FINAL EXAM - Integumentary System, Burns, Wounds Flashcards Preview

OCTH 1031 > FINAL EXAM - Integumentary System, Burns, Wounds > Flashcards

Flashcards in FINAL EXAM - Integumentary System, Burns, Wounds Deck (262)
1

Epidermis - Characteristics (10)

1. 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

The dermis contains (9)

1. hair follicles2. nerve endings3. lymph vessels4. blood vessels5. collagen6. elastin7. sweat8. sebaceous glands 9. fibroblasts

3

fibroblasts in the dermis produce

collagen

4

Fn's of the dermis (3)

1. provides nutrition2. provides protection3. source of blood flow

5

Phases of wound healing (5)

1. hemostasis2. inflammation3. epithelialization4. proliferation5. maturation

6

Hemostasis

platelets aggregate, clot formation

7

inflammation - what occurs and what are the clinical signs

phagocytosis, clinical signs are heat, pain, redness

8

epithelialization

migration of basal cells; need most environment

9

proliferation

granulation, contraction

10

maturation

remodeling, scar formation

11

Primary (First Intention)

wound borders approximate

12

Secondary

wound borders are not approximated

13

Delayed Primary (Third Intention)

Sutured after infection is controlled

14

Subcutaneous tissue - characteristics (3)

1. mostly fat and fascia2. blood vessels that support the dermis and epidermis3. provides cushioning and insulation

15

What must remain intact in order to get wound to granulate?

periosteum

16

Tendons are _____ _____ when healthy, but have poor ______

shiny whitevascularity

17

Acute wound

heals in the expected sequence and time frame

18

Chronic wound

fails to heal as expected, does not proceed through normal phases of healing

19

Chronic wound characteristics (4)

1. repeated trauma2. abnormal blood flow3. large bacterial load4. local tissue ischemia

20

Etiology of chronic wounds (3)

1. PVD2. DM3. physical immobility

21

Intrinsic factors of delayed wound healing (5)

1. age - geriatric2. chronic diseases3. edema4. poor perfusion - lack of blood flow5. immunosuppression

22

Extrinsic factors of delayed wound healing (6)

1. poor nutrition and hydration2. medications3. necrosis4. bioburden5. infection6. incontinence

23

Iatrogenic factors of delayed wound healing (4)

1. inappropriate wound management2. Desiccation (wound pops open)3. Inadequate offloading4. improper handling of dressings

24

Factors to consider with wound assessment (7)

1. wound classification2. new onset vs recurrence3. wound history - time present, prior treatment interventions4. anatomical location5. Wound appearance6. Appearance of periwound7. sensation

25

Wound appearance includes (6)

1. size2. shape3. tunneling or undermining4. wound bed5. exudate or drainage

26

Undermining

underneath the opening; NOT down into the wound

27

Factors looked at when assessing a wound bed (2)

1. color2. tissue - granulation or necrotic

28

Nectrotic wound tissue is either

Eschar or slough

29

Factors looked at when assessing exudate or drainage (5)

1. Amount2. odor3. serous = clear4. sanguineous = bloody5. purulent = thick yellow with green (bacteria)

30

Appearance of periwound factors that are assessed (3)

1. Temperature - Warm=infection; Cold = lack of blood flow2. edema3. rolled edges

31

Sensation factors that are assessed (3)

1. Pain2. temperature3. proprioception

32

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

33

What amount of time can a pressure ulcer occur?

Can occur in 2 hours

34

Common locations for Pressure ulcers (8)

1. occiput2. scapula3. sacrum4. coccyx5. ischial tuberosity6. greater trochanter7. malleolus8. heel

35

Risk factors for pressure ulcers (8)

1. cognitive decline2. impaired sensation3. advancing age4. contractures5. immobility/inactivity6. inadequate nutrition7. incontinence8. co-morbidities

36

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

38

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

39

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

40

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

41

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

42

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.

43

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

44

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)

45

Arterial wound risk factors (6)

1. smoking2. htn3. hyperlipidemia4. obesity5. inactivity6. DM

46

Arterial wound etiology (2)

1. acute - blunt trauma2. chronic - arteriosclerosis

47

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)

48

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

49

Venous wounds - Signs and Symptoms (4)

1. skin is dusky, ruddy color2. edema with pitting and possible weeping3. hemosiderin staining and lipodermaterosclerosis4. spider veins

50

Lipodermaterosclerosis appears

bumpy

51

hemosiderin staining

proteins leaks causing a brown stain like coloring in the skin

52

Venous wound risk factors (5)

1. Immobility2. pregnancy3. prolonged standing4. smoking5. excessive sodium intake

53

Etiology of venous wounds

Vascular dysfunction resulting in venous hypertension

54

Common locations for venous wounds (2)

1. pre-tibial area between knee and ankle2. medial malleolus

55

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

56

neuropathic (diabetic) ulcers - signs and symptoms (3)

1. prolonged inflammation2. impaired vascularization3. impaired immune system

57

neuropathic ulcer risk factors (7)

1. chronic hyperglycemia2. high cholesterol3. elevated blood sugar levels4. smoking5. obesity6. sedentary lifestyle7. family history

58

Etiology of neuropathic ulcers

lack of protective sensation leads to injury that may go unnoticed; don't realize they step on something

59

Neuropathic ulcer common location (3)

1. plantar aspect of metatarsal heads2. toes- tips and between toes3. lateral aspect of foot

60

Neuropathic ulcers are commonly located on the feet because

the patient continually ambulates on bony prominence

61

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

62

What is a burn and how is it classified?

thermal injury that destroys layers of the skin; classified by size, depth and mechanism

63

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%)

64

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

65

Characteristics of Superficial or First degree (3)

1. Classic sunburn2. red, dry, painful3. Heals within 3-4 days without scarring

66

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

67

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

68

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

69

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

70

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

71

electrical arc burn does not require _____ _____

direct contact

72

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)

73

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

74

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

75

Rehabilitation phase - focus (MM of Burns)

1. nutrition2. hydration3. stability4. return to function5. psychological component

76

Complications of burns (8)

1. contractures/deformities2. hypertrophic scarring3. heterotopic ossification4. pain5. heat intolerance6. sun exposure7. pruritus8. psychosocial adjustment

77

pruritus

itching

78

cutaneous

pertaining to the skin

79

lesion

wound, injury, or pathological change in body tissue

80

systemic

pertaining to a system or the whole body rather than a localized area

81

therapeutic

pertaining to treating, remediating, or curing a disorder or disease

82

What accessory organs of the skin are located in the dermis? (3)

1. nails2. sweat glands3. sebaceous glands

83

CF for fat (3)

adip/olip/osteat/o

84

adipocele

hernia containing fat or fatty tissue

85

lipocyte

fat cell

86

steatoma

fatty tumor

87

CF that mean skin (3)

cutane/odermat/oderm/o

88

hypodermic

pertaining to below the skin (dermis)

89

cyan/o

blue

90

cyanosis

physical sign causing bluish discoloration of the skin and mucous membranes

91

CF that mean red (3)

erythem/oerythemat/oerythr/o

92

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

93

erythematous

pertaining to erythema (redness of the skin)

94

erythrocyte

red blood cell

95

CF meaning sweat (2)

hidr/o**don't mistake for h2o=hydr/osudor/o

96

hidrosis

formation and excretion of sweat

97

sudoresis

profuse sweating

98

ichthy/o

dry, scaly

99

ichthyosis

congenital (meaning present at birth) dermatological (skin) disease that is represented by thick, scaly skin.

100

kerat/o

horny tissue; hard; cornea

101

keratosis

Any lesion on the epidermis marked by the presence of circumscribed overgrowths of the horny layer.

102

melan/o

black

103

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

104

myc/o

fungus

105

dermatomycosis

a superficial fungal infection of the skin or of its appendages

106

onych/o

nail

107

onychomalacia

softening of the nails

108

CFs meaning hair (2)

1. pil/o2. trich/o

109

pilonidal

pertaining to a nest of hair

110

trichopathy

disease of the hair

111

scler/o

hardening; sclera (white of the eye)

112

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.

113

seb/o

sebum, sebaceous

114

seborrhea

excessive discharge from the sebaceous glands, forming greasy scales or cheesy plugs on the body; it is generally attended with itching or burning.

115

squam/o

scale

116

squamous

scaly or platelike

117

therm/o

heat

118

xer/o

dry

119

xeroderma

dry skin

120

pyoderma

Any acute, inflammatory, purulent bacterial dermatitis.

121

diaphoresis

carrying, transmitting through or across

122

dermatoplasty

surgical repair of the skin

123

cryotherapy

cold "freezing" treatment

124

anhidrosis

abnormal condition of the absence of sweating

125

hyperhidrosis

abnormal excessive sweating

126

abrasion

scraping or rubbing away of a surface, such as skin, by friction

127

abscess

localized collection of pus at the site of an infection (characteristically a staphylococcal infection)

128

furuncle

abscess that originates in a hair follicle; also called BOIL

129

carbuncle

cluster of furuncles in the subcutaneous tissue

130

acne

inflammatory disease of sebaceous follicles of the skin, marked by comedos, papules, and pustules

131

comedos

discolored, dried sebum plugging an excretory duct of the skin; aka blackheads

132

pustules

small skin lesion filled with purulent material

133

alopecia

absence or loss of hair, especially of the head; also known as baldness

134

carcinoma

uncontrolled growth of abnormal cells in the body; also called malignant cells

135

cyst

closed sac or pouch in or under the skin with a definite wall that contains fluid, semifluid, or solid material

136

pilonidal

growth of hair in a dermoid cyst or in a sinus opening on the skin

137

eczema

redness of skin caused by swelling of the capillaries

138

gangrene

death of tissue, usually resulting from loss of blood supply

139

hemorrhage

external or internal loss of a large amount of blood in a short period

140

contusion

hemorrhage of any size under the skin in which the skin is not broken; aka bruise

141

ecchymosis

skin discoloration consisting of a large, irregularly formed hemorrhagic area with colors changing from blue-black to greenish brown or yellow, aka bruise

142

petechia

minute, pinpoint hemorrhagic spot of the skin that is a smaller version of an ecchymosis

143

hematoma

elevated, localized collection of blood trapped under the skin that usually results from trauma

144

hirsutism

excessive growth of hair in unusual places, especially in women: may be due to hypersecretion of testosterone

145

ichthyosis

genetic skin disorder in which the skin is dr and scaly, resembling fish skin

146

impetigo

bacterial skin infection characterized by isolated pustules that become crusted a rupture

147

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

148

psoriasis

chronic skin disease characterized by itchy red patches covered with silvery scales

149

scabies

contagious skin disease transmitted by the itch mite

150

skin lesions

areas of pathologically altered tissue caused by disease, injury, or a cound resulting from external factors or internal disease

151

tinea

fungal infection whose name commonly indicates the body part affected, such as tinea pedis (athlete's foot); AKA ringworm

152

ulcer

lesion of the skin or mucous membranes marked by inflammation, necrosis, and sloughing of damaged tissue

153

pressure ulcer

skin ulceration caused by prolonged pressure, usually in a patient who is bedridden; also known as decubitus ulcer or bedsore

154

urticaria

Allergic reaction of the skin characterized by eruption of pale red elevated patches that are intensely itchy; also called wheals (hives)

155

verruca

rounded epidermal growth caused by a virus; asl called wart

156

vesicle

small blister-like elevation on the skin containing a clear fluid; large vesicles are called bullae (singular bulla)

157

vitiligo

localized loss of skin pigmentation characterized by milk- white patches; also called leukoderma

158

wheal

smooth, slightly elevated skin that is white in the center with a pale red periphery; also call hives if itchy

159

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

160

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

161

cryosurgery

use of subfreezing temperature, commonly with liquid nitrogen, to destroy abnormal tissue cells, such as unwanted, cancerous, or infected tissue

162

debridement

removal of foreign material, damaged tissue, or cellular debris from a wound or burn to prevent infection and promote healing

163

fulguration

tissue destruction by means of high-frequency electrical current; also called electrodesiccation

164

incision and drainage (I&D)

incision of a lesion, such as an abscess, followed by the drainage of its contents

165

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

166

skin graft

surgical procedure to transplant healthy tissue by applying it to an injured site

167

allograft

transplantation of healthy tissue from one person to another person; also called homograft

168

autograft

transplantation of healthy tissue from one site to another site in the same individual

169

synthetic

transplantation of artificial skin produced from collagen fibers arranged in a lattice pattern

170

xenograft

transplantation (dermis only) from a foreign donor (usually a pig) and transferred to a human; also called heterograft

171

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

172

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

173

cutaneous laser

any of several laser treatments employed for cosmetic and plastic surgery

174

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

175

antibiotics

kill bacteria that cause skin infections

176

antifungals

kill fungi that infect the skin

177

antipruritics

reduce sever itching

178

corticosteroids

anti-inflammatory agents that treat skin inflammation

179

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

180

What are the two primary factors that influence the amount of tissue destruction that occurs following a burn injury?

1.temperature2. Duration of exposure

181

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

183

What is the zone of coagulation?

Area of ear reversible tissue destruction

184

What is the zone of stasis?

The area surrounding the zone of coagulation where damage results in decreased perfusion

185

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

187

Eschar

The residual necrotic layers of skin destroyed by direct heat damage or the injury occurring secondary to heat damage

188

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

190

Superficial burn healing time

Within 3 to 6 days and does not produce any residual scars

191

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

193

Full thickness injuries may be in a variety of colors such as (4)

Black, cherry red, tan or pearly white

194

Healing time for full thickness burns depend on

Availability of Donor sites

195

Full thickness burns are at severe risk for

Contracture formations

196

TBSA stands for

Total body surface area

197

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

198

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.

199

One third of burn injuries are

On children

200

Causes of burns include (6)

1.fire/flame injury2. Scalding3. Contact Burns4. Electrical5. Chemical6. Others

201

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

203

Factors that increase the risk of death with burns (three)

1. Increasing burn size2. Age of patient3. Presence of an inhalation injury

204

What are the two body systems affected by burns?

Cardiac and pulmonary

205

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

206

Most common pulmonary complications after burn (3)

1.carbon monoxide poisoning2. Upper airway obstruction3. Restrictive defects

207

Carbon monoxide poisoning

Carbon monoxide binds hemoglobin more than oxygen thus displacing oxygen and leading to asphyxia

208

Upper airway obstruction's are caused by

Irritants released from gases cause respiratory mucosa edema

209

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

210

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

211

Treatment for pulmonary complications

Administering of humidified 100% oxygen to maintain adequate oxygenation

212

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

213

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

214

Hypovolemia due to the burn shock is untreated

Organ failure (most commonly renal), and tissue hypoxia occur

215

Fluid resuscitation

Administration of intravenous fluid

216

Large burn injuries triggers

A prolonged stress response in the body and initiates a hyper metabolic state

217

Hyper metabolic state will require

Nutritional support to meet the resulting increase and basal energy expenditure

218

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

222

Commonly used analgesics include (three)

Morphine, fentanyl, or codeine

223

A common drug given to sedate the patient is

Ketamine

224

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

227

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

229

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

230

Grafting areas usually are

On the chest to allow for insertion of a central lineHands because of their functional importanceFace and ears

231

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

232

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

234

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

235

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

237

To prevent loss of graft

The grafted area is immobilized in a functional position and remains in the position until the first dressing change

238

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

248

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