
alginates come in 2 parts what are these?
flat sheets for packing wound cavity and secondary dressing to hold in place
60
alginates are avaiable with silver for
infected wounds
61
what type of dressings are allevyn and tegaderm
foam dressings
62
foam dressings are suitable for all exudating wounds but vary in their ability to absorb. They come as complete dressings with adhesive border or not and can be used as a secondary dressing. Are they more or less absorbing than alginates?
less
63
where are foam dressings best used?
to cushion fragile skin
64
what type of dressings are jelonet or bactigras examples of?
paraffin impregnated gauze
65
paraffin impregnated gauze is cotton and viscose impregnated with yellow or soft white paraffin and is X, Y, Z
greasy, waterproof and non stick
66
paraffin impregnated gauze is used as primary dressing for which wounds
partial thickness burns
67
what are duoderm and tegaderm examples of
hydrocolloids
68
hydrocolloids are semi permeable to oxygen and water and turn into a gel in the prescence of ?
exudates
69
what type of wounds are hydrocolloids useful for?
lightly exudating or dryer
70
true or false, hydrocolloids do not promote granulation?
false
71
give some benefits of hydrocolloids
complete dressings, waterproof, available in different sizes and shapes
72
community advice that you can give to someone with burns?
cool with cool or lukewarm running water for 20 mins dont rip off stuck clothes cover with clingfilm analgesia
73
a patient with burns should attend A&E if?
chemical electrical covers area larger than hand white or charred skin forms blisters
74
if a burn blisters what dressing would be the likely choice?
paraffin impregnated gauze
75
what would imply infection in a sloughy wound?
green and redness around area, check markers for infection
76
give some markers of infection that could be checked for a sloughy wound?
temp wcc
77
what type of dressing would be most suitable for an infected sloughy wound?
alginate or hydrocolloid fibrous depending on amount of exudate
78
why might an infected sloughy wound require a secondary dressing as a cover?
prevent maceration and further breakdown
79
which bacteria would systemic antibiotics need to cover and why?
staphylococcus because stays on the skin
80
give 2 abx choices for skin infections
flucloxacillin, clindamycin doxacycline if allergy
81
what is maceration?
too much moisture on surrounding skin of wound
82
what is the risk if primary dressing has not absorbed enough exudate?
maceration
83
what dressing would be appropriate for a wound that is healing well and undergoing granulation and epithelilisation?
simple protection eg low adherence dressing, vapour permeable film or hydrocolloid
84
where does sterile larvae come from?
greenbottle fly
85
what is debridement?
removing sloughy necrotic or infected tissue
86
when would larvae or maggot therapy be used?
where other options fail
87
how does larvae therapy work?
saliva contains chemicals that break down dead tissue into liquid form that larvae digest
88
does larvae therapy affect healthy tissue, yes or no?
no
89
how is larvae therapy prescribable on a fp10 prescription?
biofilm dressing (preferred by px) or free range larve

Finals (29 decks)

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