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PTH 703 - Unit 2 (Amputations and Protheses) > Skin Care > Flashcards

Flashcards in Skin Care Deck (42)
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1

What are the 5 different stages of recovery?

Pre-op
Aucte post-op
Pre-prosthetic
Prosthetic training
Long-term management

2

How will you get a safety fail?

Because you did not check the skin. That is how you lose limbs, per Towle.

3

What are 4 areas of management?

Medical Co-Morbidity Management
Residual Limb Management
ADL/Functional Activities
Patient Education***

4

What are the three parts of Pre-Op stage?

C/L limb inspection
Medical co-morbidities
Education*** (in practically every stage)
(see PPT for other 4 stages in detail)

5

Is the C/L limb a risk factor in the traumatic or non-tarumatic amputee?

BOTH! C/L limb is always a risk factor
-Previous amputation is a risk factor for another amputation

6

What patients need to know about general skin care?

ALL PATIENTS.

7

When do you begin skin care?

Early! In pre-op stage

8

Is group skin care education effective?

Yes, and written materials are essential

9

What are the 6 important concepts of skin care?

1. Inspect skin and shoes daily
2. Use supportive but non-restrictive socks
3. Do NOT use strong chemicals or products
4. NEVER walk barefoot
5. Avoid extreme temperature exposure
6. Proper nail care

10

How to limb inspection?

Inspect the entire limb! (and C/L limb too)
Feel temp

11

How should you check temperature?

Proximal to distal!

12

How should you wash the skin?

Daily, luke warm water, best at NIGHT
Mild soap, avoid brisk rubbing, do NOT soak
Use lotions as needed

13

Do you even need to manage or inspect the "good" limb?

Yes, have you been paying attention? And don't call it that.

14

What are shoe recommendations?

Leather
Ties or Velcro
Thick sole
Spacious
Aim for protection
Always look inside shoe prior to donning!
**Purchase LATE in the day**
Break-in gradually
Square toe box

15

What are some sock recommendations?

Cotton vs wool for warm vs cool air temps (CW/WC)
Stretchable
Wide, roomy at toes
Loose at top

16

How often should girth measurements be taken?

Towle: 2 cm
McAuley: 2.5-5cm
British Lab Lady: 8-10cm for Transfemoral, per O'S
and 5-8cm for Transtibial, per O'S text

17

Should girth measurements be taken bilaterally?

Yes, document use and time of day. Also note shape

18

How to measure length?

Measure to end of tissue AND to end of bone

19

Alternatives to traditional wound measurements?

Tracing
Narrative description
Photography

20

What are 3 post-op dressing options?

1. Soft dressing: Bulky gauze dressing with ace wrap or shrinker overlay, w or w/o knee immobilizer
2. Semi-rigid dressing: Unna boot
3. Rigid/rigid-removable dressing: typically with soft dressings and compression (IPOP and APOP)

21

What is the goal of RL shaping?

Improved prosthetic fit and longevity
-working to prevent deformities (dog/adductor)
Vol reduction starts with p/o dressings

22

When do you move to goals of more aggressive volume reduction and limb shaping?

AS THE INCISION HEALS

23

Five guidelines for RL shrinking devices?

reapply frequently throughout the day, if removable
Avoid wrinkles
Wearing schedules for progressive tolerance
Can typically use thin dressings over the incision
Patient/caregiver education is Essential

24

Most common shrinkers?

ACE Wraps and Elastic

25

What is goal wear-time for shrinkers

24 hours a day. Especially check for skin integrity with IPOP

26

Which dressing is typically most preferred?

Soft over Rigid and IPOP

27

When is a soft dressing indicated?

For compormised incisions and local infection
-Oldest type
-Bulky dressing (dependent by physisican) are covered by ACE wrap and loose shrinker

28

Goal of RL wrapping? (seen in earlier lecture)

Reduce edema and shape for prosthetic fitting
Dependent on preference, staples, skin integrity, and pt sensation/strength

29

Which wrap is an elastic stockinette: easy to don/doff, inexpensive, and likely less compression than the skrinker (with shorter 2nd layer)?

Tubigrip

30

Which dressing is light weight, consist of material impregnated with stuff, better edema control than soft dressings, typically applied immediately in OR, and have to be removed to monitor skin?

SEMI-RIGID DRESSING (example, unna boot - no stretch)