Wounds

Question 1

Any break in the continuity of body tissue

Answer 1

Wound

Question 2

Examples:
grazes, burns, surgical incisions, stabs,
leg ulcers, decubitus ulcers (pressure
sores)

Answer 2

Wounds

Question 3

Stages of Wound Healing

Answer 3

1. Stage 1
2. Stage 2
3. Stage 3
4. Stage 4

Question 4

Traumatic inflammation ( 0-3 days)- redness, heat, swelling

Answer 4

Stage 1

Question 5

Destructive phase ( 2-5 days)- polymorphs and macrophages clear the wound of debris and stimulate new growth

Answer 5

Stage 2

Question 6

The proliferative phase( 3-24 days increased collagen formation

Answer 6

Stage 3

Question 7

Maturation phase ( 24 days-1 year)
scar tissue decreases granulating tissue gets
stronger and changes from reddish to pale

Answer 7

Stage 4

Question 8

Closure of Surgical Wounds

Answer 8

1. Primary Closure
2. Delayed Primary Closure
3. Secondary Intention

Question 9

first intention direct suture- if no tissue loss

Answer 9

Primary Closure

Question 10

Usually, when a drain is left in the situation.

Answer 10

Delayed Primary Closure

Question 11

Wound closes by a process of contraction and
epithelialisation e.g ulcers and pressure sores

Answer 11

Secondary Intention

Question 12

Factors Influencing Wound Healing

Answer 12

 Good blood supply: ( oxygen, nutrients)
 Good nutrition:
 Rest: skin cells multiply more rapidly
during sleep
 Lack of stress: increased levels of adrenaline
and steriods delay healing
 Lack of infection:
 Age : children heal more rapidly than older
people
 Site of wound: face and neck heal more
rapidly

Question 13

Factors Delaying Wound Healing: General Factors

Answer 13

General factors
 poor diet
 anaemia
 pulmonary disease
 cardiac insufficiency
 arteriosclerosis
 diabetes mellitus
 smoking
 Jaundice
 malignant disease
 high blood urea
 stress
 lack of sleep
 drug therapy e.g.
steroids and
cytotoxic
 radiotherapy

Question 14

Factors Delaying Wound Healing: Local to Patient/Wound

Answer 14

 skin edges not lined
up
 dead tissue in wound
 foreign bodies in
wound
 tension on wound
 infection
 irritant material for
suturing
 too tight suturing

Question 15

Complications of wounds

Answer 15

 Haemorrhage ( surgical wounds)
 Infection
 non union
 rupture ( dehiscence)
 pressure and strain ( coughing vomiting)
 over granulation of scar tissue
 contractures

Question 16

Caring for Wounds: Assess For

Answer 16

Assess for:
 type of wound
 location of wound
 size of wound
 shape of wound
 level of exudate
 condition of wound bed
 condition of surrounding skin

Question 17

Caring for Wounds: Recognizing Inflammation

Answer 17

 redness over area and surrounding
tissue
 swelling
 heat
 pain/ tenderness
 loss of function

Question 18

Types of Cleansing Fluids

Answer 18

1. Antiseptics
2. Saline Solutions
3. Tap Water

Question 19

Generally discouraged now- can be toxic to tissue healing.

Answer 19

Antiseptics

Question 20

True or False: cleansing fluids should be at body
temperature

Answer 20

True

Question 21

Methods of Cleansing

Answer 21

1. Swabbing
2. Bathing
3. Irrigation

Question 22

Methods of Cleansing: not particularly effective,
mainly redistributes organisms

Answer 22

Swabbing

Question 23

Methods of Cleansing: useful for chronic wounds
such as leg ulcers. Take care with equipment to avoid cross contamination.

Answer 23

Bathing

Question 24

Method of Cleaning: shower head, waterjug,
syringes - don’t be overzealous.

Answer 24

Irrigation

Question 25

Based on the principle that the wound or dressing interface should be moist rather than dry.

Answer 25

Modern Dressing Technology: Choice of Dressing

Question 26

Common characteristics of the wound dressings

Answer 26

 Capable of maintaining high humidity at wound site  free of particles and contaminants]  non toxic / non allergenic  capable of protecting the wound from further trauma  Impermeable to bacteria  thermally insulating  capable of allowing gaseous exchange]  able to withstand infrequent changes  cost effective  long lasting

Question 27

Patient Factors Influencing the choice of dressing:

Answer 27

 Age  Lifestyle  Medical History  Care environment  Ability to maintain /change own dressing  Competence and willingness of potential carers

Question 28

Types of Dressings

Answer 28

 Low adherent dressings-Tullegras,Tegapore  Semi permeable films- Opsite, Tegaderm  Hydrocolloids - Comfeel plus, Granuflex  Hydrogels- Intrasite, Sterigel  Alginates- Sorbisan, Kaltostat  Foam dressings- Cavicare, Lyofoam extra  Antimicrobial dressings- Actisorb plus, Inadine

Question 29

Minimising Cross Infection

Answer 29

 Dressing and cleansing wounds is at the very minimum a Clean Procedure and is often an Aseptic Procedures  Thorough hand-washing and use of gloves are the most effective methods of preventing contamination of the wound  If wounds are infected then care must be taken to prevent cross contamination