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76 Cards in this Set
- Front
- Back
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Where are arterial ulcers located?
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Lower one-third leg, dorsum of foot, web spaces, lateral malleoli
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Where are venous ulcers located?
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proximal to medial malleolus
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What is the appearance of arterial ulcers?
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smooth edges, well defined, lack of granulation tissue, tend to be deep
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What is the appearance of venous ulcers?
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Irregular shape, shallow
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What is the difference in pain level between arterial and venous ulcers?
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arterial ulcers=severe
venous ulcers=mild to moderate |
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which type of ulcer has edema?
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venous ulcer
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What are the skin changes with arterial ulcers?
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thin and shiny, hair loss, yellow nails
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What are the skin changes with venous ulcers?
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flaking, dry skin; brownish discoloration
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For arterial ulcers, leg elevation _________ pain
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increases
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For venous ulcers, leg elevation ________ pain
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decreases
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Which type of wounds are hydrocolloid dressings useful for?
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partial and full-thickness wounds
Can be used for granular and necrotic wounds |
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Which dressings CANNOT be used on infected wounds?
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Hydrocolloids
Transparent films |
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Which dressings CAN be used on infected wounds?
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Gauze
Alginates |
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What are indications for Hydrogels?
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superficial and partial-thickness wounds with minimal drainage
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What are indications for Foam dressings?
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partial and full-thickness wounds with varying amounts of exudate
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What are indications for transparent films?
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superficial and partial-thickness wounds with minimal drainage
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What are indications for gauze?
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infected/non infected wounds of any size. Used for wet to wet, wet to moist, or wet to dry debridement
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What are indications for Alginates?
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Used on partial and full-thickness draining wounds like pressure wounds or venous insufficiency ulcers.
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Name the dressings from MOST occlusive to least occlusive
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Hydrocolloids, hydrogels, semi-permeable foam, semipermeable film, impregnated gauze, alginates, traditional gauze
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Name the dressings from most moisture retentive to least moisture retentive.
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Alginates, semipermeable foam, hydrocolloids, hydrogels, semipermeable films
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What are the goals for red wounds?
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Protect wound, maintain moist environment
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What are goals for yellow wounds?
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Debride necrotic tissue; absorb drainage
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What are goals for black wounds?
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Debride necrotic tissue
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Name types of selective debridement
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Sharps debridement
Enzymatic debridement Autolytic debridement |
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Name types of non-selective debridement.
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Wet to Dry dressings
Wound irrigation Hydrotherapy |
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what types of debridement are useful for infected wounds?
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Wound irrigation, Enzymatic debridement
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Name the factors that influence wound healing
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Age
Illness Infection Lifestyle Medication |
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Name the medications that interfere with wound healing
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Steroids, Anti-inflammatory, heparin, anti-neoplastic agents (cancer drugs), and oral contraceptives
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What are the general treatment guidelines for scar management?
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Massage cream 2X day on healed wound
Use of sun block and Vitamin E Pressure garments Use of silicone gel (softens scar) Consider US or E-stim |
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What does a seropurulent wound indicate?
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Impending infection
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What does a purulent wound indicate?
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wound is infected
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What are the classifications of exudate for healthy healing wounds?
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Serous or serosanguinous
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What does sanguinous exudate indicate?
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New blood vessel growth or disruption of blood vessels
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Describe a Stage 1 pressure ulcer
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NON-blanchable intact skin with changes in skin color, temp, stiffness or sensation
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Describe a Stage 2 pressure ulcer
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Partial-thickness skin loss that involved epidermis and/or dermis.
Blister, abrasion, shallow crater |
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Describe a Stage 3 pressure ulcer
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Full thickness skin loss that involves damage of subcutaneous tissue that may extend down to but not through the fascia.
Deep crater |
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Describe a stage 4 pressure ulcer.
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Full thickness skin loss with extensive destruction, tissue necrosis extends down to muscle, bone, tendon, joint capsule
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Name the factors that contribute to pressure ulcers.
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shear, moisture, heat, friction, medication, muscle atrophy, malnutrition, debilitating medical conditions
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Where are neuropathic ulcers usually found?
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Plantar surface of foot, at metatarsal heads
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How do neuropathic ulcers appear?`
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well defined by callus rim
good granulation tissue, little to no drainage distal limb shiny and cool periwound skin dry/cracked |
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What are the grades for Wagner Scale of diabetic foot ulcers?
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0 No open lesion but pre-ulcerative lesions
1 Superficial ulcer, not involving subcutaneous tissue 2 deep ulcer w/ penetration through subcutaneous tissue 3 deep ulcer with osteitis, abcess or osteomyelitis 4 gangrene of digit 5 gangrene of foot requiring disarticulation |
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What is a superficial burn?
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Involves outer epidermis.
May be red with slight swelling. Healing occurs without scarring |
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What is a superficial partial-thickness burn?
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Burn that extends through epidermis and upper part of the dermis.
Extreme pain and blisters. Minimal to no scarring. |
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What is a Deep partial-thickness burn?
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Complete destruction of epidermis and most of dermis.
Discolored with broken blisters and edema. Damage to nerve results in moderate pain only. Hypertrophic scars and keloids. |
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What is a full thickness burn?
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Complete destruction of epidermis and dermis and partial damage subcutaneous tissue.
Eschar formation, minimal pain. Requires graft, susceptible to infection |
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What is subdermal burn?
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complete destruction of epidermis, dermis, and subcutaneous tissue.
May involve muscle/bone Require surgery |
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What is zone of coagulation?
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Area of burn that receieved most severe injury along with irreversible cell damage
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What is zone of stasis?
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Area of less severe injury that possesses reversible damage and surrounds zone of coagulation
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What is zone of hyperemia?
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Area surrounding zone of stasis that presents with inflammation but will fully recover without any intervention/permanent damage
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Describe Rule of Nines
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Head and trunk 9%
Anterior trunk 18% Posterior trunk 18% Bilateral anterior arm, forearm and hand 9% Bilateral posterior arm, forearm, and hand 9% Genitals 1% Bilateral anterior leg and foot 18% Bilateral posterior leg and foot 18% Equals 100% |
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What is the children's value for rule of nines?
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A child under one has 9% taken from LE and added to head. Each year 1% is distributed back to LE until age 9.
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Name the types of topical agents used for burns
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Silver Sulfadiazine
Silver Nitrate Povidone-iodine Mafenide Acetate Gentamicin Nitrofurazone |
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Which type of topical agents kills bacteria?
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Nitrofurazone
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Which topical agent has the most advantages?
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Silver Sulfadiazine
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Which topical agent penetrates burn eschar?
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Mafenide Acetate
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What is an allograft?
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A temporary skin graft taken from another human (cadaver)
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What is an autograft?
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A permanent skin graft taken from donor site on patient's own body
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What is a heterograft or xenograft?
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A temporary skin graft taken from another species
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What is a mesh graft?
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A skin graft that is altered to create a mesh-like pattern to cover a large surface area
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What is a sheet graft?
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A skin graft transferred directly from the donor site to the recipient site
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What is a split-thickness graft?
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A skin graft that contains only a superficial layer of dermis in addition to epidermis
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What is a full-thickness skin graft?
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A skin graft that contains the dermis and epidermis
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what is the anticipated deformity of burn on anterior neck?
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Flexion with possible lateral flexion
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What is the anticipated deformity of burn on anterior chest and axilla?
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Shoulder adduction, extension, and medial rotation
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What is the anticipated deformity of burn of elbow?
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flexion and pronation
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What is the anticipated deformity of burn of hand/wrist?
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Extension/hyperextension of MCP joints; flexion of IPs, adduction and flexion of thumb; flexion of wrist
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What is the anticipated deformity of burn at hip?
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Flexion and adduction
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What is the anticipated deformity of burn at knee?
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Flexion
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What is anticipated deformity of burn on ankle?
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Plantar flexion
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What is dermis?
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Vascular layer of skin below epidermis that contains hair follicles, sebaceous glands, and sweat glands
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What is epidermis?
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Superficial avascular layer of skin that contains hair follicles, sebaceous glands, and sweat glands
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What is eschar?
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Necrotic and non-viable tissue resulting from deep burn.
Hard, dry, does not resemble normal skin |
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What is escharotomy?
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Surgical procedure that removes eschar from burn site and subsequently enhances circulation
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What is hypertrophic scarring?
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Abnormal and disorganized scar formation characterized by raised, firm scar with collagen fibers that do not follow any pattern
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What are pressure garments?
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custom-made garment that applies sustained pressure in order to improve structure of a scar.
Worn 22-23 hrs/day May be required for up to 2 years |
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What is Z-plasty?
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Surgical procedure to eliminate a scar contracture.
Incision in shape of "z" allows contracture to change configuration and lengthen scar |
