WOUND HEALING AND ADVANCED WOUNDS ppt

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Questions and Answers

Which phase of wound healing begins immediately after the injury and lasts for the first few days?

Proliferation

Secondary Intention

Hemostasis and Inflammation (correct)

Maturation

What term describes the surgical plan that allows for closure of a wound after a delay, usually for healing purposes?

Chronic Intention

Secondary Intention

Tertiary Intention (correct)

Primary Intention

Which local factor is not typically associated with impaired wound healing?

Edema

Infection

Obesity (correct)

Ischemia

What is the normal range for the ankle/brachial index indicating adequate tissue perfusion?

0.9 – 1.2 Signup and view all the answers

In wound healing, which systemic factor is most commonly associated with delayed recovery in older adults?

Age Signup and view all the answers

Which of the following conditions is most likely to result in chronic wounds that may stall in any phase of healing?

Edema Signup and view all the answers

Which of the following factors is a common local factor that can impede effective wound healing?

Hypoxia Signup and view all the answers

What aspect of wound assessment involves evaluating the type of drainage and the wound's warmth?

Physical assessment Signup and view all the answers

What is the main consequence of sensory neuropathy in diabetic patients?

Unrecognized trauma leading to ulcer formation Signup and view all the answers

Which phase of Charcot foot is characterized by joint effusion and soft tissue edema?

Acute phase Signup and view all the answers

What impact does autonomic neuropathy have on the skin of diabetic patients?

Dry skin and cracked areas that invite infection Signup and view all the answers

Which treatment method is considered after wound care and infection management have failed for diabetic foot ulcers?

Hyperbaric oxygen therapy (HBOT) Signup and view all the answers

What does the Wagner classification specifically assess?

Severity of diabetic foot ulcers Signup and view all the answers

What is a key characteristic of an ideal wound care product?

Maintains a moist wound environment Signup and view all the answers

What is the primary risk associated with diabetes in terms of limb health?

Heightened risk of amputation Signup and view all the answers

Which dressing option is known for its ability to maintain a moist wound environment effectively?

Hydrogels Signup and view all the answers

What should be done if the wound contains nonviable tissue?

Remove necrotic tissue or surface biofilm. Signup and view all the answers

Which ABI reading indicates a potential risk for tissue necrosis?

ABI of 0.4 Signup and view all the answers

What is the primary characteristic of an arterial ulcer?

Well-circumscribed and typically dry. Signup and view all the answers

What factor is crucial for wound healing when assessing moisture balance?

Maintaining a balance between dry and wet conditions. Signup and view all the answers

What is the most common site for pressure ulcers?

Sacrum Signup and view all the answers

Which statement is true regarding venous ulcers?

They account for 80% of all lower extremity ulcers. Signup and view all the answers

What should be avoided in the treatment of arterial ulcers?

Compression therapy. Signup and view all the answers

Regarding chronic wound care, which factor does NOT significantly impact healing?

Patient's ethnic background. Signup and view all the answers

What consequence is most directly associated with prolonged pressure on the skin?

Cell death and skin breakdown. Signup and view all the answers

In patients with diabetes, what is a significant underlying problem for ulcer formation?

Dysfunction of the peripheral nervous system. Signup and view all the answers

When should pressure relief strategies be implemented for patients with ulcers?

At the first sign of breakdown. Signup and view all the answers

What is the recommended approach for managing pain in patients with chronic wounds?

Adequate pain control is essential for dressing compliance. Signup and view all the answers

What is a common characteristic of venous ulcers?

Presence of weeping and edema. Signup and view all the answers

What is the primary treatment for pressure ulcers?

Pressure redistribution and proper wound care. Signup and view all the answers

Study Notes

Wound Healing Overview

All surgeries create a wound that typically heals by primary intention.
Secondary intention healing is used for wounds that do not close properly, potentially taking weeks or months.
Tertiary intention is planned delayed closure by a surgeon.

Phases of Wound Healing

Hemostasis and Inflammation: Immediate response lasting a few days.
Proliferation: Begins after a few days and lasts several weeks.
Maturation: Starts around 2-3 weeks and can last several months; phases may overlap, and wounds can stall.

Local Factors Affecting Wound Healing

Mechanism of injury
Infection and edema
Ischemia and necrotic tissue
Radiation effects and malignancy
Hypoxia and foreign bodies

Systemic Factors Affecting Wound Healing

Age, nutrition, and obesity
Trauma and stress responses
Metabolic diseases and immunosuppression
Connective tissue diseases and smoking
Vasoconstriction

Wound Healing History and Physical Examination

Duration of the wound (days, weeks, months)
Associated findings: drainage, erythema, warmth
Previous wounds and treatments in the same or other locations
Comprehensive assessment to identify common causative factors

Key Steps in Wound Healing

Assess tissue perfusion through ankle/brachial index; normal is 0.9 – 1.2.
Identify and remove nonviable tissue; avoid surgical debridement in severe ischemia.
Evaluate for infection; consider cultures or imaging for diagnosis.
Manage edema with compression if perfusion is adequate.
Maintain moisture balance in the wound bed.
Optimize tissue growth with NPWT, HBOT, or growth factors.
Ensure pain is well-controlled for better dressing compliance.
Regular reassessment at every visit.

Chronic Wounds

Chronic wounds often heal by secondary intention.
Factors affecting chronic wounds overlap with those for primary intention.
Common causes: pressure, venous insufficiency, arterial insufficiency, diabetes, and neuropathy.

Pressure Ulcers

Localized skin and deep tissue injury from constant pressure due to impaired mobility.
Reduced blood flow leads to necrosis and skin breakdown; common sites include sacrum, back, and heels.
Affects 2.5 million patients yearly at a cost of $27 billion.
Annual lawsuits: 17,000; pressure ulcers are a leading cause of wrongful death with 60,000 deaths associated annually.

Treatment of Pressure Ulcers

Identify risk factors like immobility, moisture exposure, and nutritional deficits.
Reposition immobile patients every two hours.
Use pressure-relieving surfaces and maintain skin moisture.
Ensure appropriate wound care.

Venous Ulcers

Affect about 1% of Americans; 80% of lower extremity ulcers.
Risk factors: previous leg injuries, DVT, obesity, and older age.
Symptoms include pain, swelling, varicosities, and ulcers that are irregular and shallow.
Standard treatment involves compression therapy and proper wound care.

Arterial Ulcers

Present with severe pain, especially when the leg is elevated; "punched out" appearance is common.
Associated with risk factors like smoking, hypertension, and diabetes.
ABI is crucial for diagnosis; an ABI < 0.5 indicates severe disease.
Treatment includes proper wound care and vascular surgery; avoid compression.

Diabetic Foot Ulcers (DFUs)

Diabetic patients face a significantly higher risk of ulcers due to nerve dysfunction.
Neuropathy presents symptoms affecting motor, sensory, and autonomic functions, leading to unrecognized trauma.
Charcot foot can result from prolonged diabetes complications, leading to foot deformity.
Treatment focuses on wound care, managing blood sugar levels, and avoiding trauma.

Lower Extremity Amputation

Patients with diabetes are 10 times more likely to undergo amputation.
Five-year survival rate post-diabetic amputation is 30%; high risk of contralateral amputation.

Generalized Wound Care

Wound care pertains to managing chronic wound closure.
Focus on treating the patient holistically; thorough assessment is essential.

Moist Wound Healing

Preventing dry scab formation promotes quicker epithelization.
Ideal wound care products maintain a moist environment, are painless, non-allergenic, and cost-effective.

Types of Wound Dressings

Gauze, transparent films (Tegaderm), hydrocolloids, hydrogels, alginates, foam, collagen, iodine, and silver dressings.

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Description

Explore the processes and phases involved in wound healing through this quiz. Understand the different intentions of wound closure and the factors affecting healing time. Ideal for students in nursing or medical fields.