Wounds and burns (3) Flashcards
4 types of burns
- Sunburn - caused by overexposure to UVA and UVB rays from natural sunlight or use of commercial tanning beds/lamps
- Thermal burn - result from skin contact with flames, scalding liquids, or hot objects
- Electrical burn - heat of electric current damages the skin; typically has an entry and exit points on the body
- Chemical burn - tissue damage secondary to exposure to corrosive or reactive chemicals
2 types of wounds
- Abrasion - rubbing or friction applied to epidermal layer of the skin
- Laceration - cut through multiple skin layers from a sharp-edged object
3 phases of wound healing
- Inflammatory
-first 3-4 days, platelets go to site of bleeding to form clot to stop bleeding (hemostasis and clot formation) - Proliferative
-next 3 weeks, skin cells develop (wound is filled with new connective tissue and covered with new epithelium) - Maturation/Remodeling
-next several weeks - breakdown and resynthesize of collagen over and over to strengthen new epithelial layer
Risk factors for poor wound healing
Local
o Inadequate tissue perfusion and oxygenation
o Inadequate moisture of injured area
o Presence of foreign bodies, necrotic tissue, infection
Systemic
o Age > 60 years
o Stress
o Inadequate nutrition
o Diabetes
o Obesity
o Immunocompromised conditions
4 types of wounds based on severity
- Superficial skin injury
-red unbroken, non blistered skin, painful to the touch - Superficial partial thickness skin injury
-broken skin, may lead to blistering and drainage of fluid from area, blanching occurs with pressure
^these 2 are self care candidates
The following require a referral:
- Deep partial thickness skin injury
-edema, little to no blanching, no blisters, pain sensation may be altered - Full thickness and subdermal skin injury
-requires hospitalization, underlying tissues visible
What is blanching
momentary turn to a lighter color because of pressure applied (sign of delayed blood return)
this is used to assess if wound is superficial partial thickness
harder to detect in individuals with darker skin - so for these individuals we assess for pain and temperature changes
Assessment of wounds in dark skin individuals
Blanching may not be visible - assess pain and temperature change in affected area instead
Inflammation may be subtle or unnoticeable to the naked eye (may appear darker than patient’s normal skin tone)
Erythema may present as hyperpigmentation instead - affected area darker than surrounding skin tone
A wound is considered chronic if it lasts longer than _________
30 days
(exclusion to self care)
Which sites of injury are exclusions to self care? (5)
Hands
Feet
Face
Genitalia
Major joints
If a wound does not show signs of healing after __________ days it is an exclusion to self care
7 days
Exclusions to self care (11)
- Chemical, electrical, or inhalation burns
- Wounds secondary to animal or human bite
- Deep partial thickness, full thickness or subdermal injury
- Signs of infection
- Circumferential burn (the entire circumference of a limb (or the trunk, neck, or digits) is burned)
- preexisting medical disorders that may delay wound healing (i.e. diabetes)
- wound containing foreign debris after irrigation
- chronic wound (lasting longer than 30 days)
- site of injury: hands, face, feet, major joints, genitalia
- larger than 3 inches in diameter
- does not show signs of healing after 7 days
Self care wound treatment (4 steps)
- Irrigate wound with clean cool tap water for 20 minutes
-note antiseptic rinses are not more effective than water - Apply moisture using skin protectants
- Wound dressing
-any type is okay for superficial injuries
-moist healing environment dressings are required for superficial partial thickness injuries
-Change dressing if dressing is dirty or not adhering to area - do not change too often - Pain management
-oral (NSAIDs/acetaminophen) or topical anesthetics
Note - patients should avoid peeling off or pulling at loose skin; may delay healing process
Which type of wound dressings provide a moist healing environment? (2)
Hydrocolloids and transparent adhesive films
Gauze and regular band-aids do NOT provide a moist healing environment
Moist healing environment is required for superficial partial thickness skin injuries
Which skin protectants can be used (4), what is their purpose?
They promote moist healing and prevent injured area from irritation
Options:
petrolatum
glycerin
cocoa butter
colloidal oatmeal
Which OTC systemic analgesics can be used for pain?
Acetaminophen
NSAIDs:
Aspirin, naproxen, ibuprofen
