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MPharm 2 - PH2107 > Wounds and their management > Flashcards

Wounds and their management Flashcards

1
Q

What is a wound?

A

A significant discontinuity of the epithelial barrier

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2
Q

What causes a wound?

A

Trauma
Disease
Infection

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3
Q

What does a wound involve?

A

Bleeding - deep enough to rupture the microvasculature(the system of tiny blood vessels, including capillaries, venules, and arterioles, that perfuse the body’s tissues) in the dermis
- includes superficial abrasion

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4
Q

What are the problems with wounds?

A 
Loss of blood/fluids (exudates)
Pain
Shock
Ingress of microbes
- wound contamination
- colonisation
- wound infection
- systemic infection e.g. tetanus
- sepsis (septicaemia)
Chronic wounds
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5
Q

How many microorganisms reside on the skin?

A

1000 species or so

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6
Q

Where are skin microorganisms often found?

A

Most are found in the superficial layers of the epidermis and the upper parts of the hair follicles

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7
Q

How do skin microorganisms behave on the skin?

A

Usually non-pathogenic

  • commensal (not harmful to their host)
  • mutualistic (offer a benefit to the host)
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8
Q

Why is it important for a pharmacist to know about wounds?

A

Increasing encouragement for patients to consult a pharmacist prior to booking a GP appointment, which can be up to 2 weeks
- must be able to spot potentially serious cases

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9
Q

Where should a patient be sent if the pharmacist suspects they have a serious wound?

A

GP

A&E

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10
Q

What must a pharmacist be able to provide for patients with less serious wounds?

A
  • recommend, from a wide variety of products, an appropriate treatment
  • provide advice on bandages/stockings
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11
Q

What is an abraision?

A

A graze

  • occurs after skin rubs against a hard surface
  • contamination and foreign introduced
  • superficial
  • friction scrapes away the epithelium, exposing the epidermal or dermal layers
  • bleeding low/moderate
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12
Q

What is an incision?

A

A surgical procedure

  • precise, regular wound using a sharp-edged object (i.e. scalpel through skin to facilitate an operation or procedure)
  • clean and sterile
  • regular, defined edge
  • primary intension is healing
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13
Q

How is an incision healed?

A

A healthy, healing wound will have edges that meet neatly and are held closely together by sutures, staples or another method of closure

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14
Q

What is a laceration?

A

Non-surgical wound

  • caused by contact with a sharp edge e.g. broken glass
  • imprecise tear-like wounds
  • comparatively irregular edge
  • not sterile
  • most lacerations affect only the upper layers of the skin and subcutaneous tissues
  • significant/profuse bleeding
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15
Q

What is an avulsion?

A

Skin is forcibly detached or torn from its normal point of attachment by either trauma or friction

  • commonly refers to a surface trauma where all layers of the skin have been torn away, exposing the underlying structures (i.e. subcutaneous tissue, muscle, tendons or bones)
  • involves partial or full detachment from the body
  • profuse bleeding
  • not necessarily contaminated
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16
Q

What is a puncture?

A

Entry of sharp pointed object into the skin to create a small hole

  • caused by a nail, pin or needle
  • often the wound seems to close almost instantly
  • hard to locate
  • usually minor bleeding
  • can still be a risk of infection, especially if the penetrating object is not sterile
17
Q

What is a penetration/perforation?

A

An object pierces the skin and enters the subcutaneous tissue of the body, creating an open wound
- object may remain in the tissues, come back out the way it entered, or exit from another area

18
Q

What is a perforation injury?

A

Where an object enters the body and passes all the way through

  • bleeding
  • non-sterile
19
Q

What can cause penetration wounds?

A

Bites

  • mammals
  • reptiles
  • insects
  • wasps
  • ants
  • ticks
  • mites
  • bedbugs
  • fleas
  • spiders (false widow)
20
Q

What is envenomation?

A

The process of venom being injected into the skin during a bite or skin

21
Q

What is the main problem with bites?

A

Microbes introduced to the skin

22
Q

What is a blister?

A

A pocket of fluid between epidermis and dermis

23
Q

What is the hemidesmosome?

A

Provides adhesion of epithelial cells to the underlying basement membrane, but are weaker than desmosomes
- break down to allow ingress of fluid, and creates a blister

24
Q

What is a burn?

A

Wound caused by (dry) heat, cold, electricity, friction, chemical or physical agents

25
Q

What are the 4 types of burn?

A
  • 1st degree (superficial)
  • 2nd degree (partial thickness)
  • 3rd degree (full thickness)
  • 4th degree
26
Q

Describe a 1st degree burn

A

Appear red without blisters

Pain typically lasts around three days

27
Q

Describe a 2nd degree burn

A

Blisters
Very painful
Healing can require up to eight weeks

28
Q

Describe a 3rd degree burn

A

Injury extends to all layers of the skin
No pain
Burn area is stiff

29
Q

Describe a 4th degree burn

A

Includes injury to deeper tissues

  • muscle
  • tendons
  • bone
30
Q

What is a scald?

A

Damage to the skin usually caused by wet heat

  • hot water
  • steam
  • egg?
31
Q

What is the purpose of wound healing?

A

A complex sequence of events aimed at repairing the discontinuity between edges of the wound and re-establishing the function of tissue and its barrier function

32
Q

What are the four stages of wound healing?

A
  • bleeding (up to 20 minutes)
  • inflammation (3 - 4 days)
  • proliferation (21 days)
  • maturation (2 years)
33
Q

What is the problem with wound healing?

A

Full mechanical strength never attained

34
Q

What is the body’s first response to a new wound?

A

Coagulation which lasts up to 10 - 20 minutes

  • localised vasoconstriction
  • clot formation
  • control of blood loss
35
Q

Which three key components are involved in blood clotting?

A
  • platelets
  • fibrin
  • red blood cells
    via a complex clotting cascade

MPharm 2 - PH2107 (26 decks)

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