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Wound Evaluation

QuestionAnswer
Subjective Exam (general) includes: 1. demographics 2. employment 3. social info 4. PMH 5. current status
Important medication types Anti-inflammatory, Anti-diabetic, cardiac, antibiotic
Subjective Exam (wound specific) includes: 1. MOI or disease 2. date of onset 3. duration of injury/disease 4. course of events 5. past or current interventions/effects 6. Pain/paresthesia/anesthesia 7. Special questions (imaging, cultures, labs, S&S of infection, orthopnea if cardiac)
Serum albumin norm and importance 3.5-5.5 longer half life :.longer index of malnutrition
Prealbumin norm and importance 20-40 shorter half life :. shorter/recent index of malnutrition
Fasting blood glucose norm 70-115
Glycosylated hemoglobin (A1C) nrom 4-6%
Hemoglobin norm 12-16 females; 13-18 males
Hematocrit norm 37-48% females; 42-52% males
WBC norm 4.5-11 x 10^3
Objective exam 1. Presentation (footwear, AD, position, functional mob) 2. Presence of dressings (integrity, appropriateness) 3. Tests & Measures (pending wound type--sensory, vascular, girth, ROM, etc)
Depth deepest aspect of wound to horizontal plane of intact wound edge
Tunnel linear channel extending beyond wound base; may have entrance and exit points
Sinus tract dead end channel
undermining wound edge erosion where fascia separates from deeper tissue around wound edge
Fistula vertical or oblique channel originating from a wound that penetrates a body cavity
Serous drainage clear, watery drainage, found in inflammation and proliferation phases
sanguinous red, bloody drainage due to damaged vessels
serosanguinous pink/reddish, water drainage; found in inflammation and proliferation phases
purulent/pus yellow, green, tan drainage that may be cloudy, watery or viscous; may have odor
Sign of staph creamy, yellow pus
sign of proteus fishy odor
sign of pseudomonas green or blue-green, fruity odor
Pus: yes or no? anaerobes NO
Pus: yes or no? streptococcal cellulites NO
Pus: yes or no? gas gangrene NO
Pus: yes or no? infected burns NO
local S&S of infection erythema palpable heat odor edema/induration
Signs of sepsis unexplained fever tachycardia hypotension AMS chills N&V
Epithelium translucent layer covering previous granulation
granulation pink/red, granular looking
slough/fibrin soft, moist, dead fibrous tissue; may be tan/white/brown/green; may be stringy, loose, or adherent to wound bed
eschar brown or black necrotic tissue; may be adhered or separated from wound edge; may be hard, soft, or boggy
exposed structure Bone (white or light grey) tendon/ligament (white or light yellow) Adipose (yellow, globular, waxy texture) Muscle (bright red with visible striations) vessels (ropelike; arteries firm, veins thin and compressible)
Complete epithelialization wound bed is covered with epithelium; closed
epithelializing epidermal cells advancing from wound edges and/or epithelial appendages
epibole curled wound edge due to contact inhibition of epithelial cells
callus thick, hyperkeratotic tissue
indisctinct/diffuse edges cannot distinguish boundaries of wound edges from periwound
fibrotic, scarred immediate wound edge/periwound skin is scarred
ecchymosis/hemorrhagic blue, purple, black tissue from disrupted blood vessels
excoriated tissue injury from mechanical, chemical, or thermal injury
indurated tissue hardened from edema, inflammation, or granulation
inflamed tissue response to injury: redness, warmth, edema, pain, loss of function
macerated tissue damage or softening from too much moisture
Created by: ktay13
 

 



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