Wounds And Burns

Question 1

Epidermis cell types

Answer 1

Melanocytes
Langerhans - infection
Merkel cell - light touch
Keratinocytes - epithelialization

Question 2

Dermis contains…

Answer 2

Blood vessels
Lympathics
Nerve endings
Glands, nails, hair

Question 3

Subcutaneous tissue

Answer 3

Loose CT< adipose tissue, elastin

Question 4

Infection

Answer 4

Excess edema
Hot to touch, fever, malaise
Large exudate
Red, may be blistering
Severe pain no position of comfort

Question 5

Inflammatory phase main points

Answer 5

Debris removal, cell repair and regeneration
Platelets aggregate at injury site, release of WBCs
Edema, redness, inflammation, pain

Question 6

Proliferative phase

Answer 6

Angiogenesis and epitheliallization
Granulation tissue fills in wound
Fibroblasts pull wound edges in

Question 7

Remodeling

Answer 7

New collagen forms, old collagen breaks down

Question 8

Epibole

Answer 8

Sign of halted process
Manage via cross-hatching, silver nitrates to burn edges

Question 9

Arterial wounds

Answer 9

Ischemia
Dry wound bed
Even edges
PAD
Bergers test

Question 10

Venous wounds

Answer 10

Valves faulty or obstruction or lack of pumping, cannot get blood out of area
Majority of wounds
Wet wound bed, gaiter area, hemo staining

Question 11

Neuropathic

Answer 11

Linked with DM — hyperglycemia increases stiffness of vessels

Question 12

Stage 2 pressure injury

Answer 12

Only one thats partial thickness loss

Question 13

Non-selective debridement (4)

Answer 13

Wet to dry (waxing)
Irrigation
Hydrotherapy (whirlpool)
Abrasion

Question 14

Selective debridement contraindications

Answer 14

Stable heel eschar
ABI <0.8
Coagulation therapy
Gangrene, osteomyelitis
**unidentified structures
**terminally ill

Question 15

Selective types of debridement

Answer 15

Autolytic
Enzymatic
Biosurgical
Sharp debridement (requires MD orders)
Surgical (MD only)

Question 16

Active drain types

Answer 16

JP drain
Hemovac

Question 17

Passive drain types

Answer 17

Penrose, pigtail, ostomies, t-tube

Question 18

Dressings for wet wounds

Answer 18

Alginate
Gauze
Foam

Question 19

Dressings for dry wounds

Answer 19

Hydrogel
Film
Hydrocolloid

Question 20

Superficial burn

Answer 20

Not included in TBSA
Bright red
Painful
Epidermis only

Question 21

Partial thickness superficial

Answer 21

Epidermis and dermis involving papillary only
Red
Very painful
Minimal to no scarring

Question 22

Partial thickness deep

Answer 22

Epidermis, dermis papillary and reticular
White to pink
+ pain = healing, - pain = deep burn
Surface: pseudoeschar blanching = healing
Hypertrophic scarring

Question 23

Full thickness burn

Answer 23

Epidermis, dermis, subcutaneous
Mixed white, leathery, dry, charre, waxy
Minimal pain
skin graft required