Medical Terminology

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ENZYMATIC DEBRIDEMENT

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the topical application of proteolytic substances (enzymes) to break down devitalized tissue

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ENZYMATIC (CHEMICAL) DEBRIDEMENT

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removal of foreign material and devitalized or contaminated tissue from a wound by physical forces rather than by chemical (enzymatic) or natural (autolytic) forces. examples are wet-to-dry dressings wound irrigation whirlpool

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NEUROPATHY

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a condition affecting the nerves supplying the arms and legs. Typically the feet and hands are involved first. If sensory nerves are involved numbness tingling and pain are prominent and if motor nerves are involved the patient experiences weakness.

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ULCER

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a local defect or excavation of the surface of an organ or tissue produced by the sloughing of necrotic inflammatory tissue

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WHAT ARE THE FOUR METHODS OF DEBRIDEMENT?

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autolytic debridement enzymatic debridement mechanical debridement sharp debridement

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PURULENCE

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exudate consisting of or containing pus

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WHAT CAN V.A.C THERAPY DO TO ASSIST WITH MOISTURE IMBALANCE?

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remove exudate reduce edema (interstitial fluid) provide a moist wound healing environment

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WHAT THREE THINGS ARE CHARACTERISTICS OF INADEQUATE TISSUE PERFUSION AS A BARRIER TO WOUND HEALING?

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lack of adequate blood flow lack of angiogenesis lack of cellular activity (senescence)

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WHAT IS THE FIRST PHASE OF WOUND HEALING AND HOW IS IT CHARACTERIZED?

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Hemostasis: the stopping of bleeding

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REMODELING

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the final differentiation processes in biological systems such as the attainment of total functional capability by a cell a tissue or an organ. In wound healing this is the fourth phase of healing and is seen as scar formation

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EDEMA

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the presence of abnormally large amounts of fluid in the interstitial space

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ERYTHEMA

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redness of the skin surface produced by vasodilation

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ALTEREED TISSUE PERFUSION

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when oxygenated blood does not flow freely through the vessels to the tissue

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IMPEDIMENT

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something that impedes; a hinderance or an obstruction

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DENUDE

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to divest of a covering

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ESCHAR

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avascular tissue found in a wound that is characterized by a dark and leathery appearance

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CELL MIGRATION

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movement of cells in the repair process

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AVASCULAR

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without vascularization

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EXUDATE

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material such as fluid cells or cellular debris which has escaped from blood vessels and has been deposited in tissue surfaces usually as a result of inflammation or injury. it is characteristically high in protein and white blood cells.

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WHAT ARE THE CLINICAL GOALS FOR A CHRONIC WOUND IN THE INFLAMMATION STAGE OF WOUND HEALING?

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convert into an acute wound assist wound progression

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MICROSTRAIN

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a unit of measurement of strain. A microstrain equals the strain that produces a deformation of one part per million

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PERFUSION

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the passage of fluid (such as blood) through a specific organ or area of the body

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DEHISCE

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to split along a natural line

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VENOUS STASIS

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the pooling of venous blood in a particular region which in the legs results in edema hyperpigmentation and possibly ulceration

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WHAT ARE PRESSURE ULCERS COMMONLY KNOWN AS?

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bedsores

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FIBROBLAST

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any cell or corpuscle from which connective tissue is developed

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PRIMARY INTENTION

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a method of wound closure using sutures staples or surgical bond to approximate wound edges.

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DISTAL

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remote; farther from any point of reference (my def: away from the heart)

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COLLAGEN

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main supportive protein of skin tendon bone cartilage and connective tissue

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WHAT IS THE FOURTH PHASE OF WOUND HEALING & WHAT IS IT CHARACTERIZED BY?

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remodeling: characterized by scar formation, or maturation

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DIALYSIS

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a process of filtering and removing waste products from the bloodstream. Two main types are hemodialysis and peritoneal dialysis. In hemodialysis the blood flows out of the body into a machine that filters out the waste products and routes the cleansed blood back into the body. In peritoneal cavity dialysis the cleansing occurs inside the body. Dialysis fluid is injected into the peritoneal cavity and wastes are filtered through the peritoneum the thin membrane that surrounds the abdominal organs.

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ANTERIOR

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situated at or directly toward the front; opposite of posterior

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MACERATION

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softening of tissue by soaking in fluids

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HYDROPHOBIC

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repelling moisture

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FASCIA

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a sheet or band of fibrous tissue that lies deep below the skin or encloses muscles and various organs of the body

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WHEN DOES THE INFLAMMATION PHASE HAPPEN IN AN ACUTE WOUND?

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between 20 minutes and up to 4 days following injury

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POSTERIOR

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directed toward or situated at the back; opposite of anterior

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NECROTIC TISSUE

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avascular tissue that is dead or devitalized

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DIABETES

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a disease characterized by an inability to process sugars in the diet due to a decrease in or total absence of insulin production. may require injections of insulin before meals to aid in the metabolism of sugars.

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LIST THE FIVE THINGS V.A.C THERAPY CAN DO FOR ACUTE AND CHRONIC WOUNDS (PROLIFERATION PHASE)

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draw wound edges together reduce edema promote perfusion promote granulation tissue formation prepare wound bed for closure

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PLANTAR

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pertaining to the sole of the foot

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WHAT IS THE SECOND PHASE OF WOUND HEALING AND WHAT IS IT CHARACTERIZED BY

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Inflammation: characterized by pain, heat, redness, and swelling

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SUPERIOR

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situated in a higher position on the body closer to the head and farther from the feet

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HYDRATION

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the introduction of additional fluid into the body

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MICROORGANISM

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an organism of microscopic or ultramicroscopic size

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ISCHEMIA

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a deficiency of blood due to functional constriction or obstruction of a blood vessel to a part

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WHAT THREE THINGS DENOTE BACTERIAL BURDEN AS A BARRIER TO WOUND HEALING?

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excess bacterial burden inadequate protection from infection need for antimicrobials and infection control

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WHAT IS ANOTHER NAME FOR TERTIARY INTENTION?

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delayed primary intention

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EPIDERMIS

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the outer nonsensitive and nonvascular layer of the skin

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METABOLISM

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the chemical changes in living cells by which energy is provided for vital processes and activities and new material is assimilated

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HEMOSTASIS

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the stopping of bleeding or blood flow through a blood vessel or organ. in wound healing this is the first phase

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MEDIAL

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toward the middle

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HYDROPHILIC

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attracting moisture

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WHAT ARE THE FOUR PHASES OF WOUND HEALING.

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hemostasis inflammation proliferation remodeling

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INFERIOR

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a part of the body located below another; the opposite to superior. For example the legs are inferior to the hands when facing the body

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DEVITALIZED TISSUE

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dead tissue

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EPITHELIALIZATIOM

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regeneration of the epidermis across wound surface

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MACROSTRAIN

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the visible contraction of wound edges under negative pressure

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GRANULATION TISSUE

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the pink/red moist tissue that contains new blood vessels collagen fibroblasts and inflammatory cells which fills an open previously deep wound when it starts to heal

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PROXIMAL

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nearest to a point of reference, as to a center of median line or to the point of attachment or origin (my def: nearest to the heart)

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WHAT IS THE THIRD PHASE OF WOUND HEALING & WHAT IS IT CHARACTERIZED BY?

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proliferation: characterized by presence of granulation tissue, wound edge contraction, & epithelialization

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INFLAMMATION

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a protective tissue response to injury or destruction of tissues which serves to destroy dillute or wall off both the injurious agent and the injured tissues. The classical signs of acute inflammation are pain heat redness and swelling. In wound healing this is the second phase of healing

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INFECTION

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the establishment of a pathogen in its host after invasion

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PUS

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thick fluid containing leukocytes bacteria and cellular debris; may be indicative of infection

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APOPTOSIS

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programmed cell death a process including coagulative necrosis and shrinkage

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PARTIAL THICKNESS TISSUE LOSS

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loss of epidermis and possible partial loss of dermis. does not extend into the subcutaneous fat or below

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WHAT CAN V.A.C. THERAPY DO TO ASSIST WITH INADEQUATE TISSUE PERFUSION

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promote perfusion promote granulation tissue formation through cell migration and proliferation

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AUTOLYSIS

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disintegration of tissue or of cells by the body's own mechanisms (leukocytes/enzymes)

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PROLIFERATION

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the growth and reproduction of similar cells. in wounds this is the third phase of wound characterized by the presence of granulation tissue wound edge contraction and epithelialization

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WHAT CAN V.A.C THERAPY DO TO ASSIST WITH BACTERIAL BURDEN?

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remove infectious materials provide protected wound healing environment deliver antimicrobials

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COCCYX

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tail bone

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LIST THE FOUR MAJOR THINGS V.A.C. THERAPY CAN DO IN WOUND HEALING PROGRESSION (INFLAMMATION PHASE)

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remove exudate remove infectious material reduce edema promote perfusion

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MICRODEFORMATION

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the deformation of tissue at the cellular level as cells are stretched with V.A.C. GranuFoam under negative pressure

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VASCULAR

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pertaining to vessels particularly blood vessels

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SEROMA

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a collection of serum/plasma within a wound

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TERTIARY INTENTION

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a method of wound closure used on contaminated or "dirty" wounds leaving them open for a short period of time for cleansing and disinfecting and then closed with sutures, staples, or surgical bond

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WHAT IS SCAR FORMATION ALSO KNOWN AS?

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maturation

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SHARP DEBRIDEMENT

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removal of foreign material or devitalized tissue by a sharp instrument such as a scalpel. laser debridement is also considered a type of sharp debridement

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GROWTH FACTORS

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proteins that affect the proliferation movement maturation and biosynthetic activity of cells. for the purpose of this guideline these are proteins that can be produced by living cells

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HYPERBARIC OXYGEN THERAPY

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(aka HBO) a treatment in which the patient is placed in a chamber and breathes oxygen at higher-than-atmospheric pressure

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SLOUGH

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necrotic (dead) tissue in the process of separating from viable portions of the body. In wounds this tissue is usually yellow or creamy in color moist and stringy

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AUTOLYTIC DEBRIDEMENT

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

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VENOUS INSUFFICIENCY

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lack of perfusion from the veins

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SECONDARY INTENTION

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a method of wound closure used on large deficit wounds that cannot be closed with sutures. This methods leaves the wound open to heal from the inside out

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FULL THICKNESS TISSUE LOSS

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tissue destruction extending through the dermis to involve the subcutaneous layer and possibly muscle/bone

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WHAT IS A CHARACTERISTIC OF DEVITALIZED TISSUE AS A BARRIER TO WOUND HEALING?

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presence of necrotic tissue

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CAPILLARIES

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small thin-membraned permeable blood vessels that link arterioles and venules feeding and removing wastes from the tissues through which they pass

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ANGIOGENESIS

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the formation of new blood vessels especially blood vessels that supply oxygen and nutrients to tissue

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DEBRIDEMENT

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removal of devitalized tissue and foreign matter from a wound. various methods can be used for this purpose

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EXCRETION

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a waste product (as urine feces or vomit) eliminated from the body

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WHAT THREE THINGS CAN INDICATE MOISTURE IMBALANCE AS A BARRIER TO WOUND HEALING?

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excess exudate excess edema (interstitial fluid) absence of moisture

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MECHANICAL DEBRIDEMENT

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removal of foreign material and devitalized or contaminated tissue from a wound by physical forces rather than by chemical (enzymatic) or natural (autolytic) forces. examples are wet-to-dry dressings wound irrigation whirlpool.

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DERMIS

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the sensitive vascular inner mesodermic layer of the skin

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ETIOLOGY

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the cause or origin of a disease or disorder as determined by medical diagnosis

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MALLEOUS

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ankle bone

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WOUND BED PREPARATION

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the management of the wound to accelerate endogenous healing or to facilitate the effectiveness of other therapeutic measures

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WHEN DOES THE PROLIFERATION PHASE OCCUR IN WOUND HEALING?

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between 3 and 21 days after injury

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ALBUMIN

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a class of simple water-soluble proteins that can be coagulated by heat and precipitated by strong acids and are found in egg whites blood serum milk and many other animal and plant juices and tissues

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ELECTROLYTES

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any of the ions (as of sodium potassium calcium or bicarbonate) that in a biological fluid regulate or affect most metabolic processes (as the flow of nutrients into and waste products out of cells) used especially in biology and biochemistry

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FIBRIN

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an insoluble protein that is essential to clotting of blood formed from fibrinogen by action of thrombin

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LATERAL

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on the side

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PRESSURE ULCER

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also known as a decubitus ulcer pressure ulcers are open wounds that form whenever prolonged pressure is applied to skin covering bony outcrops of the body. Patients who are bedridden are at risk of developing pressure ulcers.

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SENESCENT CELLS

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found in chronic wounds these are old cells that are unresponsive and unable to divide

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INCONTINENCE

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inability to control evacuation functions such as defecation or urination

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HOMEOSTASIS

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the state of balance in the internal environment of the body achieved by various control mechanisms

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PERSISTALSIS

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a sequence of muscle contractions that progressively squeeze one small section of the digestive tract and then the next to push food along the tract something like pushing toothepaste out of its tube

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ABSCESS

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localized collection of pus in any part of the body

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SACRUM

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triangular bone at the base of the spine

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COAGULATION

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the clotting of blood

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EXCORIATION

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superficial traumatic abrasions and scratches which remove some of the skin substance

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SUPINE

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body lying face up on the back ( my way to remember: sup = face-sup)

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WHAT ARE THE CLINICAL GOALS OF THE PROLIFERATION STAGE OF WOUND HEALING?

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reduce wound volume assist wound progression prepare wound for closure

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PRONE

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the body lying face down

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ARTERIAL INSUFFICIENCY

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lack of perfusion from the arteries

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WOUND MARGIN

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rim or border of wound

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FIBRINOGEN

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a protein in the blood plasma that is essential for the coagulation of blood and is converted to fibrin by thrombin and ionized calcium

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CELLULITIS

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inflammation of tissue around a lesion characterized by redness swelling and tenderness. signifies a spreading infectious process

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WHAT ARE THE CLINICAL GOALS FOR AN ACUTE WOUND IN THE INFLAMMATION STAGE OF WOUND HEALING?

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manage excessive inflammation assist