Wound Care Flashcards
1
Q
What is a wound?
A
Any injury to the body (i.e. bruises, tendonitis, lacerations)
2
Q
What type of tissue comprises skin?
A
- Epidermis
- Dermis
- Subcutaneous tissue
3
Q
What is epidermis?
A
- Thin outer layer of skin
- Regenerates every 4 to 6 weeks
- Functions to maintain skin integrity
- Acts as a barrier
- Protects from UV light
- Provides sensation
- Controls temperature
- Vitamin D is produced (Vitamin D is important for absorption of Ca)
4
Q
What is dermis?
A
- Blood vessels (remove waste via capillaries)
- Hair follicles
- Lymphatic vessels (removes waste via lymphatic gates; lymphatic system is in dermis and not blood vessels)
- Sweat glands
- Nerves (sensation)
- Fibroblast (the repair squad), collagen, and elastic fibers
- Ground substance (assists in healing)
- Proteins (assists in healing)
- Provides support and strength
5
Q
What gives skin strength?
A
- Collagen
- Collagen bundles anchor to the subcutaneous tissue
- Collagen is normally organized and alighned in a smooth collagen matrix
- Collagen deteriorates as we age
6
Q
What happens following any injury?
A
- All tissues undergo a similar process of repair. Whether it be a sprain, strain, laceration, surgery, pressure sore, scratch, scrape, or contusion
- Injury to vascular tissue initiates a series of responses collectively known as inflammation (1st stage of wound healing) and repair
- The ultimate goal of these responses is to eliminate the pathological or physical insult, replace the damage tissue, promote regeneration, and restore function
7
Q
What are the three types of wound healing closures?
A
- Primary intention
- Secondary intention
- Tertiary intention
8
Q
What is primary intention?
A
- Wound closure
- Ex: sutures
- Sutures are the best type of healing for a wound. It heals the fastest, cleanest, and with the least amount of scarring
9
Q
What is secondary intention?
A
- The wound heals from the body out
- The wound is not closed surgically
- Ex: blisters, pressure sores, contusions
10
Q
What is tertiary intention?
A
- There is a delay in wound closure
- Needs to be irrigated, debrided, and pumped full of antibiotics before closing
- Wound is usually dangerous due to bacteria
- Ex: cat bites, human bites, burns
11
Q
What happens during primary intention healing?
A
- Edges of wound are approximated and held together with sutures, steri-strips, or surgical adhesive
- Wound bed is closed and covered with skin
12
Q
What happens during secondary intention healing?
A
- The wound is left open to fill from the bottom up and from the sides from outside in
13
Q
What happens during tertiary intention healing?
A
- There is a delayed primary closure
- The wound is left open to drain or be irrigated in order to prevent infection
- There is a combination of primary and secondary healing
- Types of injuries include dog, cat, or human bites, traumatic injuries or injuries that occur in dirty environments where debris might be present
14
Q
What is tensile strength?
A
- Load is applied per unit of cross-section area (kg/cm2)
- Measured in newtons of force
- It is how much force the tissue can take before breaking or rupturing
- It increases with collagen synthesis
- Fibrin contribute to its strength
15
Q
When is peak tensile strength achieved?
A
- By 60days post injury in a healthy individual and continues on to eight weeks
- The scar tissue has decreased vascularity
- Scar tissue strength returns to 70% to 80% of normal strength
16
Q
What is the timeline for tensile strength recovery?
A
- 4 weeks: 40% to 50%
- 6 weeks: 60%
- 8 weeks: 70-80%
- Tensile strength will never be 100% strength post injury
17
Q
What is the tensile strength recovery timeline for flexor tendon injuries?
A
- 4 weeks: 50% strength signals that it is safe to do active motion
- 6 weeks: 60% signals that person can usually come out of splint if injury is hand
- 8 weeks: 70% to 80% signals that person can start working on strengthening with resistance
