Wounds and Closure Flashcards
If the wound is disrupted parallel to the long axis of the fibers of Langer’s Lines, what will occur?
Re-approximation
If the wound is disrupted to where the fibers are perpendicular to Langer’s Lines, what will occur?
Gape
Wounds that are “x” hours old are considered clean and eligible for closure with sutures.
6 - 8 hours
Highly vascular areas such as the face and scalp can be considered for primary closure up to “x” hours after the injury
24 hours
When all layers of a wound are closed.
Primary Intention
When deep layers of a wound are closed and superficial layers are left open to granulate on their own.
Secondary Intention
When deep layers of a wound are primarily closed and superficial layers are left open until reassessment on the 4th or 5th day after closure, at which time the wound is inspected for infection.
Tertiary Intention
25% or less of the bandage being covered in wound drainage
Small or Scant
25% - 50% of the bandage being covered in wound drainage.
Medium
More than 50% of the bandage being covered in wound drainage.
Large
Combination of blood and serous drainage
Serosanguineous
Clear fluid drainage
Serous
Blood flow from wound drainage
Sanguineous
Drainage that is thick or thick and sometimes yellow or brown.
Purulent
Chronic venous stasis changes the skin texture and elasticity that results in a brownish discoloration of the lower legs.
Hemosiderin Staining
Indicates that the edges of a wound have extra fluid around them.
Induration
May be slightly lighter to light pink surrounding, indicating past wounds that have healed recently or quite some time ago.
Scar Tissue
What should be a part of routine wound management?
Wound Irrigation
What is typically used to irrigate a wound?
Saline
Should you add iodine or other antiseptic solutions when irrigating a wound?
Not usually
Cleansing agent that is strongly bactericidal against Gram (+) and (-)
Povidone-Iodine
Cleansing agent that is strongly bactericidal against Gram (+) and less strong against Gram (-)
Chlorhexidine
Cleaning agent that is Bacteriostatic against Gram (+) and much less effective against Gram (-). Teratogenic with repeated uses.
Hexachlorophene
Cleansing agent that has very weak antibacterial activity and is toxic to red cells.
Hydrogen Peroxide
Silver-containing foam dressings were NOT found to significantly improve ulcer healing at four weeks compared with non-silver containing dressings.
True
(Silver Sucks)
What is the most useful way to classify dressings?
Water-retaining abilities
What is the primary goal of a dressing?
Maintenance of moisture in the wound environment
A patient has a minor wound that is “clean.” The patient states that they have received all their Tetanus vaccines within the last 10 years. Should you give another dose?
No
Patients with severe wounds should receive the Tetanus vaccine if how much time has passed since their last one?
5+ Years Ago
If there is any doubt that a patient has received their Tetanus vaccine, how many doses should be administered?
3 Doses
How are the 3 doses of the Tetanus vaccine spaced out?
1st: undefined
2nd: 4 weeks later
3rd: 6 - 12 months later
What is considered the best way to assess the patient and the potential risks of developing a pressure ulcer?
Braden Scale
What are the 6 subscales of the Braden Scale?
Sensory Perception
Activity
Mobility
Moisture
Nutrition
Friction and Shear
Intact skin with non-blanchable redness.
Stage 1 Pressure Ulcer
Partial thickness skin loss with exposed dermis. May appear pink or red.
Stage 2 Pressure Ulcer
Full thickness skin loss in which adipose tissue is visible in the ulcer and granulation tissue and rolled wound edges are present.
Stage 3 Pressure Ulcer
Full thickness skin loss in which fascia, muscle, tendons, ligament, cartilage, or bone is present.
Stage 4 Pressure Ulcer
Focal circumscribed accumulation of purulent materials
Abscess
