Wound Healing, Burns and Rehabilitation Flashcards
Path of electrical resistance (least to greatest)
Nerve - Artery - Vein - Bone
Three Zones of Burn Injury
Coagulation, Stasis, Hyperemia
Zone of irreversible damage; (+) Necrosis
Zone of Coagulation
Zone of reversible cell damage; (+) Ischemia
Zone of Stasis
Zone of minimal cell damage; (+) Inflammation
Zone of Hyperemia
If the Zone of Stasisis not treated, how long before the cell death happens?
24-48 hours
Burn Classification: 3-4 days
Superficial Epidermal Thickness Burn Injury
Burn Classification: 7-21 days
Superficial Partial Thickness Burn Injury
Burn Classification: 21-35 days
Deep Partial Thickness Burn Injury
Burn Classification: (+) red/pink with slight edema, delayed pain, and without blister and scar
Superficial Epidermal Thickness Burn Injury
Burn Classification: Epidermis and Upper Dermis Affectation
Superficial Partial Thickness Burn Injury
Burn Classification: (+) bright red with intact moist weeping blister, and severe pain.
Superficial Partial Thickness Burn Injury
Burn Classification: (+) waxy white/red with marked edema and hypertrophic/keloid scars
Deep Partial Thickness Burn Injury
Burn Classification: no definitive time
Full Thickness Burn Injury
Burn Classification: (+) blacked with dry surface anesthetic pain and skin grafting
Full Thickness Burn Injury
Burn Classification: (+) osteitis, osteomyelitis, and the damage is up until the bone
Subdermal Burn Injury
Burn Classification: Electrical burn & Prolonged contact with flame
Subdermal Burn Injury
Fourth Degree Burn
Subdermal Burn Injury
Third Degree Burn
Full Thickness Burn Injury
What degree is a chemical burn?
Third Degree or Full Thickness Burn Injury
Severity of Burn Injury: 15-30% TBSA
Second Degree, Moderate
Severity of Burn Injury: <3%
Third Degree, Minor
Severity of Burn Injury: >30%
Second Degree, Major
Severity of Burn Injury: 2-10%
Third Degree, Moderate
Severity of Burn Injury: <15%
Second Degree, Minor
Severity of Burn Injury: >10%
Third Degree, Major
Five other major or critical burn injury
Smoke Inhalation Injury, Electrical Burn, Burn with complication, Burn with fracture and Burn at the face, hands, feet, and perineum.
A scar that goes beyond the boundary
Keloid
A scar that stays at the boundary
Hypertrophic
Rules of Nine (Adult): Trunk
36%
Rules of Nine (Adult): Head and Neck
9%
Rules of Nine (Adult): 1 UE
9%
Rules of Nine (Adult): 1 LE
18%
Rules of Nine: Perineum
1%
Rules of Nine (Child): Head and Neck
18%
Rules of Nine (Child): 1 LE
14%
Rules of Nine (Child): Trunk
36%
Rules of Nine (Child): 1 UE
9%
The most common cause of death in burn patients
Infection
The most significant cause of loss of function in burn patients
Infection
Abnormal bone growth at the joint
Heterotrophic Ossificans
The most common site of HO in burn patients
Posterior Elbow
Cause of HO in burn patients
Immobility and Sepsis
The most common site of MO in UE
Brachialis
The most common site of MO in LE
Quadriceps Femoris
Management for MO
Gentle active ROM exercise
The common deformity of the Neck and Knee
Flexion
The common deformity of the Shoulder
Shoulder ABIR
The common deformity of the Hand
Claw Hand: Wrist and IP flexed, MCP extended and Thumb adducted
The common deformity of the Hip
Hip FADIR
The common deformity of the Ankle
Plantarflexion
The common deformity of the Elbow
Elbow Flexion and Pronation
Intrinsic Plus Position
Wrist: 15-20 degrees extension, MCP: 70 degrees flexion, IP: extension, Thumb: slight abduction
Intrinsic Minus
Claw Hand
Orthosis for Shoulder Deformity
Airplane Splint
Orthosis for Claw Hand Deformity
Resting Hand Splint
Position for Hip Deformity Stress
Extension, Abduction and Neutral Rotation
Position of Shoulder Deformity Stress
Slight flexion, 90 degrees abduction and ER
Topical drug for skin grafting to prevent infection
Furacin/Nitrofurazone
Topical drug for surface organism
Silver Nitrate
A topical drug used against pseudomonas
Silver Sulfadiazine/Silvadine
A topical drug used for penetration of thick eschar
Sulfamylon/Manefide Acetate
A topical drug used to liquify eschar
Travase/Elase
Topical drug for debridement of necrotic tissue with green exudate
Panafil Keratolytic
“Homograft”
Allograft
“Heterograft”
Xenograft
Type of graft that uses skin from the same species
Allograft
Type of graft that uses skin from different species
Xenograft
Type of graft that uses patient’s own skin
Autograft
A permanent type of graft
Autograft
Cadaver or Donor skin
Allograft
Pig’s skin
Xenograft
Source of autograft in the body
Cheek, Hip, Buttocks, Stomach
Two types of Biosynthetic graft
Laboratory Grown and Artificial
Biosynthetic graft: (+) collagen and synthetics
Laboratory Grown
Biosynthetic graft: (+) synthetics only
Artificial
Type of graft where the donor’s skin composed of epidermis and upper dermis skin layer
Split Thickness Graft
Type of graft where the donor’s skin composed of epidermis and whole dermis skin layer
Full Thickness Graft
Four Other Names of Pressure UIcer
Pressure Sore, Bed Sore, Ischemic Ulcer and Decubitus Ulcer
How often do you need to do bed turning in patients with pressure ulcers?
Every 2 hours
How often do you need to do wheelchair turning in patients with pressure ulcers?
Every 15-20 minutes
The most common site of pressure ulcer in adults
Sacrum
The most common site of pressure ulcer in children
Occiput
Stage of Pressure Ulcer: (+) Superficial Skin Loss
Stage 1
Stage of Pressure Ulcer: (+) Partial Thickness Skin Loss
Stage 2
Stage of Pressure Ulcer: (+) Full Thickness Skin Loss
Stage 3
Stage of Pressure Ulcer: (+) Full Thickness Skin Loss up to fascia, muscle and bones
Stage 4
Stage of Pressure Ulcer: (+) Abrasion, shallow crater and blister
Stage 2
Stage of Pressure Ulcer: (+) Deep Crater (+/-) Undermining or Tunneling
Stage 3
Stage of Pressure Ulcer: (+) Osteitis and Osteomyelitis
Stage 4
Stage of Pressure Ulcer: (+) non-blanchable erythema with pain and itching
Stage 1
“Diabetic Ulcer”
Neuropathic Ulcer
The most common site of Neuropathic Ulcer
Plantar aspect of Foot
Wagner Ulcer Classification: Pre-ulcerative healed ulcer
Stage 0
Wagner Ulcer Classification: (+) Bone Deformity
Stage 0
Wagner Ulcer Classification: (+) Deep Ulcer in Subcutaneous Tissue
Stage 2
Wagner Ulcer Classification: Osteitis, Abcess, Osteomyelitis
Stage 3
Wagner Ulcer Classification: Gangrene of Toes
Stage 4
Wagner Ulcer Classification: Gangrene of Foot
Stage 5
Wagner Ulcer Classification: (+) Superficial lesion not involving subcutaneous tissue
Stage 1
Ulcer: (+) Well-Defined and Deep Shape
Arterial Ulcer
Ulcer: (+) Browny and Dry Flakes
Venous Ulcer
Ulcer: (+) Thin, shiny, yellow nails and hair loss
Arterial Ulcer
Ulcer: (+) Cyanotic on dependency
Venous Ulcer
Ulcer: (+) Pallor on Elevation
Arterial Ulcer
Ulcer: (+) Rubor on Dependency
Arterial Ulcer
Ulcer: (+) Pain and Gangrene
Arterial Ulcer
Location of Arterial Ulcer
Lateral Malleolus, Anterior Tibia and Dorsum of foot
Location of Venous Ulcer
Medial Malleolus
Ulcer: (+) Irregular and Shallow Shape
Venous Ulcer
Ulcer: (+) decreased temperature
Arterial Ulcer
Ulcer: (+) Moderate and Heavy Drainage
Venous Ulcer
Three types of Selective Debridement
Sharp, Autolytic, Enzymatic
Type of selective debridement done by a PT with no anesthesia using scalpel and forceps to remove necrotic tissue
Sharp Debridement
Type of selective debridement that uses the body’s own natural mechanism to remove necrotic tissue
Autolytic Debridement
Type of selective debridement that uses the application of enzyme (topical drug) to remove necrotic tissue
Enzymatic Debridement
Type of selective debridement: (+) Enzyme and Dressing
Autolytic Debridement
Type of selective debridement: (+) Enzyme and (-) Dressing
Enzymatic Debridement
The least effective way to remove necrotic tissue
Whirlpool
Debridement medication use with clean wound and clear exudate
Normal Saline Solution
Debridement medication use with infected wound and green exudate with pus or foul-smelling
Povidine Iodine, Sodium Hypochloride and Hydrogen Peroxide
PT management that uses vacuum-assisted closure
Negative Pressure Wound Therapy
PT management that uses inhalation of 100% oxygen
Hyperbaric Oxygen
What charged pat will you put in clean wounds when using electrical stimulation?
Anode (+)
What charged pat will you put in infected wounds when using electrical stimulation?
Cathode (-)
Three dry wound dressings
Hydrogel, Wet-to-Wet, Transparent Film
Two minimal to moderate dressing
Hydrocolloid, Wet-to-Dry
Three moderate to heavy dressing
Calcium Alginate, Semi-permeable, Dry-to-Dry
Best dry dressing use for superficial to partial wounds
Hydrogel
Best minimal to moderate dressing that is gel-forming
Hydrocolloid
Best moderate to heavy dressing use for partial and full-thickness wounds
Calcium Alginate
Drainage: Clear, thin, watery
Transudate
Drainage: Clear with a tinge of brown-red hues
Serous Anguineus
Drainage: Yellowish, creamy Thick
Exudate
Drainage: Yellow-brown with moderate to heavy thickness
Pus
Drainage: Green, blue, yellow, hues with a thick foul smell
Infected Pus
