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Flashcards in wound management Deck (23)
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1

abrasion

wound caused by friction ex, scrape, blister

2

hematoma

a large blood clot under the skin caused by trauma, swelling is present

3

contusion

damage to the tissue without laceration to the skin ex. bruise, bowed tendon

4

puncture wound

wound caused by a foreign object (ex. nail), generally little to no bleeding which may cause infection, small hole on the skin surface

5

incision

cleaner than laceration, generally caused by a sharp object, edges of wound will come back together easily

6

laceration

complicated injury with turns and torn edges of the skin

7

complicated wound

difficult to heal, torn edges, necrotic tissue, infection may be involved. will take a long time to heal

8

3 phases of healing

1. inflammation 2. granulation 3. contraction and epitheliazation

9

inflammation

clot provides scaffolding for new matrix and migration of cells, phagocytic cells will debride wound

10

granulation

cannot proceed until blood clots, necrotic tissue, debris, and infection have been eliminated. angiogenesis for blood supply, granulation tissue made of loose ECM develops 3-6 days after injury and continues until epitheliazation occurs. begins closing wound and protects against additional bacteria

11

construction and epithelialization

very slow, but starts within hours of wounding. cells migrate centripetally. healing epithelium is fragile and poorly adherent to underlying tissues. the wound contracts and a scar is formed

12

purpose of granulation tissue

1. provides surface for epitheliazation (attachment of skin cells)
2. resistant to infection
3.necessary for wound contraction

13

factors that delay healing

location, infection, movement, wound dimensions, involvement of deep structures, poor blood and/or oxygen supply, foreign bodies, nutritional factor, previous treatment, age of wound, economic factor

14

how does location delay wound healing

wounds on limbs heal slower and are more problematic than other parts of the body due to decreased vascular supply, bone prominences, no supporting deep musculature, highly mobile joints, higher degree of contamination. wounds closer to the heart heal faster.

15

initial wound cleaning

wash wound with saline or water, cover the wound with hydrogel (water soluble gel) before clipping (remember hair becomes a foreign body and impedes healing). clean wound with 0.5% chlorohexidine. flaps of skin should be lifted and flushed underneath. do not wipe wound after it has been flushed. always clean wounds from the inside to outside

16

wound assessment

use sterile gloves to prevent contamination, may need to use anesthesia for safety

17

wound debridement

convert an accidental wound into a surgical wound by cutting along the edges. a scalpel should be used instead of scissors

18

provisions of a moist environment

use water soluble gels instead of petroleum

19

types of wound closure

primary closure, delayed primary closure, second intension. TETANUS VACCINE OR ANTISERUM SHOULD BE GIVEN

20

primary closure

wounds should not be completely closed unless the deeper tissues are sterile. suture dehiscence is a result of infection, skin loss, tension in suture line or marked swelling

21

when to use antibiotics

infection will delay healing, use for known or suspected infections and as prophylaxis, important to choose effacious drug, convenient route and dose with minimal side effects, it is important to give the full course to prevent bacterial resistance

22

parenteral antibiotic

used only initially unless the wound becomes complicated

23

wound lavage or flushing

removes dead tissue, bacteria, foreign matter without compromising the physiological status of the new forming tissues. the two main factors are the type of fluid and pressure