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Stack #175203


Describe the most common pressure points for development of wounds Sitting: Scapula, Ischial Tuberosity, heels, greater trochanter, popliteal crease.Supine: Sacrum, elbows, ischial tuberosity, iliac crest.Prone: ASIS, patella, acromion,perianal area.Sidelying: heels,thigh,iliac crest,acromion malleoli
Characteristics of Arterial, Venous, Diabetic wounds Arterial: Painful at rest, pain incrases with elevation. Distal lateral leg. Temperture decreased. Pale color in elevation red on dependency. Venous: painless, decreased pain with elevation, medial aspect of lower leg and ankle. Temperture increased. R
Describe pressure ulcer classification Stage 1: changes in skin temperature,tissue consistency, sensation, red blue or purple hues. Stage 2: Loss of partial thickness of the skin ulcer is superficial(abrasion, blister,shallow crater). Stage 3: Loss of full thickness of the skin, deep crater
THE FOUR DEGREES OF BURN INJURY ARE? I superficialII partial thicknessIII full thickness IV full thickness+underlying tissue
FOUR PHASES OF WOUND HEALING I: inflamation edema phagocytosis II: granulation, proliferation (5-30 days)III: fibroblasts bring wound edges closer together.IV: Scar formation
NINES RULE Adults: Head 9% Chest and Abdomen 18% Upper mid low back/buttocks 18% UE 9% each Groin 1% LE 18% each
TREATMENT ................ KEEP GOING!!!!!!!!!!!!!
MANAGEMENT OF MAJOR AND MINOR WOUNDS Major: primary excision prevents infectiondebridement: promotes healing Watch for pneumonia!!!!!!Minor: cleansing/debridement
PHASES OF WOUND MANAGEMENT Emergent: 5 days(24-48 hours) watch for respiratory distress. fluid loss and edemaAcute: weeks or months. fluid control diuresis Watch for infection!!!!!!!!!!!PT: maintain ROM/pain managementRehabilitative: Wound cover with skin or healed. Return patient
PRINCIPLES OF VACUM ASSISTED WOUND CLOSURE Negative wound pressure therapy used to promote granulation in the wound bed.
EMERGENCY WOUND MANAGEMENT Inmersion of burned part in cold water inmediately or cold compress.Cover wound with sterile or clean cloth NO oinments or creams.
Created by: adriossa