FINAL EXAM - Integumentary System, Burns, Wounds Flashcards
(262 cards)
1
Q
Epidermis - Characteristics (10)
A
- Prevents dehydration2. Protects from microbes3. Keeps nutrients in the skin4. Responds to stimuli5. Keratin6. Reproductive layer of the skin7. Surrounds hair follicles8. Surrounds sweat and sebaceous glands9. thin10 avascular
2
Q
The dermis contains (9)
A
- hair follicles2. nerve endings3. lymph vessels4. blood vessels5. collagen6. elastin7. sweat8. sebaceous glands 9. fibroblasts
3
Q
fibroblasts in the dermis produce
A
collagen
4
Q
Fn’s of the dermis (3)
A
- provides nutrition2. provides protection3. source of blood flow
5
Q
Phases of wound healing (5)
A
- hemostasis2. inflammation3. epithelialization4. proliferation5. maturation
6
Q
Hemostasis
A
platelets aggregate, clot formation
7
Q
inflammation - what occurs and what are the clinical signs
A
phagocytosis, clinical signs are heat, pain, redness
8
Q
epithelialization
A
migration of basal cells; need most environment
9
Q
proliferation
A
granulation, contraction
10
Q
maturation
A
remodeling, scar formation
11
Q
Primary (First Intention)
A
wound borders approximate
12
Q
Secondary
A
wound borders are not approximated
13
Q
Delayed Primary (Third Intention)
A
Sutured after infection is controlled
14
Q
Subcutaneous tissue - characteristics (3)
A
- mostly fat and fascia2. blood vessels that support the dermis and epidermis3. provides cushioning and insulation
15
Q
What must remain intact in order to get wound to granulate?
A
periosteum
16
Q
Tendons are _____ _____ when healthy, but have poor ______
A
shiny whitevascularity
17
Q
Acute wound
A
heals in the expected sequence and time frame
18
Q
Chronic wound
A
fails to heal as expected, does not proceed through normal phases of healing
19
Q
Chronic wound characteristics (4)
A
- repeated trauma2. abnormal blood flow3. large bacterial load4. local tissue ischemia
20
Q
Etiology of chronic wounds (3)
A
- PVD2. DM3. physical immobility
21
Q
Intrinsic factors of delayed wound healing (5)
A
- age - geriatric2. chronic diseases3. edema4. poor perfusion - lack of blood flow5. immunosuppression
22
Q
Extrinsic factors of delayed wound healing (6)
A
- poor nutrition and hydration2. medications3. necrosis4. bioburden5. infection6. incontinence
23
Q
Iatrogenic factors of delayed wound healing (4)
A
- inappropriate wound management2. Desiccation (wound pops open)3. Inadequate offloading4. improper handling of dressings
24
Q
Factors to consider with wound assessment (7)
A
- wound classification2. new onset vs recurrence3. wound history - time present, prior treatment interventions4. anatomical location5. Wound appearance6. Appearance of periwound7. sensation
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Wound appearance includes (6)
1. size2. shape3. tunneling or undermining4. wound bed5. exudate or drainage
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Undermining
underneath the opening; NOT down into the wound
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Factors looked at when assessing a wound bed (2)
1. color2. tissue - granulation or necrotic
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Nectrotic wound tissue is either
Eschar or slough
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Factors looked at when assessing exudate or drainage (5)
1. Amount2. odor3. serous = clear4. sanguineous = bloody5. purulent = thick yellow with green (bacteria)
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Appearance of periwound factors that are assessed (3)
1. Temperature - Warm=infection; Cold = lack of blood flow2. edema3. rolled edges
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Sensation factors that are assessed (3)
1. Pain2. temperature3. proprioception
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Pressure ulcers
localized injury to the skin and/or underlying tissue usually over a bony prominence, as a result of pressure, or pressure in combination with shear and/or friction
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What amount of time can a pressure ulcer occur?
Can occur in 2 hours
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Common locations for Pressure ulcers (8)
1. occiput2. scapula3. sacrum4. coccyx5. ischial tuberosity6. greater trochanter7. malleolus8. heel
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Risk factors for pressure ulcers (8)
1. cognitive decline2. impaired sensation3. advancing age4. contractures5. immobility/inactivity6. inadequate nutrition7. incontinence8. co-morbidities
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Pressure Ulcer SDTI description
looks like a bruise, purple or maroon localized area of discolored intact skin or blood filled blister due to damage of underlying soft tissue from pressure and/or shear. May be painful, firm, mushy, warmer or cooler compared to adjacent tissue. Never Used to Describe a Bruise
37
Once a SDTI opens what stage is it usually?
III
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Stage I pressure ulcer description
intact skin with nonblanchable redness of a localized area usually over a bony prominence. May be painful, firm, soft, warmer or cooler compared to adjacent skin
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Stage II pressure ulcer description
Partial thickness, loss of dermis presenting as a shallow open ulcer with a pink wound bed WITHOUT slough. May present as an intact or open serum filled blister. Should not be used to describe skin tears, tape burns, dermatitis, maceration
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Stage III pressure ulcer description
Full thickness tissue loss into the subcutaneous layer, fat may be visible but NOT bone, tendon or muscle. Slough may be present but does not cover the depth of the tissue loss. May include undermining and tunneling. Depth varies based on anatomical position
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Stage IV pressure ulcer description
full thickness loss WITH exposed bone, tendon, or muscle; slough or eschar, and undermining or tunneling may be present. Osteomyelitis (bone infection) is possible based on the exposed structures
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Unstageable pressure ulcer description
Full thickness tissue loss in which the base of the ulcer is cover by slough and/or eschar in the wound bed. True depth cannot be determined until the eschar is removed. NEVER remove a "hard cap", unless it's loose and there's debris around it.
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Stage a pressure ulcer by (4)
1. ID the deepest part of the wound2. If eschar or slough cover the wound it's unstageable and assumed it's either Stage III or IV3. Using staging tools - Pressure ulcer scale for healing (PUSH); Pressure Sore status tool
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Arterial Wounds signs and symptoms (6)
1. diminished pulse - lack of blood flow to the extremity2. pale, cool, thin or shiny skin3. hair loss4. claudication5. Pain Increase with elevation and exercise (pain when walking)6. dependent position decreases symptoms ( leg hanging off side of bed)
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Arterial wound risk factors (6)
1. smoking2. htn3. hyperlipidemia4. obesity5. inactivity6. DM
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Arterial wound etiology (2)
1. acute - blunt trauma2. chronic - arteriosclerosis
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Arterial wound - common locations ( 3)
1. Anterior tibial region of lower leg2. Dorsum and lateral side of foot3. tips of toes (no blood flow = necrotic tissue)
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Arterial wound appearance ( 6)
1. punched - out or circular in appearance with measureable depth2. distinct borders with pale dry wound base3. scant to minimal drainage4. significant pain5. periwound reddened6. if edema - localized
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Venous wounds - Signs and Symptoms (4)
1. skin is dusky, ruddy color2. edema with pitting and possible weeping3. hemosiderin staining and lipodermaterosclerosis4. spider veins
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Lipodermaterosclerosis appears
bumpy
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hemosiderin staining
proteins leaks causing a brown stain like coloring in the skin
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Venous wound risk factors (5)
1. Immobility2. pregnancy3. prolonged standing4. smoking5. excessive sodium intake
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Etiology of venous wounds
Vascular dysfunction resulting in venous hypertension
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Common locations for venous wounds (2)
1. pre-tibial area between knee and ankle2. medial malleolus
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Appearance of venous wounds (6)
1. moderate to heavy exudate2. yellow fibrinous superficial wound base3. wound edges irregular and large4. periwound fibrotic and indurated5. hypergranulation6. warm temperature - lots of fluid
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neuropathic (diabetic) ulcers - signs and symptoms (3)
1. prolonged inflammation2. impaired vascularization3. impaired immune system
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neuropathic ulcer risk factors (7)
1. chronic hyperglycemia2. high cholesterol3. elevated blood sugar levels4. smoking5. obesity6. sedentary lifestyle7. family history
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Etiology of neuropathic ulcers
lack of protective sensation leads to injury that may go unnoticed; don't realize they step on something
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Neuropathic ulcer common location (3)
1. plantar aspect of metatarsal heads2. toes- tips and between toes3. lateral aspect of foot
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Neuropathic ulcers are commonly located on the feet because
the patient continually ambulates on bony prominence
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Neuropathic ulcer appearance (6)
1. bloody exudate2. dry and necrotic3. edema localized4. smaller, but significant depth5. painless due to lack of sensation6. callus formation around periwound
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What is a burn and how is it classified?
thermal injury that destroys layers of the skin; classified by size, depth and mechanism
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Classification of burn by size (2)
1. TBSA - total burn surface area2. rule of 9s (even if only a small area on the chest it's still 9%)
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What are the classifications of burns by depth? (5)
1. superficial or first degree2. superficial partial thickness or superficial second degree3. Deep partial thickness or deep second degree4. Full thickness or third degree5. subdermal or fourth degree
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Characteristics of Superficial or First degree (3)
1. Classic sunburn2. red, dry, painful3. Heals within 3-4 days without scarring
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Characteristics of Superficial partial thickness or superficial second degree
1. pink to red2. Painful3. blisters - still in tact4. moist5. edema6. heals within 7-10 days minimal scarring
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Characteristics of Deep partial thickness or deep second degree (6)
1. pale due to disrupted blood flow to the area2. painful3. edema4. decreased sensation5. heals in 3-4 wks - may require grafting6. Heterotrophic scarring
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Characteristics of full thickness or third degree
1. Dermis has been removed2. black to mottled red/brown to pale, waxy white 3. leather like - tight4. insensate5. epidermis & dermis destroyed6. heals in 4-6wks with scarring 7. need to keep the area stretched to avoid contractures
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Characteristics of subdermal or fourth degree
1. dry, charry appearance2. muscle or bone exposed3. requires grafting or muscle flap4. hypertrophic scarring - not flat, bumpy/rigid
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Classification of burns by mechanism (5)
1. thermal (hot liquids/scalding)2. radiation3. chemical (acid, alkali, gas or tar)4. Electrical - pure, arc and flame 5. Other - frostbite
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electrical arc burn does not require _____ _____
direct contact
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Who is at risk of burns? (7)
1. children; ages 1-14yrs old, 2. children that are abused3. men due to work field4. pmh of mental health, dm, neuropathy, and substance abuse5. O2 Dependent (smokers)
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Emergent phase 1. time frame 2. focus (6) (MM of burns)
0-72 hrs after injury1. sustain life2. preventing infection3. prepare for surgical closure4. promote healing5. managing pain6. scar formation
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Acute phase 1. time frame 2. focus (6) (MM of burns)
72 hours after injury or until wound is closed1. infection control2. grafts3. dressings4. support along with pain management5. splinting6. Social and psychological support
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Rehabilitation phase - focus (MM of Burns)
1. nutrition2. hydration3. stability4. return to function5. psychological component
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Complications of burns (8)
1. contractures/deformities2. hypertrophic scarring3. heterotopic ossification4. pain5. heat intolerance6. sun exposure7. pruritus8. psychosocial adjustment
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pruritus
itching
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cutaneous
pertaining to the skin
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lesion
wound, injury, or pathological change in body tissue
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systemic
pertaining to a system or the whole body rather than a localized area
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therapeutic
pertaining to treating, remediating, or curing a disorder or disease
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What accessory organs of the skin are located in the dermis? (3)
1. nails2. sweat glands3. sebaceous glands
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CF for fat (3)
adip/olip/osteat/o
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adipocele
hernia containing fat or fatty tissue
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lipocyte
fat cell
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steatoma
fatty tumor
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CF that mean skin (3)
cutane/odermat/oderm/o
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hypodermic
pertaining to below the skin (dermis)
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cyan/o
blue
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cyanosis
physical sign causing bluish discoloration of the skin and mucous membranes
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CF that mean red (3)
erythem/oerythemat/oerythr/o
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erythema
redness of the skin caused by congestion of the capillaries in the lower layers of the skin. It occurs with any skin injury, infection, or
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erythematous
pertaining to erythema (redness of the skin)
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erythrocyte
red blood cell
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CF meaning sweat (2)
hidr/o**don't mistake for h2o=hydr/osudor/o
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hidrosis
formation and excretion of sweat
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sudoresis
profuse sweating
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ichthy/o
dry, scaly
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ichthyosis
congenital (meaning present at birth) dermatological (skin) disease that is represented by thick, scaly skin.
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kerat/o
horny tissue; hard; cornea
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keratosis
Any lesion on the epidermis marked by the presence of circumscribed overgrowths of the horny layer.
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melan/o
black
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melanoma
malignant tumor that originates in melanocytes and is considered the most dangerous type of skin cancer, which, if not treated early, becomes difficult to cure anc can be fatal
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myc/o
fungus
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dermatomycosis
a superficial fungal infection of the skin or of its appendages
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onych/o
nail
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onychomalacia
softening of the nails
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CFs meaning hair (2)
1. pil/o2. trich/o
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pilonidal
pertaining to a nest of hair
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trichopathy
disease of the hair
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scler/o
hardening; sclera (white of the eye)
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scleroderma what is it?what does it cause?what does it affect?
autoimmune disorder where there is an overproduction of abnormal collagen accumulation throughout the body, causing hardening (sclerosis), scarring (fibrosis), and other damage. The damage may affect the appearance of the skin, or it may involve only the internal organs.
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seb/o
sebum, sebaceous
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seborrhea
excessive discharge from the sebaceous glands, forming greasy scales or cheesy plugs on the body; it is generally attended with itching or burning.
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squam/o
scale
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squamous
scaly or platelike
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therm/o
heat
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xer/o
dry
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xeroderma
dry skin
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pyoderma
Any acute, inflammatory, purulent bacterial dermatitis.
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diaphoresis
carrying, transmitting through or across
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dermatoplasty
surgical repair of the skin
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cryotherapy
cold "freezing" treatment
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anhidrosis
abnormal condition of the absence of sweating
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hyperhidrosis
abnormal excessive sweating
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abrasion
scraping or rubbing away of a surface, such as skin, by friction
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abscess
localized collection of pus at the site of an infection (characteristically a staphylococcal infection)
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furuncle
abscess that originates in a hair follicle; also called BOIL
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carbuncle
cluster of furuncles in the subcutaneous tissue
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acne
inflammatory disease of sebaceous follicles of the skin, marked by comedos, papules, and pustules
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comedos
discolored, dried sebum plugging an excretory duct of the skin; aka blackheads
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pustules
small skin lesion filled with purulent material
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alopecia
absence or loss of hair, especially of the head; also known as baldness
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carcinoma
uncontrolled growth of abnormal cells in the body; also called malignant cells
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cyst
closed sac or pouch in or under the skin with a definite wall that contains fluid, semifluid, or solid material
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pilonidal
growth of hair in a dermoid cyst or in a sinus opening on the skin
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eczema
redness of skin caused by swelling of the capillaries
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gangrene
death of tissue, usually resulting from loss of blood supply
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hemorrhage
external or internal loss of a large amount of blood in a short period
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contusion
hemorrhage of any size under the skin in which the skin is not broken; aka bruise
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ecchymosis
skin discoloration consisting of a large, irregularly formed hemorrhagic area with colors changing from blue-black to greenish brown or yellow, aka bruise
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petechia
minute, pinpoint hemorrhagic spot of the skin that is a smaller version of an ecchymosis
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hematoma
elevated, localized collection of blood trapped under the skin that usually results from trauma
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hirsutism
excessive growth of hair in unusual places, especially in women: may be due to hypersecretion of testosterone
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ichthyosis
genetic skin disorder in which the skin is dr and scaly, resembling fish skin
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impetigo
bacterial skin infection characterized by isolated pustules that become crusted a rupture
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keloid
overgrowth of scar tissue at the site of a skin injury (especially a wound, surgical incision, or sever burn) caused by excessive collagen formation during the healing process
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psoriasis
chronic skin disease characterized by itchy red patches covered with silvery scales
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scabies
contagious skin disease transmitted by the itch mite
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skin lesions
areas of pathologically altered tissue caused by disease, injury, or a cound resulting from external factors or internal disease
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tinea
fungal infection whose name commonly indicates the body part affected, such as tinea pedis (athlete's foot); AKA ringworm
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ulcer
lesion of the skin or mucous membranes marked by inflammation, necrosis, and sloughing of damaged tissue
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pressure ulcer
skin ulceration caused by prolonged pressure, usually in a patient who is bedridden; also known as decubitus ulcer or bedsore
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urticaria
Allergic reaction of the skin characterized by eruption of pale red elevated patches that are intensely itchy; also called wheals (hives)
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verruca
rounded epidermal growth caused by a virus; asl called wart
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vesicle
small blister-like elevation on the skin containing a clear fluid; large vesicles are called bullae (singular bulla)
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vitiligo
localized loss of skin pigmentation characterized by milk- white patches; also called leukoderma
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wheal
smooth, slightly elevated skin that is white in the center with a pale red periphery; also call hives if itchy
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biopsy (bx)
removal of a small piece of living tissue from an organ or other part of the body for microscopic examination to confirm or establish a diagnosis, estimate prognosis, or follow the course of a disease
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skin test
any test in which a suspected allergen or sensitizer is applied to or injected into the skin to determine the patient's sensitivity to it
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cryosurgery
use of subfreezing temperature, commonly with liquid nitrogen, to destroy abnormal tissue cells, such as unwanted, cancerous, or infected tissue
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debridement
removal of foreign material, damaged tissue, or cellular debris from a wound or burn to prevent infection and promote healing
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fulguration
tissue destruction by means of high-frequency electrical current; also called electrodesiccation
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incision and drainage (I&D)
incision of a lesion, such as an abscess, followed by the drainage of its contents
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Mohs surgery
surgical procedure used primarily to treat skin neoplasms in which tumor tissue fixed in place is removed layer by layer for microscopic examination until the entire tumor is removed
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skin graft
surgical procedure to transplant healthy tissue by applying it to an injured site
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allograft
transplantation of healthy tissue from one person to another person; also called homograft
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autograft
transplantation of healthy tissue from one site to another site in the same individual
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synthetic
transplantation of artificial skin produced from collagen fibers arranged in a lattice pattern
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xenograft
transplantation (dermis only) from a foreign donor (usually a pig) and transferred to a human; also called heterograft
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skin resufacing
procedure that repairs damaged skin, acne scars, fine or deep wrinkles, or tattoos or improves skin tone irregularities through the use of topical chemicals, abrasion or laster
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chemical peel
use of chemicals to remove outer layers of skin to treat acne scarring and general keratoses as well as from cosmetic purposes to remove fine wrinkles on the face; also called chemabraion
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cutaneous laser
any of several laser treatments employed for cosmetic and plastic surgery
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dermabrasion
removal of acne scars, nevi, tattoos, or fine wrinkles on the skin through the use of sandpaper, wire brushes, or other abrasive material on the epidermal layer
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antibiotics
kill bacteria that cause skin infections
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antifungals
kill fungi that infect the skin
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antipruritics
reduce sever itching
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corticosteroids
anti-inflammatory agents that treat skin inflammation
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Functions of the skin (six)
Protection against infection Prevention of loss of body fluidControl of body temperatureFunctioning as an excretory organHelping to determine personal identity
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What are the two primary factors that influence the amount of tissue destruction that occurs following a burn injury?
1.temperature2. Duration of exposure
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Ischemia
Restriction and blood supply to tissues
182
There are three zones to a burn injury what are they?
Zone of coagulationZone of stasisZone of hyperemia
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What is the zone of coagulation?
Area of ear reversible tissue destruction
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What is the zone of stasis?
The area surrounding the zone of coagulation where damage results in decreased perfusion
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What is the zone of hyperemia?
The outer zone area. damaged and considered at risk but with proper care should recover and heal
186
The aim of care after burn injury is to
Reduce or prevent dermal ischemia therefore avoiding further tissue death
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Eschar
The residual necrotic layers of skin destroyed by direct heat damage or the injury occurring secondary to heat damage
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The depth of a burn influences (four)
survival rates healing time treatment Scar formation
189
Superficial burns are caused by (two)
A variety of causes1. Sunburn2. Flash from an explosion
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Superficial burn healing time
Within 3 to 6 days and does not produce any residual scars
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Because some of the dermis remains in a partial thickness burn the wound will eventually
Regenerate skin cells
192
Full thickness burn injuries will not
Heal spontaneously
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Full thickness injuries may be in a variety of colors such as (4)
Black, cherry red, tan or pearly white
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Healing time for full thickness burns depend on
Availability of Donor sites
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Full thickness burns are at severe risk for
Contracture formations
196
TBSA stands for
Total body surface area
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The rule of nines
Convenient and rapid method that may be effectively used at the scene of an accident to estimate extent of burns. It divides the body service into areas representing 9% are multiples of 9%. It has limited accuracy with children
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The Lund and Browder scale
Used when calculating the extent of burns on children. This scale modifies the percentage of the area according to age that's reflecting the fact that the head and neck of the child make up greater percentages of the body surface area than that of an adult.
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One third of burn injuries are
On children
200
Causes of burns include (6)
1.fire/flame injury2. Scalding3. Contact Burns4. Electrical5. Chemical6. Others
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Most burns occur where (four)
1. In the home2. Occupationally3. Street/highway4. Other mechanisms
202
Advance treatments of burn injuries include (three)
1.early excision and skin grafting2. Antibiotic treatment3. Use of cultured epithelium
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Factors that increase the risk of death with burns (three)
1. Increasing burn size2. Age of patient3. Presence of an inhalation injury
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What are the two body systems affected by burns?
Cardiac and pulmonary
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Immediately following a burn injury during the emergency phase of treatment what two complications are the most common cause of death
Pulmonary and/or cardiac complications
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Most common pulmonary complications after burn (3)
1.carbon monoxide poisoning2. Upper airway obstruction3. Restrictive defects
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Carbon monoxide poisoning
Carbon monoxide binds hemoglobin more than oxygen thus displacing oxygen and leading to asphyxia
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Upper airway obstruction's are caused by
Irritants released from gases cause respiratory mucosa edema
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Restrictive defects can lead to respiratory distress when the presence of
A tight, circumferential, restrictive eschar on the chest, neck or abdomen causes difficulty with inspiration and expiration
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Signs and symptoms that may indicate the potential for respiratory complications include (eight)
1. Facial burns2. Singed nasal hair and or black oral mucosa3. Horse voice4. Cough5. Drooling6. Stridor 7. Tachypnea 8. Hypoxia
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Treatment for pulmonary complications
Administering of humidified 100% oxygen to maintain adequate oxygenation
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Escharotomies
Incision through the eschar down to viable tissue to release the restriction and allow for expansion of the chest wall during inspiration and expiration
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Burn shock
Cardiac complications due to the fluid or plasma portion of the circulating blood volume permeating into the interstitial Space producing burn wound edema. Lasts for the first 24 hours
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Hypovolemia due to the burn shock is untreated
Organ failure (most commonly renal), and tissue hypoxia occur
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Fluid resuscitation
Administration of intravenous fluid
216
Large burn injuries triggers
A prolonged stress response in the body and initiates a hyper metabolic state
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Hyper metabolic state will require
Nutritional support to meet the resulting increase and basal energy expenditure
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Eschar is the common denominator for
Burn sepsis
219
In the acute phase of treatment the most common cause of death is
Sepsis
220
Debridement
Cleansing and removal of non-adherent and nonviable tissue; this is a painful procedure and it is important to make sure the patient has been premedicated with analgesics and sedative medications prior to starting dressing changes
221
Daily cleansing and debridement of a burn wound is necessary to (3)
Decrease the potential for Burn wound sepsisFacilitate healingPrepare the wound for grafting if needed
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Commonly used analgesics include (three)
Morphine, fentanyl, or codeine
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A common drug given to sedate the patient is
Ketamine
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Anxiolytics are used to control
Anxiety
225
Anxiety influences what?
Pain perception
226
Hydrotherapy
Tub bath used for burn blown cleansing as the Jets help loosen nonviable tissue and facilitate range of motion exercises
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Dressing bandages act as
A barrier to the environment decreased temperature lost through the wound and promote comfort
228
Topical antimicrobial agents such as silvadine are
Delay and minimize burn wound colonization
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Full thickness injuries are at risk for
Bacterial entrance and fluid/heat loss through the wound continues until the wound is closed either temporarily or permanently through the application of synthetic dressings or biologic coverage
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Grafting areas usually are
On the chest to allow for insertion of a central lineHands because of their functional importanceFace and ears
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If the patient does not have available donor sites then
The wound will be excised down to viable tissue and temporarily closed through the application of synthetic dressings or allograft
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Allograft
Referred to as homograft or cadaver skin; donor skin taken from another person rejection will usually occur within 10 to 14 days after application
233
Synthetic and biological dressings are only temporary because
It allows for the time needed to achieve a permanent method for closing the wound
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The only way to achieve Permanent wound closure in large full thickness burn injuries is
through surgical intervention and the application of either an autographed or cultured epithelium
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Donor site takes about how many days to heal?
7 to 10
236
Cultured epithelium
Used when a patient has limited donor sites available; a biopsy of unburned skin is taken and sent to a laboratory that can grow cultured epithelium; it takes 3 to 4 weeks to be available for grafting;they are sensitive to infection
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To prevent loss of graft
The grafted area is immobilized in a functional position and remains in the position until the first dressing change
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If graphs are placed on the chest or back the bandages are suture to the body to decrease
The risk of shearing when repositioning the patient
239
Range of motion to the graft area is avoided until
The graft is stable which is usually about 4 to 5 days after surgery
240
During the emergency phase rehabilitation focuses on(2)
1.range of motion exercises to help reduce edema and maintain joint mobility2. Splints are constructed to prevent the formation of contractor deformities and should be worn when the patient is asleep or resting
241
In the acute phase of treatment rehabilitation focuses on
1. Re-conditioning exercises2. Range of motion exercises3. Splinting
242
Once the patient's condition is stable then occupational therapy will focus on(2)
Ambulation and activities of daily living
243
The focus of rehab for patients with graphs that have healed include (5)
1. Reconditioning2. ROM3. Scar revision 4. Contractor release5. Reconstruction
244
Destruction of sebaceous glands and partial and full thickness injuries cause
Dry skin and itching
245
How to care for burn scars(4)
1.Use unscented soap2.Apply moisturizing lotion several times a day to reduce itching3.Take antihistamine to control itching and promote comfort4.Apply sunscreen to the burn scar
246
Hypertrophic scar
Scars in Wichita's shoes are enlarged above the surrounding skin and typically present as red, raised, and rigid
247
As hypertrophic scars mature and they will(3)
Fade in color, flat in, and become more pliable
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Collagen
Basic structural fibrous protein found in all tissue
249
Methods that may help control hypertrophic scar formation include(5)
Compression garmentsscar massagetopical siliconesteroid injectionsurgery
250
Burn scars can take up to how many years to mature
1 to 2
251
Wound healing involves three processes
One. EpithelializationTwo. Connective tissue depositionThree. Contraction
252
Burn scar contracture(3)
Shortening and tightening of the burn scar most problematic over large joints severely limit ROM interfere with the ability to perform ADLs
253
Prevent burn scar contracture's through
ExercisePositioningSplinting
254
Positioning of comfort often results in
Contracture formation
255
ROM exercises help reduce the risk of
Contracture formation
256
Individualized exercise plan should be developed that meet
The needs of the patient
257
It is important to involve both the patient and his or her family members and the development and execution of their exercise plan because it will
Increase the likelihood that it will be followed
258
The use of splints at night will aid in maintaining
The stretch achieved during the day through ROM Exercises
259
Burn injuries that have the greatest potential to impact occupational performance include(5)
1. Deep partial thickness or full thickness burns2. Burns involving major joints3. Larger burn injuries4. Hypertrophic scar formation5 contracture deformities
260
Burn support groups can be helpful in assisting patients and families in dealing with
Lifelong disfigurement and dysfunction that may result from a major burn injury
261
Families benefit from meeting with another burn survivor because
It will help them prepare for the challenges ahead and assist them to deal with their emotions
262
Summer camp for burn children can also help to
Improve self-esteem and allow them to realize that they can overcome the difficulties they face
