Skin Integrity & Wound Care

Question 1

wound

Answer 1

a wound is a break or disruption in the normal integrity of the skin and tissues

Question 2

wound types (can be labeled by underlying issue)

Answer 2

-closed (skin closed, deep wound)/open
-clean/dirty
-pressure injury
-venous ulcers
-arterial ulcers
-diabetic ulcers
-incision
-contusion (bruise)
-abrasion
-puncture (goes into skin, iv)
-laceration (not clean (like incision) cut)

Question 3

wound classifications

Answer 3

-partial thickness (dermis/epidermis)
-full thickness (down to subq, musculature, bones, tendons)
-acute or chronic (how long to take to heal)
-intentional (surgical) or unintentional (trauma, accidents)
-specialty classifications such as PI staging

Question 4

principles of wound healing review from hygiene chapter

Answer 4

-intact skin is the first line of defense
-normal healing requires:
-circulation
-clean environment (moist & clean)
-nutrition
-hydration
-ability to heal depends on the extent of the wound & person’s general health

Question 5

types of wound healing

Answer 5

-primary intention
-secondary intention
-tertiary intention

Question 6

primary intention

Answer 6

wound edges well approximated; leave alone and will heal

Question 6

secondary intention

Answer 6

-edges cannot be approximated
-extensive tissue loss (burns, leave open until heals, let heal from bottom up)
-repair time longer
-scarring is greater
-susceptibility to infection is greater

Question 7

tertiary intention

Answer 7

-combo of primary/secondary
-wounds that are left open for 3-5 days then closed with sutures

Question 8

look at slide 7 for wound healing stages

Question 9

phases of wound healing

Answer 9

-hemostasis (clotting; happens right away)
-inflammatory phase (white cells; macrophages; cleans out wounds; will have red/swelling)
-proliferation phase (cells are growing; renewal)
-maturation or remodeling phase (wound is stabilized; more scar tissue)