Venous Insufficiency and Surgical Wounds - Class 4

Question 1

venous insufficiency ulcers are caused by

Answer 1

unrelieved venous hypertension in LEs

–> d/t incompetent perforator valves

Question 2

venous insufficiency ulcers are usually located

Answer 2

medial ankle

gait area

Question 3

venous insuff LE presents w/

Answer 3

firm edema

dilated superficial veins

possible dermatitis

hyperpigmentation

Question 4

venous insufficiency ulcers are

Answer 4

highly draining

Question 5

venous ulcers present as

Answer 5

superficial wound

irregular margins

ruddy granular

Question 6

venous ulcers –> exudates

Answer 6

usually w/ heavy exudates

Question 7

venous ulcers –> pain

Answer 7

no pain

Question 8

tests for venous vasculature

Answer 8

venous doppler

Trendelenburg test

percussion test

cuff test

Question 9

venous insufficiency intervention

Answer 9

reduce venous hypertension

compression therapy

leg elevation

re-establishing calf-muscle pump

exercise activity

local wound care to absorb heavy exudates

Question 10

venous insufficiency interventions –> compression therapy

Answer 10

obtain ABI

–> if <0.8 –> no compression tx

Question 11

acute surgical wound

Answer 11

incision

heal w/in a specific time frame

Question 12

types of surgical wound closure

Answer 12

primary (acute surgical wound)

secondary (left open)

tertiary (delayed primary) (cut them, let infection resolve, let soft tissue edema resolve then close them)

Question 13

assessment of acute surgical wound

Answer 13

suture/wound

surrounding skin tissue

as it related to the 3 phases of healing

Question 14

how do we asses an acute wound

Answer 14

measurement of incision

wound tissues

wound closure

exudate

palpation of suture line

palpation and color of surrounding tissue

Question 15

exudate –> assessment

Answer 15

amount and type

Question 16

palpation of suture line –> assessment

Answer 16

presence of healing ridge

raised tissue firmness from collagen deposition

Question 17

inflammatory phase of incisional wound

Answer 17

first 3-4 days

Question 18

inflammatory phase will be accompanied by

Answer 18

normal signs of inflammation

warmth, redness, edema, pain

Question 19

what does absence of inflammation point to –> inflammatory phase

Answer 19

trouble

Question 20

inflammatory phase –> wound edges

Answer 20

approximation of wound edges

-epithelialization
-no tenson on sutures

Question 21

type of draining –> inflammatory phase

Answer 21

sanguineous to serosanguinous

Question 22

incisional wound in the proliferative phase

Answer 22

presence of healing ridge

draining

asses for swelling and induration

asses skin color for erythema ecchymosis

Question 23

presence of healing ridge –> proliferative phase

Answer 23

firmness along incision extending 1 cm on either side from deposition of new collagen

Question 24

when does the presence of a healing ridge appear

Answer 24

post op day 5-9

Question 25

proliferative phase --> drainage

Answer 25

should be serosanguinous --> serous --> nil asses for nearly draining incision once closed

Question 26

how long does the remodeling phase occur

Answer 26

1-2 years

Question 27

incision color --> remodeling phase

Answer 27

changes from red/pink silvery --> gray to white

Question 28

remodeling phase --> healing ridge

Answer 28

gradually softens

Question 29

remodeling phase --> wound strength

Answer 29

80% of pre wounded stage

Question 30

what should we asses for in the remodeling phase

Answer 30

signs of abnormal scarring keloid or hypertrophic

Question 31

keloid scarring

Answer 31

raised goes beyond borders of initial wound

Question 32

hypertrophic scarring

Answer 32

raised stays w/in wound borders

Question 33

wound management for acute surgical wound

Answer 33

primary dressing secondary dressing

Question 34

primary dressing

Answer 34

absorbent of wound exudate protects incision from further trauma non-adherent to wound maintains sterile wound environment limits frequent dressing changes

Question 35

secondary dressing

Answer 35

absorbs excess drainage wicked away by primary dressing secures primary dressing in place