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Finals > Wound Care + Dressings lec > Flashcards

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
Q

what colour is used to describe a sloughy wound?

A

yellow

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26
Q

describe granulating tissue

A

newly formed capillary loops that grow into damaged tissue to form new tissue, characteristically red

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27
Q

final stage of wound healing is epithelisation, describe what it would look like?

A

keratinocytes migrate from wound margins or hair follicles and sebaceous glands to cover wound surface, pink

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28
Q

list 5 different factors that can affect healing?

A

age
nutrition
comorbidities
medications
lifestyle

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29
Q

what effect does ageing have on healing?

A

collagen production decreases and weaker so increases risk

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30
Q

in terms of nutrition why carbs better for wound healing

A

body burns aa’s and proteins for energy, needed for repair
depletion -> impaired inflamm, poor immune response

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31
Q

tissues need O2 to survive, amny disease affecting tissues and O2 -> poor wound healing
give examples

A

COPD
peripheral vasc disease
anaemia

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32
Q

high dose X can affect wound healing due to suppression of the immune system

A

steroids

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33
Q

what effect can abuse of alcohol and smoking have on healing?

A

impairs

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34
Q

give 2 causes for diabetic foot ulcers?

A

peripheral diabetic neuropathy and peripheral arterial disease

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35
Q

what causes the initial foot damage in diabetic patients?

A

lack of nerve sensation in feet

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36
Q

what exmaination checks for peripheral pulses in feet?

A

doppler

37
Q

peripheral arterial disease is a result of X, less blood flow to lower limbs -> diab foot ulcer

A

atherosclerosis

38
Q

what would be the purpose of angiography

A

check for peripheral circ and rectify blockages w angioplasty/ stenting

39
Q

what may cause a diabetic foot ulcer

A

poor fitting shoes
rubbing
stone in shoe
step on sharp
walk on hot sand
step in hot bath

40
Q

in what different ways can leg ulcers be classified? 5

A

venous
arterial
mixed
diabetic
autoimmune

41
Q

why do venous leg ulcers occur?

A

failure of calf muscle to pump blood effectively

42
Q

risk factors for venous leg ulcers

A

dvt
varicose veins
lower limb surgery
trauma

43
Q

patients with brachial arterial diease have a ABPI below 1, what is indicated by a lower number?

A

more significant damage and atherosclerosis

44
Q

how is ABPI calc?

A

highest ankle systolic over highest brachial systolic

45
Q

tx of venous ulceration normal abpi

A

graduated compression hosiery
inc pressure gradient from ankle to knee = assisted venous return

46
Q

what is a pressure ulcer?

A

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
Q

early signs of pressure ulcers

A

discoloured skin, red or purple patches, warm spongy or hard patch, pain

48
Q

what grade of pressure ulcer is non blanchable erythema of intact skin?

A

1

49
Q

what grade of pressure ulcer is partial thickness skin involving epidermis dermis or both?

A

2

50
Q

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?

A

3

51
Q

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?

A

4

52
Q

pressure ulcers more common in what areas of body

A

bony parts: heels elbows hips spine

gradually develop sometimes quick if px in poor state of health

53
Q

list some different properties of an ideal dressing?

A

control moisture around wound
protect from microorganisms and infection
mechanical protection
easy to use
non toxic
cost effective

54
Q

what 2 things to think about before choosing dressing

A

is wound wet/ dry
is dressing complete

55
Q

list 2 different simple dressings?

A

low adherence dressings and absorbent dressings

56
Q

list 3 different advanced wound dressings?

A

hydrogels, films and foams

57
Q

what are sorbsan and algosteril examples of?

A

alginates

58
Q

alginates are obtained from seaweed and absorb exudate. They are suitable for wounds with what properties?

A

moderate to heavily exuding wounds

59
Q

alginates come in 2 parts what are these?

A

flat sheets for packing wound cavity and secondary dressing to hold in place

60
Q

alginates are avaiable with silver for

A

infected wounds

61
Q

what type of dressings are allevyn and tegaderm

A

foam dressings

62
Q

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?

A

less

63
Q

where are foam dressings best used?

A

to cushion fragile skin

64
Q

what type of dressings are jelonet or bactigras examples of?

A

paraffin impregnated gauze

65
Q

paraffin impregnated gauze is cotton and viscose impregnated with yellow or soft white paraffin and is X, Y, Z

A

greasy, waterproof and non stick

66
Q

paraffin impregnated gauze is used as primary dressing for which wounds

A

partial thickness burns

67
Q

what are duoderm and tegaderm examples of

A

hydrocolloids

68
Q

hydrocolloids are semi permeable to oxygen and water and turn into a gel in the prescence of ?

A

exudates

69
Q

what type of wounds are hydrocolloids useful for?

A

lightly exudating or dryer

70
Q

true or false, hydrocolloids do not promote granulation?

A

false

71
Q

give some benefits of hydrocolloids

A

complete dressings, waterproof, available in different sizes and shapes

72
Q

community advice that you can give to someone with burns?

A

cool with cool or lukewarm running water for 20 mins
dont rip off stuck clothes
cover with clingfilm
analgesia

73
Q

a patient with burns should attend A&E if?

A

chemical
electrical
covers area larger than hand
white or charred skin
forms blisters

74
Q

if a burn blisters what dressing would be the likely choice?

A

paraffin impregnated gauze

75
Q

what would imply infection in a sloughy wound?

A

green and redness around area, check markers for infection

76
Q

give some markers of infection that could be checked for a sloughy wound?

A

temp
wcc

77
Q

what type of dressing would be most suitable for an infected sloughy wound?

A

alginate or hydrocolloid fibrous depending on amount of exudate

78
Q

why might an infected sloughy wound require a secondary dressing as a cover?

A

prevent maceration and further breakdown

79
Q

which bacteria would systemic antibiotics need to cover and why?

A

staphylococcus because stays on the skin

80
Q

give 2 abx choices for skin infections

A

flucloxacillin, clindamycin
doxacycline if allergy

81
Q

what is maceration?

A

too much moisture on surrounding skin of wound

82
Q

what is the risk if primary dressing has not absorbed enough exudate?

A

maceration

83
Q

what dressing would be appropriate for a wound that is healing well and undergoing granulation and epithelilisation?

A

simple protection eg low adherence dressing, vapour permeable film or hydrocolloid

84
Q

where does sterile larvae come from?

A

greenbottle fly

85
Q

what is debridement?

A

removing sloughy necrotic or infected tissue

86
Q

when would larvae or maggot therapy be used?

A

where other options fail

87
Q

how does larvae therapy work?

A

saliva contains chemicals that break down dead tissue into liquid form that larvae digest

88
Q

does larvae therapy affect healthy tissue, yes or no?

A

no

89
Q

how is larvae therapy prescribable on a fp10 prescription?

A

biofilm dressing (preferred by px) or free range larve

Finals (29 decks)

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