Wound Management Overview
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Questions and Answers

Which of the following factors can interfere with wound healing?

  • Edema
  • Infection
  • Necrosis
  • All of the above (correct)

    • Older adults tend to heal more quickly than children and healthy adults.

    False (B)

    What is the primary reason why adequate blood flow is essential for wound healing?

    Adequate blood flow delivers nutrients and oxygen to the wound area, while removing toxins, bacteria, and debris.

    Dead tissue present in a wound is called ______ or ______.

    <p>slough</p> Signup and view all the answers

    Match the following nutritional components with their role in wound healing:

    <p>Proteins and carbohydrates = Rebuild cells and tissues Vitamin A and C = Re-epithelialization and collagen synthesis Zinc = Cell proliferation Fluids = Optimal function of cells</p> Signup and view all the answers

    Sutures are beneficial in closing surgical wounds but can also hinder healing due to their foreign body nature.

    <p>True (A)</p> Signup and view all the answers

    Why can obesity affect wound healing?

    <p>Obesity can slow wound healing due to decreased blood supply in fatty tissue, increased susceptibility to infection, and slower healing time.</p> Signup and view all the answers

    Which of the following is NOT a systemic factor that can affect wound healing?

    <p>Wound Condition (D)</p> Signup and view all the answers

    Which of the following best defines a wound?

    <p>A break or disruption in the normal integrity of the skin and tissues (D)</p> Signup and view all the answers

    A wound can be defined as a minor scrape on the skin only.

    <p>False (B)</p> Signup and view all the answers

    What are two factors that can affect wound healing?

    <p>Infection and age</p> Signup and view all the answers

    A wound is defined as a break or disruption in the normal integrity of the skin and __________.

    <p>tissues</p> Signup and view all the answers

    Match the following types of wounds with their definitions:

    <p>Laceration = A tear or cut in the skin Abrasions = A scraped area of skin Puncture = A wound made by a sharp object Contusion = An injury causing bleeding beneath the skin without breaking it</p> Signup and view all the answers

    What is a possible indication of delayed healing or infection in a wound?

    <p>Increase in pain accompanied by purulent drainage (A)</p> Signup and view all the answers

    The wound edges being separated indicates that dehiscence is likely present.

    <p>True (A)</p> Signup and view all the answers

    What are the three types of wound drainage?

    <p>Serous, sanguineous, purulent</p> Signup and view all the answers

    To promote wound healing and reduce the risk of abscess formation, drains may be inserted in or near a wound to promote _____ .

    <p>drainage</p> Signup and view all the answers

    Match the following signs of infection with their corresponding descriptions:

    <p>Redness = Increased blood flow around the wound Swelling = Accumulation of fluid or tissue fluid Tenderness = Sensitivity in the area of the wound Foul odor = Unpleasant smell indicating possible infection</p> Signup and view all the answers

    What is the primary focus of patient care during the maturation phase of wound healing?

    <p>Avoiding strain on the suture line (C)</p> Signup and view all the answers

    Scar tissue is more elastic than uninjured tissue.

    <p>False (B)</p> Signup and view all the answers

    What is the effect of pressure on wound healing?

    <p>It disrupts blood supply and delays healing.</p> Signup and view all the answers

    The phase of wound healing that begins about 3 weeks after an injury is called the _____ phase.

    <p>maturation</p> Signup and view all the answers

    Which phase of wound healing typically involves the formation of granulation tissue?

    <p>Proliferative (C)</p> Signup and view all the answers

    Match the following wound healing phases with their characteristics:

    <p>Phase I = Fever, malaise Phase II = Feeling better Phase III = Raised scar formed Phase IV = Flat, thin scar</p> Signup and view all the answers

    Desiccation refers to the overhydration of cells.

    <p>False (B)</p> Signup and view all the answers

    What happens to collagen during the maturation phase of wound healing?

    <p>It is remodeled to make the healed wound stronger.</p> Signup and view all the answers

    What is the liquid that forms at an injury site due to increased capillary permeability?

    <p>Exudate (D)</p> Signup and view all the answers

    Macrophages are primarily responsible for the formation of new blood vessels during the inflammatory phase.

    <p>False (B)</p> Signup and view all the answers

    What characterizes acute inflammation at the injury site?

    <p>Pain, heat, redness, and swelling.</p> Signup and view all the answers

    During the inflammatory phase, the patient's body may show a mildly elevated __________.

    <p>temperature</p> Signup and view all the answers

    Match the following phases of healing with their descriptions:

    <p>Hemostasis = Blood vessel constriction and clot formation. Inflammatory Phase = Involvement of white blood cells and macrophages. Proliferation Phase = Formation of granulation tissue and scar tissue development.</p> Signup and view all the answers

    Which cells arrive first at the wound site during the inflammatory phase?

    <p>Leukocytes (D)</p> Signup and view all the answers

    Granulation tissue is characterized as being poorly vascularized and does not bleed easily.

    <p>False (B)</p> Signup and view all the answers

    What role do fibroblasts play during the proliferation phase?

    <p>They build new tissue to fill the wound space.</p> Signup and view all the answers

    Which condition can compromise wound healing?

    <p>All of the above (D)</p> Signup and view all the answers

    Corticosteroids can enhance the inflammatory process to aid wound healing.

    <p>False (B)</p> Signup and view all the answers

    What is the term for the protrusion of viscera through the incisional area?

    <p>Evisceration</p> Signup and view all the answers

    The presence of ______ can increase the risk for infection and skin breakdown postoperatively.

    <p>fistula</p> Signup and view all the answers

    Match the wound complications with their definitions:

    <p>Dehiscence = Partial or total disruption of wound layers Evisceration = Protrusion of viscera through an incision Fistula = Abnormal passage from an internal organ to the skin Hemorrhage = Excessive bleeding from a wound</p> Signup and view all the answers

    What is a common result of postoperative fistula formation?

    <p>Fluid and electrolyte imbalances (D)</p> Signup and view all the answers

    Signs of infection include a swollen and deep red wound.

    <p>True (A)</p> Signup and view all the answers

    What happens to the color of a healthy surgical wound after one week?

    <p>It becomes closer to normal in appearance.</p> Signup and view all the answers

    Flashcards

    Definition of Wound

    A break or disruption in the normal integrity of the skin and tissues.

    Types of Wounds

    Different categories of wounds, such as acute, chronic, open, and closed.

    Physiology of Wound Healing

    The biological process your body uses to repair wounds.

    Factors Affecting Wound Healing

    Elements that can speed up or slow down the healing process, such as nutrition and infection.

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    Complications of Wound

    Potential issues that can arise during the healing process, like infection or delayed healing.

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    Corticosteroids

    Drugs that reduce inflammation but may delay healing.

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    Radiation Therapy

    Treatment that may lower leukocyte levels, increasing infection risk.

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    Chronic Illness Impact

    Long-term diseases can hinder wound healing.

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    Immunosuppression

    Decreased immune function can delay wound healing.

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    Infection Complications

    Bacteria can invade wounds during or after trauma.

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    Dehiscence

    Partial or total disruption of wound layers.

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    Fistula Formation

    Abnormal passage from organ to skin or between organs.

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    Wound Assessment

    Evaluating wound edges, color, and signs of complications.

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    Platelet Activation

    The process where platelets adhere to a wound, promoting clotting.

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    Exudate

    A liquid that leaks from blood vessels during inflammation, containing plasma and cells.

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    Inflammatory Phase

    The phase after hemostasis, lasting 4-6 days, characterized by white blood cell activity.

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    Macrophages

    Large white blood cells that ingest debris and secrete growth factors for healing.

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    Growth Factors

    Substances released by macrophages that stimulate tissue growth and healing.

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    Proliferation Phase

    The phase where new tissue forms, lasting several weeks, mainly by fibroblasts.

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    Granulation Tissue

    New, highly vascular tissue that forms the foundation for scar formation.

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    Collagen Synthesis

    The process where collagen is produced, essential for tissue strength and scar formation.

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    Edema

    Swelling at a wound site that restricts blood supply.

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    Infection

    The presence of microorganisms that drain immune energy for repair.

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    Necrosis

    Dead tissue in a wound that obstructs healing processes.

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    Systemic Factors

    Body-wide conditions influencing healing, such as age and health.

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    Age's Effect

    Older adults heal more slowly due to physiological changes.

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    Circulation and Oxygenation

    Blood flow necessary for delivering nutrients and removing waste.

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    Nutritional Status

    Adequate nutrition is crucial for effective wound healing.

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    Wound Condition

    The state of a wound that affects how fast it heals.

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    Wound drainage

    Fluid and cells that escape from blood vessels and accumulate in a wound.

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    Exudate types

    Exudates can be serous, sanguineous, or purulent, based on the wound condition.

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    Signs of infection

    Indicators include redness, swelling, warmth, pus, and foul odor around the wound.

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    Pain assessment in wounds

    Pain may increase with delayed healing or infection; it's usually worst within the first few days.

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    Wound care education

    Keep wounds clean and dry, report infections, elevate to reduce swelling.

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    Wound Healing Phases

    The sequential stages of healing after an injury: Hemostasis, Inflammatory, Proliferative, and Maturation.

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    Phase 1: Hemostasis

    Initial phase from incision to 2nd postoperative day focused on stopping bleeding and inflammatory response.

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    Phase 2: Inflammatory

    Lasts from the 3rd to 14th postoperative day where granulation tissue forms and patients feel better.

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    Phase 3: Proliferative

    Occurs from the 3rd to 6th postoperative week, characterized by collagen deposition leading to scar formation.

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    Phase 4: Maturation

    Final stage of healing starting about 3 weeks after injury, lasting months to years; scar tissue forms.

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    Collagen in Wound Healing

    Protein that is deposited during healing, providing strength and structure to the wound as it heals.

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    Factors Affecting Healing

    Elements that impact the wound healing process, such as pressure, desiccation, trauma, and maceration.

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    Desiccation

    The drying out of cells in a wound which can lead to cell death and delayed healing.

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    Study Notes

    Wound Management

    • Wound is defined as a break or disruption in the normal integrity of skin and tissues.

    Learning Objectives

    • Define different types of wounds
    • Describe the physiology of wound healing
    • Identify factors affecting wound healing
    • Outline wound complications
    • Describe wound management
    • Educate patients on wound healing promotion

    Types of Wounds

    • Incision: Cutting or sharp instrument; wound edges are close and aligned.
    • Contusion: Blunt instrument; overlying skin intact, injury to underlying soft tissue; possible bruising or hematoma.
    • Abrasion: Friction; rubbing or scraping epidermal layers of skin; top skin layer is abraded.
    • Laceration: Tearing of skin and tissue with blunt or irregular instrument; tissues not aligned; often with loose flaps.
    • Puncture: Blunt or sharp instrument puncturing skin; intentional (venipuncture) or accidental. Foreign object entering skin/mucous membrane.
    • Penetrating: Foreign object enters skin/mucous membrane and lodges in underlying tissue; fragments can scatter. Destroys skin layers.
    • Burns (thermal, chemical, irradiation): Destroys skin layers.
    • Pressure ulcers: Compromised circulation secondary to pressure.

    Wound Classification

    • Clean: Non-traumatic site; uninfected; no inflammation; no break in aseptic technique.
    • Clean-contaminated: Entry into respiratory, alimentary, genitourinary tracts or oropharynx without unusual contamination (appendectomy). Minor disruption of aseptic technique.
    • Contaminated: Open, newly injured traumatic wounds; gross spillage from gastrointestinal tract; major break in aseptic technique; enters genitourinary or biliary tract with infected urine or bile.
    • Dirty: Traumatic wounds with delayed repair, devitalized tissue, foreign body, or fecal contamination; acute inflammation with purulent drainage during procedure.

    Wound Healing Physiology

    • Wound healing is a tissue response to injury.
    • Injured tissues are repaired by physiologic mechanisms that regenerate functional cells and replace connective tissue with scar tissue.
    • The process involves phases.

    Phases of Wound Healing

    • Phase 1 (Hemostasis): Occurs immediately after injury. Involved blood vessels constrict; blood clotting begins via platelet activation and clustering. Blood vessels dilate briefly after initial constriction. Capillary permeability increases, allowing plasma and blood components to leak out (exudate), causing swelling and pain. Increased blood flow causes heat and redness. A clot forms, protecting the injury. Platelets release substances to stimulate other cells to migrate to the injury.
    • Phase 2 (Inflammatory): Follows hemostasis; lasts 4-6 days. White blood cells (leukocytes) move to the wound; leukocytes arrive to ingest bacteria and cellular debris. Macrophages arrive 24 hours later to ingest debris and release growth factors, which promote new blood vessels and epithelial cells. Acute inflammation characterized by pain, heat, redness, and swelling. Patients often have a mildly elevated temperature, leukocytosis (increased white blood cells), and general malaise.
    • Phase 3 (Proliferation): Known as the fibroblastic, regenerative, or connective tissue phase; lasts several weeks. New tissue (granulation tissue) fills the wound space primarily through the actions of fibroblasts. Capillaries grow across the wound to provide oxygen and nutrients. Fibroblasts form fibrin that stretches through the clot. A thin layer of epithelial cells forms across the wound, and blood flow across the wound is restored. Granulation tissue forms the foundation for scar tissue development; highly vascular, red, and bleeds easily. Collagen synthesis and accumulation peak in 5-7 days.
    • Phase 4 (Maturation): The final stage; begins about 3 weeks after injury and may continue for months or years. Collagen that was haphazardly deposited remodels; the healed wound becomes stronger. New collagen deposition compresses blood vessels in the healing wound, so that scar tissue forms (avascular, does not sweat, grow hair, or tan). Scar tissue is strong but less elastic than uninjured tissue. If a scar is over a joint, it may limit movement.

    Factors Affecting Wound Healing

    • Local factors:
      • Pressure: Disrupts blood supply, interferes with blood flow, delays healing.
      • Desiccation (drying): Cells dehydrate and die; crusting occurs; healing delayed.
      • Maceration (overhydration): Moisture causes pH change, bacterial overgrowth, skin infection or erosion.
    • Systemic factors:
      • Age: Children heal faster; older adults may have more chronic illnesses, impede healing.
      • Circulation/oxygenation: Blood flow and oxygen delivery crucial for nourishment and toxin removal; may be impacted by obesity.
      • Nutritional status: Requires adequate proteins, carbohydrates, fats, vitamins, and minerals to rebuild cells, promote tissue repair. Healing slowed with poor nutritional status or fluid imbalances.

    Wound Complications

    • Infection: Bacteria invading the wound at any time.
    • Hemorrhage: From a slipped suture, dislodged clot, stress at suture line, operative site, infection, or erosion of a blood vessel by a foreign body.
    • Dehiscence: Partial or total disruption of wound layers.
    • Evisceration: Protrusion of viscera through the incision.
    • Fistula formation: Abnormal passageway from an internal organ to the skin or another internal organ.

    Nursing Management

    • Assessment: Appearance, approximation of wound edges, colour, drains/tubes/staples/sutures, signs of dehiscence or evisceration. Healthy wounds appear clean, approximated, with a crust along edges. Initially edges may be reddened, swollen but normal within a week. If infection is present, wound will be swollen, deep red, hot, with increased purulent drainage, foul odour. Dehiscence or separation of edges is imminent.
    • Drainage: Inflammatory response leads to exudate formation. Exudate contains fluid and cells escaping blood vessels and deposited on tissue. Exudates are serous, sanguineous, or purulent (if infected). Drains may be inserted to promote drainage and healing. Evaluate amount, colour, odour, and consistency.
    • Pain: Pain from the wound may be constant, especially with increase/purulent drainage (indicates delayed healing or infection). Incisional pain is usually most severe for the first 2-3 days then progressively diminishes.

    Patient Education

    • Keep wound dry and clean if soiled, notify caregiver.
    • Report signs of infection (redness, swelling, increased warmth, pus, foul odor).
    • Elevate affected body part.
    • If pain or soreness apply a cold pack or analgesics.
    • Eat plenty of protein and Vitamin C rich foods.

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    Wound Management PDF

    Description

    Explore the essential aspects of wound management in this quiz. Learn to define various types of wounds, understand the physiology of wound healing, and identify factors that affect healing processes. Equip yourself with the knowledge to outline complications and promote effective patient education on wound care.

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