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Flashcards in Integumentary Deck (62):
1

5 key functions of the integ system

Protection
sensation
thermoregulation
excretion of sweat
vitamin D synthsis

2

Wound Healing: Inflammatory stage

1-10days
platelet activation, clotting cascade, kill bacteria,
Establishes a clean wound bed which triggers tissue regeneration

3

Wound Healing; Proliferative phase

3-21 days
formation of new tissue, capillary buds and granulation tissue fill bed, skin integrity is restored

4

Wound Healing: maturation/remodeling phase phase

7 days to 2 years
granulation tissue and epithelial differentiation appear in wound bed, fiber reorganization, thin/shrinking of scar, new tissue =15% of strength, mature tissue can increase up to 80%

5

primary intention

occurs with acute wounds and min tissue loss, use sutures/staples/adhesives to close wound, min scarring, typically superficial of partial thinkness wounds

6

Secondary intention

healing without superficial closure due to infection, necrosis, irregular edges, etc. Assoc with DM, ischemic conditions, pressure ulcers. Require ongoing wound care/ large scars.

7

Tertiary intention

delayed primary intention due to possible complications of dehiscence/sepsis. Closed by primary intention once risk factors are mitigated.

8

Arterial Insufficiency Ulcers

Smooth edges, lack granulation tissue, deep, severe pain, diminished pulses, decreased skin temp, thin shiny skin, leg elev inc pain

9

Venous insufficiency ulcers

irregular shape, shallow, mild/mod pain, normal pulses, inc edema, flaky dry skin, brownish color, elev leg decreases pain

10

Neuropathic ulcers

well defined circle or oval, good granulation tissue, no pain, decreased skin temp, dry inelastic, shiny skin, loss of protective sense.

11

Wound classification: Superficial

trauma to skin, epidermis intact (non-blistering sunburn)

12

Wound classification: partial thickness

extends through epidermis, into dermis but not all the way through. (abrasions, blisters, skin tears)

13

Wound classification: full thickness

through dermis into deeper structures such as subQ fat. (deeper than 4mm)

14

wound classification: subcutaneous wound

through integ tissue into subq fat, muscle, tendon, bone. require secondary intentions typically

15

Pressure ulcer staging: Stage I

intact skin, non-blanchable rednes, local coloration differs from surrounding area, usually on bony prominence

16

Pressure ulcers: Stage II

partial thickness, shallow open ulcer with red/pink wound bed,

17

Pressure ulcer: Stage III

full thickness tissue loss, subQ fat may be visable but not bone or muscle tissue, can have tunneling /undermining

18

Pressure ulcer: Stage IV

Full thickness tissue loss with exposed bone, tendon or muscle, osteomyelitis is possible

19

Pressure ulcer: Suspected deep tissue injury

purple of maroon areas of intact skin or blood filled blister

20

Pressure Ulcer: unstageable

full thickness tissue loss, base is covered by slough and/or eschar. cant stage until enough shit is removed

21

Serous

clear light color, thin, watery. normal in healthy healing wound

22

Sanguineous

red color, thin, watery. red due to blood. indicative of new blood vessel growth or disruption of blood vesels

23

sersnguineous

light red/pink, thin, watery. normal in healthy healing wound. observe during inflamm and proliferative stages.

24

seropulent

cloudy or opaque, yellow or tan, thin watery. may be early warning of infection. Abnormal

25

Purulent

yellow or green, thick viscous. abnormal. indicator of infection

26

Eschar

hard leathery, black/brown, dehydrated tissue, firmly adhered to wound

27

Gangrene

death or decay of tissue from loss of blood flow. can also be charaterzed based on type of bacteria

28

hyperkeratosis (callus)

white grey. firm or soggy based on moisture level

29

slough

moist, stringy, or mucinous. white/yellow tissue loosly attached in clumps to the wound bed.

30

Wound healing: red-yellow-black system: Red

pink granulation tissue> protect wound, maintain moist environ

31

Wound healing: red-yellow-black system: Yellow

moist yellow slough: > remove exudate and debris; absorb drainage

32

Wound healing: red-yellow-black system: Black

black, thick eschar firmly adheared > debride necrotic tissue

33

dessicated

drying out or dehydration of the wound.

34

desquamation

peeling or shredding of outer layers of epidermis. usualle occurs in small scales

35

ecchymosis

discoloration below intact skin from trauma or blood seepage. typically blue/ black changing to green/yellow. Bruise

36

Epidermis

avascular, flat squamous cells, round basal cells, and melanocytes

37

Dermis

vascular, contains hair follicles, sebaceous glands, sweat glands, lymph and BV, nerve endings

38

Erythema

diffuse redness from capillary dilation, congestion/ inflamm

39

friable

tissue that redily tears/ bleeds when gently palpated

40

Hematoma

localized swelling/ mass of clotted blood

41

hypergrnaulation

increased thickness of the granular layer of the epidermis that exceeds the surface height of skin

42

hyperpigmentation

darker than the surrounding areas

43

hypertrophic scaring

abnormal scar form excessive collogen formation. raised, red, firm, disorganized collogen formation

44

Keloid

red, raised, thick, excessive scar outside boundary of original wound

45

maceration

skin softening and degeneration, from prolonged exposure to water or other fluids

46

Turgor

relative speed that skin regains its normal appearance after being lightly pinched. indicator of elasticity and hydration

47

compression garments and scars

recommended for burns needing more than 14 days to heal. sustained compression. 15-35 mmHg. 22-23 hours/day.

48

Silver sulfadiazine

Advantage: used w/o dressings, painless, pplied to wound directly, broad spectrum, effective against yeast
Disadvantage:does not penetrate eschar

49

Silver Nitrate

Adv: broad spectrum, non-allergenic, painless dressing
Dis: poor penetration, Discolors (making assessment difficult), can casue electrolyte imbalance, painful removal

50

Povidone-iodine

Adv: broad spectrum, anti-fungal, easily removed with water
Dis: not effective against pseudomonas, may impair thyroid function, painful application

51

Mafenide Acetate

Adv: broad spectrum, penetrates burn eschar, may be used with/ without occlusive dressings
Dis: metabolic acidosis, compromise resp function, inhibit epithialization, painful application

52

Gentamicin

Adv; broad spectrum, may be covered of left open to air
Dis: has caused resistant strains, ototoxic, nephrotoxic

53

Nitrofurazone

Adv: bacteriocidal, broad spectrum
Dis: may lead to overgrowth of fungus and psudamonas, painful application.

54

Skin Graft: Allograft (homograft)

temporary graft taken from another human (cadaver)

55

Autograft

permanent skin graft from donor site from self

56

escharotomy

open/ remove eschar to reduce tension, relieve pressure, enhance circulation

57

Full thickness graft

contains dermis and epidermis

58

Heterograft

temporary graft from another species

59

Mesh graft

skin graft altered to cover larger area

60

sheet graft

skin graft directly transferred to prepared recipient site

61

split thickness graft

superficial layer of dermis and all of epidermis

62

Z-Plasty

surgical procedure to eliminate a scar contracture. Z incisions allows contracture to change configuration and lengthen scar.