What is a Partial Thickness Wound?
All or a portion of the dermis is intact.
What is a Full Thickness Wound?
The entire dermis, sweat glands, and hair follicles are severed.
What is a Complex Wound?
Dermis and underlying SC fat tissue are damaged or destroyed.
What is a Avulsion Wound?
Tearing a structure from normal anatomic position; possible damage to blood vessels, nerves, and other structures.
What are the 4 phases of Wound Healing?
- 1. Hemostasis - Immediately after injury, blood vessels constrict, clotting begins,exudate, swelling, pain
- 2. Inflammatory- 4-6 days - WBC's move to the wound, release growth factors, new blood cells form, increased temp and WBC's, generalized malaise.
- 3. Proliferation - Fibroblastic, regenerative, connective tissue phase. Several Weeks. Fibroblasts create and secrete collagen; blood flows across wound delivering oxygen.
- 4. Maturation - 3 weeks after injury; healed wound stronger. Avascular scar tissue.
What is the first indication of a possible pressure ulcer?
Blanching = becoming pale and white
What are the characteristics of a Stage 1 Pressure Ulcer?
Persistent Redness; nonblanchable.
What are the characteristics of a Stage 2 Pressure Ulcer?
Partial Thickness skin loss involving the epidermis and/or dermis. Abrasion, blister, or shallow crater.
What are the characteristics of a Stage 3 Pressure Ulcer?
Full-Thickness skin loss involving damage or necrosis of SC tissue, may extend down to the fascia, wet to dry dressing. Cannot see bone or tendon.
What are the characteristics of a stage 4 Pressure Ulcer?
Full thickness skin loss with extensive destruction, tissue necrosis, may need skin grafts. Exposed bone, tendon, or muscle.
What are the effects of applying Heat to a wound?
- Accelerates inflammation to promote healing.
- Creates Vasodilation, increases blood flow, increases nutrients, O2, Pulse, decreases BP.
What are the effects of applying Cold to a wound?
- Constricts peripheral blood vessels, reduces muscle spasms, promotes comfort.
- Decreases blood flow and the local release of pain due to decreasing inflammation.
- Increases coagulation, BP, and shivering.
What are the 4 stages of Infection?
- 1. Incubation - Organisms are growing and multiplying; no symptoms yet.
- 2. Prodromal - Person is most infectious, early S&S, but nonspecific. Several Hours - Several Days. Pt does not know they are contagious so infection spreads.
- 3. Full stage of Illness - Presence of specific S&S.
- 4. Convalescent - Recovery from the infection. S&S disappear
What is a Exogenous infection?
Causative agent is aquired from other people.
What is a Endogenous infection?
- Causative agent comes from microbial life harbored in the person.
- Normal flora becomes altered and overgrows.
What is a Iatrogenic infection?
Results from a treatment or diagnostic procedure. Like a UTI after a Cath.
What is a Suprainfection?
An infection that occurs during treatment for a primary infection.