Flashcards in Wound Care Deck (50)
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1
What are the three types of healing?
Primary intention
Secondary intention
Tertiary intention
2
What is part of primary intention healing?
Tissue surfaces approximated
Minimal or no tissue loss
Minimal granulation tissue and scar
Surgical incision
3
What is part of secondary intention healing?
Edges cannot or should not be approximated
Repair time longer
More scarring and risk of infection
4
What is part of tertiary intention healing?
Left open for 3-5 days and then closed
Allows edema to resolve exudate to drain
Closed with sutures, staples, or adhesive skin closures
"Delayed primary intention"
5
What are the phases of wound healing?
Hemostasis phase
Inflammatory phase
Proliferative phase
Maturation phase (remodeling)
6
What are some complications of wound healing?
Hemorrhage
Infection
Dehiscence
Evisceration
7
What are some modifiable factors for wound healing?
Nutrition
Lifestyle
Medications
8
What happens in the hemostasis phase?
Cessation of bleeding
Vasoconstriction and formation of clot
- Scab inhibits infection
- Epithelial cells migrate into wound- prevent entry of microorganisms
9
What happens in the inflammatory phase?
Blood supply increases
- Erythema and edema
- Exudate cleanses wound
- Neutrophils first 24 hours
- Replaced by macrophages
- Phagocytosis
- Crucial to healing
10
What happens in the proliferative phase?
Day 3-4 to 21 days
- Fibroblasts synthesize collagen: adds strength to wound
- Capillaries grow across wound, bring fibrin
- Granulation tissue forms
- Light red or pink
11
What happens in the maturation phase?
From day 21 up to 1-2 years
- Fibroblasts continue to synthesize collagen
- Wound site is remodeled and contracted
- Scar becomes stronger
-
12
What happens with a hemorrhage complication?
May bleed uncontrollably: emergency
Apply pressure
Surgery may be needed
Hematoma under wound may obstruct blood flow to area
13
What happens with an infection complication?
- Microbes compete for oxygen and nutrition: impairs wound healing
- Change in wound color, pain, drainage
- May occur during injury, surgery, or post-op
- Confirmed by culture
- May have fever, elevated WBC
- Immunosuppressed increased risk
14
What happens with a dehiscence complication?
- Partial or total rupture of sutured wound
- Cover with sterile saline gauze
- Patient to bed with knees bent
- Notify doctor
15
What happens with an evisceration complication?
- Protrusion of internal viscera through an incision
- Cover with large sterile dressing
- Patient in bed with knees bent
- Notify surgeon immediately
16
What are some risk factors for evisceration?
Obesity
Poor nutrition
Trauma
Failure to suture
Coughing
Vomiting
Straining
17
When does evisceration usually occur?
4-5 days post-op
18
Prevention: Nutrition
Protein
CHO's
Lipids
Vitamins A and C
Iron
Zinc
Copper
19
Prevention: Lifestyle
Regular exercise leads to better circulation
Smokers at risk for delayed healing
20
Prevention: Medications
Anti-inflammatory
Anti-neoplastic
Prolonged antibiotics
21
What is serous exudate?
Clear, thin, watery plasma.
Normal during inflammatory: in small amounts Moderate to heavy amount may indicate a high bioburden.
22
What is sanguineous exudate?
Fresh bleeding
In deep partial-thickness and full-thickness wounds.
Small amount may be normal during the inflammatory stage
23
What is Serosanguineous exudate
Thin, watery, and pale red to pink in color
The pink tinge indicates damage to the capillaries with dressing changes
24
What is a clinical manifestation of wounds?
Exudate
25
What is purulent exudate?
Thick and opaque
Tan, yellow, green, or brown in color
Never normal in a wound bed.
26
What are the different types of exudate?
Serous
Serosanguineous
Sanguineous
Purulent
27
Why are elderly patients at risk for impaired wound healing?
Impaired liver function
Nutritional deficiencies
Chronic illness
Vascular changes
Delayed inflammatory response
Slowed collagen synthesis
28
What is a diagnostic test for wounds?
Wound culture and sensitivity
29
When would there be a need for an emergency surgery for wounds?
Life threatening
Repair tissue or vessels
30
