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39 Cards in this Set

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What is medical asepsis?
Practices that are used to decrease the number and transmission of microorganisms; termed clean technique and includes: hand washing, clean enviornment, exam gloves or gowns, etc.
What is surgical asepsis?
Practices that are used to eliminate microorganisms from an area or equipment; termed sterile technique and includes: sterile fields, sterile gloves, sterile supplies & equipment, etc.
True or False? If a sterile glove contacts a sterile field or sterile dressing the glove and the field/dressing are considered contaminated.
False, sterile-to-sterile rules apply and a sterile glove touching a sterile field would remain sterile.
When is sterile technique used?
In the operating room, when inserting an indwelling catheter or on some dressing changes.
What is the "no-touch technique" used on dressing changes?
A method of changing topical dressings without touching the wound or any surface that will or might come in contact with the wound.
What are some different types of wounds?
Intentional, unintentional, closed, open, acute, chronic, and pressure ulcers.
What is an example of an intentional wound?
when an incision is made during surgery.
What is a closed wound?
A wound which the edges are well approximated or sutured or stapled together.
What are pressure ulcers?
localized areas of tissue necrosis that develope when soft tissue is compressed between a bony prominence and an external surface for a prolonged period of time.
What are some other names for pressure ulcers?
decubitus ulcer, bedsore, or dermal ulcer
What are some factors that can affect wound healing?
The extent of the damage or injury, the general health of pt (immune deficiencies, chronic illnesses, etc.), age, nutritional status, effectiveness of the circulatory sys, and medications
What are three possibile methods to wound closure?
Primary intention, Secondary intention, or tertiary intention
What is primary intention of wound closure?
This method occurs when the wound edges are well approximated and sutures or staples are used to maintain and intact the wound.
What is secondary intention of wound closure?
This is used when extensive tissue loss occurs and the wound is open with dressings covering the wound and it heals from the base of the wound.
What is tertiary intention of wound closure?
When a wound is left open because of potential for bacterial contamination. They wounds are kept moist with dressings and closed when risk of infection is minimal.
What are the phases of wound healing?
1. inflammatory phase 2. proliferation phase 3. maturation phase
The activities of the inflammatory phase include __________ and __________.
hemostasis, phagocytosis
What is the first step of the inflammatory phase?
Vasoconstriction occurs and coagulation begins as the body attempts to stop the bleeding.
True or False? During the inflammatory phase growth factors are released by platelets which attract inflammatory cells to the area.
True
During the inflammatory phase migration of _________ cells, __________, and __________ cells is initiated.
epithelial, fibroblasts, vascular
During the inflammatory phase why does edema occur around the wound?
Edema occurs becuase of vasodilation around the area of injury. This fluid contains proteins, enzymes, antibodies and growth factors necessary for healing.
What do macrophages do during wound healing?
They digest microorganisms and other debris, release chemicals that cause vasodilation, and stimulate the activity of the fibroblasts.
What do fibroblasts do during wound healing?
They initiate the production of collagen
What happens during the proliferation phase?
fibroblastic and collagen activity increases, new blood vessels and granulation tissue begins to form, epithelial cells migrate across the wound from its edges, collagen increases and the scar begins to change, and sensory nerves begin to develope (in minor wounds)
What is contraction?
Contraction is when the wound edges move toward the center and the size of the wound bed decreases.
What happens during the maturation phase?
Collagen is rearranged and is termed remodeling. The cells become less vascular and the strength of the tissue increases.
The scar that is formed over a wound is not as strong as the original tissue, why is this?
The reason for this is the scar consists of collagen rather than the original tissue, elastin.
How long do each of the stages of wound healing normally last?
Inflammatory phase: 3-4 days
Proliferation phase: 4-24 days
Maturation phase: several months
What does the acronym "TIME" mean when considering barriers to healing?
T=tissue
I=infection
M=moisture
E=edges
True or False? Nonviable tissue, such as necrotic tissue, can interfere with the movement of cells needed to build granulation tissue and therefore removal of this tissue is important.
True
What is debridement and what are some different methods to doing it?
It is the removal of necrotic tissue. Surgical debridement is removal using instruments, Mechanical debridement uses force to remove, autolytic debridement is removal using mositure and body's own enzymes, Enzymatic debridement uses topical enzymatic drugs to remove and biological debridement which uses maggots for removal.
True or False? Low amounts of bacteria may actually help healing through the release of proteases or stimulate the release of proteases from neutrophils.
True
wounds with low levels of bacteria that are not replicating or are replicating (colonizing) is considered normal. What is NOT considered normal?
Critical colonization of bacteria that delays wound healing is not normal.
What are some signs and symptoms of critical colonization and impending infection in a wound?
serous exudates, friable granulation tissue, bright red granulation tissue, increase pain, wound odor, fever, warmth, edema, pain, erythema, and purulent drainage.
What is granulation tissue?
New tissue made of collagen, fibroblasts and rich vascularity. It is seen as a shiny red tissue and bleeds easy. It fills the wound bed and provides a surface for epithelialization.
True or False? A moist enviornment delays wound healing.
False, it supports wound healing because the epithelial cells migrate faster in an appropriately moist enviornment.
What are some things that can be done if a wound bed is TOO moist?
Diuretics may be ordered or compression therapy. Also hydrocolloid, alginate, foam, or specialty absorbent dressings may be used. Wounds with extreme amounts of moisture may need negative pressure wound closure therapy (wound vac)
What is undermining of a wound?
When the epithelial cells cannot slide over each other properly and you see a hard rolled wound edge.
What are some ways to manage problems with wound edges?
debridement of wound edge, application of biological factors such as growth factor, skin grafts, electrical wound stimulation or wound vacs.