Wounds, Burns, Scars

Question 0

Laceration

Answer 0

Increased tissue loss with ragged edges

Question 1

Abrasion

Answer 1

Superficial wound with ragged edges

Question 2

Incision

Answer 2

Clean, approximated wound edges

Question 3

Puncture

Answer 3

Clean edges, small edges

Question 4

Animal bite

Answer 4

Combination of crush, laceration and puncture.

Question 5

Burn

Answer 5

Caused by external thermal agent

Question 6

Phases of wound healing

Answer 6

Inflammatory
Proliferation
Remodelling

Question 7

Inflammatory phase of healing

Answer 7

Acute
3-6 days

Goals: decrease pain, increase ROM, stabilize injured area, control inflammation.

Hemostasis, vasoconstriction, platelet aggregation, clot formation,

Question 8

Proliferative phase

Answer 8

Subacute

2 days to three weeks.

Granulation, new collagen laid down, angiogenesis, epitheliazation

Goals: increase ROM, prevent atrophy, promote reorganization along lines of stress, control inflammation.

Question 9

Remodelling Phase

Answer 9

Chronic

3 weeks to 2 years

Localized pain, decreased ROM, muscle weakness, low grade inflammation

Goals: increase strength, create functional scar tissue, improve ROM, balance and proprioception, promote muscle balance

Question 10

First degree burn

Answer 10

Superficial. Epidermis only.

Question 11

Second degree burns

Answer 11

Partial thickness (superficial or deep burn)

Epidermis and dermis

Blistering and erythymia

Question 12

Third degree burn

Answer 12

Full thickness burn

Extends to subQ. May affect bone, nerves, tendons, etc.

Question 13

Fourth degree burn

Answer 13

Full thickness FUBAR burn

Catastrophic damage to subQ.

Will require grafting if survived.

Question 14

Difference between superficial and deep partial thickness burns

Answer 14

Both second degree.

Deep affects reticular layer.

Question 15

Decubitus ulcers

Answer 15

Pressure sores

Caused by impaired circulation due to pressure, shear force or friction.

Question 16

Bedsores and pressure

Answer 16

Compression of tissues, usually bone against surface.

Question 17

Shear force and bedsores

Answer 17

Skin stays in one place, deep fascia and skeletal muscle slide down.

Question 18

Friction and bedsores

Answer 18

Force resisting shearing of skin.

Excess shedding through layers of epidermis.

Question 19

How many stages of decubitus ulcers?

Answer 19

Four

Question 20

Decubitus ulcers: Stage 1

Answer 20

Local erythymia, warmth, swelling but tissues intact.

Nonblanchable.

If erythymia doesn’t resolve within 30 min of pressure relief –> bedsore developing.

Question 21

Reactive hyperaemia vs stage 1 pressure ulcer

Answer 21

1. Reactive hyperaemia resolved within 3/4 of the time pressure was applied
2. Reactive hyperaemia blanches with pressure

Question 22

Stage 2 Decubitus ulcers

Answer 22

Epidermis and maybe dermis affected. Blister, abrasion, and or shallow ulcer.

Partial thickness damage

Moist, pink and painful.

Question 23

Stage 3 decubitus ulcer

Answer 23

Full thickness damage.

Cavity created to subQ layer. Eschar.

Question 24

Eschar

Answer 24

Thick and leathery necrotic tissue

Present in stage 3 & 4 decubitus ulcers.

Question 25

Stage 4 decubitus ulcer

Answer 25

Full thickness damage. Through subQ to muscle and bone.