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Medical PCM I > Wounds > Flashcards

Flashcards in Wounds Deck (81):
1

Duration of inflammatory phase

Injury to day 4 post injury

2

Cardinal signs of inflammation (english)

Redness, swelling, warmth, pain

3

Cardinal signs of inflammation (Latin)

Rubor, Tumor, Calor, Dolore

4

Endothelial cells produce?

Blood vessels

5

Epithelial cells produce?

Skin

6

Fibroblasts produce?

Collagen

7

Duration of proliferative phase

Day 4 to day 21

8

Theory of hypergranulation tissue

Too much oxygen promotes hypergranulation (because synthesis is oxygen dependent). Epithelial cells can't climb the hump of tissue against gravity and epithelialization is stopped. Skin will start to grow under wound.

9

Duration of maturation phase

Day 21 to 2 years post injury

10

Characteristics of an immature scar

Red, raised, rigid

11

Characteristics of a mature scar

Pale, planar, and pliable

12

Epibole

Hypergranulation causes skin to start to migrate under wound and cause edges of wound to be rounded

13

When is angiogenesis complete?

At the end of the inflammatory stage

14

Formula for percent chnage

(Baseline area - current area)/Baseline area

15

Crater

Tissue defect extending at least to the subcutaneous layer

16

Dead space

Any open area produced as a result of undermining, tunneling, or sinus tracking

17

Dermis

Contains blood vessels, nerve endings, epidermal appendages; composed of collagen and elastin fibers; thickenss depends on site and function

18

Epidermis

Functions for protection, sensation, temperature control;

19

Fistula

Abnormal passage between two organs or between an organ and outside of the body

20

Sinus Tract

A soft cavity or channel without defined edges that involves an area larger than the visible surface of the wound

21

Subcutaneous tissue

Fatty tissue, not well vascularized

22

Black wound color

Presence of necrotic tissue
Usually dry
Least healthy of wound types
Needs debridement/cleaning

23

Yellow wound color

Presence of necrotic tissue, possible infection
Usually heavy exudate
Less healthy than Red wound
Needs debridement/cleaning

24

Red wound color

Clean
Mild to moderate exudate
Granulating
Healing; healthiest of wound types

25

Stage 1 pressure ulcer

Nonblanchable erythema of intact skin that persists for more than thirty minutes after the pressure has been removed
In individuals with darker skin, discoloration, warmth, edema, and induration (hardness)

26

Stage 2 pressure ulcer

Partial thickness skin loss involving epidermis, dermis, or both
Superficial and presents as an abrasion, blister, or shallow crater

27

Stage 3 pressure ulcer

Full thickness skin loss involving damage to or necrosis of subcutaneous tissue that may extend down to, but not through underlying fascia
Presents clinically as a deep crater with or without undermining of adjacent tissue
Typically over a bony prominence

28

Stage 4 pressure ulcer

Full thickness skin loss with extensive destruction, tissue necrosis, or damage to muscle, bone, or supporting structures
Undermining and sinus tracts

29

Eschar

Thick, leathery skin on top of wound that is dead tissue

30

What does CEAP stand for?

Clinical, etiology, anatomic, pathophysiological

31

Category I skin tear

Tears in which epidermal tissue can be approximated without loss of coverage

32

Category II skin tear

Tears show scant (25%) to moderate (75%) loss of epidermal tissue

33

Category III skin tear

Tears show complete loss of epidermal tissue

34

Contaminated wound

Containing non-replicating bacteria, other microorganisms, or foreign material

35

Colonized wound

Contain replicating microorgansims adherent to wound, but with no injury to host
Indications of infection (purulent exudate, foul odor, or inflammation) are absent

36

Infection

Containing replicating microorganisms within a would with damage to host

37

Equation for infection

Dose x virulence / Host resistance

38

Host resistance influenced by

Nutritional status
Disease status
Medication use

39

Primary cause of necrotizing facitis and how o treat it

Strept A
Treatment: Aggressive surgical debridement and amputation

40

How many colony forming units indicate infection?

10^5

41

Symptoms of fungal infections

Pruritis
Inflammation
Swelling
Skin eruptions
Scaling of skin

42

Who is at increased risk for fungal infections?

Compromised immune system
Antibiotic therapy
Diabetes

43

Examples of fungal infections

Candida (thrush and intertriago)
Ringworm
Athletes foot; jock itch
Aspergilli (mold)

44

Bacteriostatic

A substance that prevents or arrests the growth of microorganisms by preventing multiplication

45

Bactericidal

An agent that prevents or arrests the action of microorganisms either by inhibiting their activity or by destroying or killing them

46

Antiseptic

An agent used on living skin, either bactericidal or bacteriostatic

47

Risk Assessment Tools

Braden scale
Norton scale (specificity of 0.75)
Risk Assessment Pressure Sore (RAPS)

48

Categories of Norton Pressure Sore Risk

Physical condition
Mental condition
Activity
Mobility
Incontinence

49

Guidelines for Bed Pressure - High Risk

Dynamic flotation mattress
Low air loss bed system
Air-fluidized bed

50

Guidelines for Bed Pressure - Medium Risk

Static air-filled mattress overlay
Gel mattress overlay
T-foam mattress overlay

51

Guidelines for Bed Pressure - Low Risk

Mattress overlay 3"-4" foam
Gel mattress overlay
Water-filled mattress overlay

52

Guidelines for Bed Pressure - No Immediate Risk

Sheepskin pads - questionable effect
Heel protectors
Convoluted foam mattress tops

53

Autolysis

Disintegration of liquefaction of tissue or of cells by the body's own mechanisms, such as leukocytes and enzymes

54

Crusted

Covered over with dried secretions

55

Denude

Removal of epidermis

56

Stripping

Denuding by mechanical means

57

Eschar

Dry, black or brown leathery materials; result of destruction of cells/blood vessels and desiccation of devitalized tissue

58

Ischemia

Deficiency of blood supply to a tissue, often leading to tissue necrosis

59

Macerate

To soften by wetting or soaking; refers to degenerative changes and disintegration of skin when it has been kept too moist

60

Necrosis

Death of tissue

61

Pus

Thick fluid indicative of infection containing leukocytes, bacteria and cellular debris

62

Scab

Dried exudate covering superficial wounds, usually containing hemolytic components

63

Slough

Moist yellowing or gray substance composed of a mixture of fibrin tissue debris and pus that contains bacteria and leukocytes

64

Autolytic

Use of synthetic dressing to cover a wound and allow eschar to self-digest by the action of enzymes present in wound fluids

65

Enzymatic

Topical application of proteolytic substances (enzymes) to breakdown devitalized tissue

66

Mechanical

Removal of foreign material and devitalized or contaminated tissue from a wound by physical forces rather than by chemical or natural forces

67

Non-selective debridement

Removes both healthy and non-healthy tissue

68

Selective debridement

Removes only necrotic tissue

69

Examples of non-selective debridement

Wet to dry
Vigorous whirlpool jet agitation
Wound irrigation
Dakin's
Hydrogen peroxide

70

Examples of selective debridement

Sharp/surgical
Enzymatic
Autolytic

71

Collagenase (chemical agent) most effective on what kind of tissue

Yellow-green fibrotic tissue and eschars

72

Indications for hydrotherapy

Need for hydration and increased circulation
Removal of cellular debris, foreign contaminants, and loosely attached necrotic tissue
Softening of thick, hard necrotic eschar
Ischemic wounds that have decreased pain when dependent

73

Use of calcium alginates

Moderately to highly exudative full thickness wounds and as fillers for moderately to highly exudative full thickness wound cavities

74

Use of cadexomer iodine

Chronic venous ulcers

75

Use of foam dressings

Full thickness wounds with moderate to heavy exudate

76

Use of hydrocolloid

Wounds with light to moderate exudate

77

Use of hydrogel

To fill a deep, dry wound

78

Use of transparent film

Open partial thickness wounds with minimal exudate or on closed wounds

79

Use of biosynethic dressings

Temporary or extended coverage of skin loss wounds like burns, donor sites, or skin tears

80

Indications for packing

Dead space impairs wound healing and predisposes abcess formation and infection

81

Contraindications for packing

Patient at increased risk for bleeding
Damage to tissue
Infection