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PTA Integumentary

2013 Terms, wound classification by depth of injury, Staging ulcers, etc

What are the five key functions of the integumentary system? 1. Protection 2. Sensation 3. Thermoregulation 4. Excretion of sweat 5. Vitamin D syntheses
Phases of normal wound healing: What is the first phase? (How many days?) Inflammatory Phase. Days 1-10. Goals: reestablish homeostasis through platelet activation and clotting cascade. WBC establish a clean wound bed which triggers epithelialization (usually 24 hrs @ wound boarders)
Phases of normal wound healing: What is the second phase? (How many days?) Proliferative phase (3-21 days): Formation of new tissue signals the beginning of this phase. Granulation tissue fills the wound bed which creates the support structure for migration of epithelial cells. Wound contraction and wound closure occurs here.
Phases of normal wound healing: What is the third phase? (How many days?) Maturation (days 7- 2 years): "Remodeling phase" Granulation tissue and epithelial differentation begin to appear in the wound bed. Fiber reorganization and contraction shrink the wound and thin the scar. Scar tissue is remodeled and strengthened.
What factors influence wound healing? (There's eight) Age (old = thin skin) Co-morbidities (poor cellular activity) Edema (excessive = alteration in hemodynamics) Harsh/inappropriate wound care Infection (increased toxins) Lifestyle (activity helps healing) Medication (can impact healing) Obesity
Acute Wounds: Abrasion Wound caused by combination of friction and shear forces (such as rough surface, scrape, etc)
Acute Wounds: Avulsion Serious wound resulting from tension that causes skin to become detached from underlying structures
Acute Wounds: Incisional wound most often assoc with surgery and is created intentionally
Acute Wounds: Laceration (irregular tear of tissues) associated with trauma, can result from shear, tension, or high force compression with the resultant wound characteristics dependent on how it happened.
Acute Wounds: Penetrating wound results from various mechanisms of injury and is described as a wound that enters the interior of an organ or cavity.
Acute Wounds: Puncture Sharp pointed object penetrates the skin and underlying tissues.
Acute Wounds: Skin Tear results from trauma to fragile skin (eg: bumping an object, adhesive removal, shear or friction forces.)
Arterial Insufficiency Ulcers: What general recommendations exist for PTs/PTAs? Have the patient: Rest, protect limb, education on risk reduction, avoid unecessary leg elevation, heating pads or soaking feet in hot water, wear good shoes/clean socks Therapist should: inspect legs and feet daily