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Integument review


Layers of superficial burn epidermis only
Appearance of superficial burn red, dry tender
Healing of superficial burn 2-3 days, no scars
superficial partial thickness layers epidermis into papillary layer of dermis
superficial partial thickness appearance blisters intact, red
superficial partial thickness healing 7-21 days w/ minimal scarring
Deep partial thickness layers epidermis, dermis (including hair, sweat glands)
Deep partial thickness appearance Marked edema, mixed red w/ waxy white, broken blisters,
Deep partial thickness healing spontaneous, 3-5 wks excessive scarring
Full thickness layers epidermis, dermis, subcutaneous, possible into muscle
full thickness appearance white, gray, black, escar, leathery
full thickness healing heals w/ graft
subdermal layers all into muscle and bone
subdermal appearance charred
subdermal healing grafting, tissue defects
hand position to prevent deformities after burn wrist ext, MCP flex, PIP and DIP ext, thumb abd
hip position to prevent deformities after burn neutral roation w/ slight abd
redness w/ lesions, itchy, weeping crusted skin dermatitis
inflamation, pus filled vessicles, itching Impetigo
pus, hot, red edematous, fever common cellulitis
contraindications of shingles US, heat
erythematous plaques covered w/ silvery scale psoriasis
red rash w/ raised scaly plaques lupus
skin is taut, firm, edematous, firmly bound scleroderma
scleroderma precaution sensitive to pressure, acute HTN can occur
round, irregular, dry, flat on sun exposed skin actinic keratosis (pre-cancerous)
raised lesion on trunk usu in elders seborrheic keratosis
ivory raised w/ indented center in fair skinned basal cell (malignant, rarely mets)
poorly defined borders, red, flat, sun exposed skin squamous cell (can met)
asymmetric irregular border, color variation malignant (from melanocytes)
red or purple/blue, usu. LE kaposi's sarcoma
Transparent film indications autolytic debridement, secondary dressing, Stage I and II,
transparent film considerations avoid w/ infection, non-absorptive
hydrocolloids indications mild exudate, maintains moist, supports autolytic
hydrocolloids considerations odor w/ yellow exudate is normal when dressing is removed avoid in infections or with heavy exudate
hydrogel indications necrosis, burns, rehydrates, autolytic
hydrogel considerations comes in many types and absorptive capacity varies, don't use sheet w/ infection dressing must be changed every 8-48 hours
Foams indications min-mod exudate
Foams considerations do not use w/ dry escar or wounds w/ no exudate
Alginates indications mod to large amount of exudate infected and non-infected
Alginates considerations car dry wound bed
Gauze dressing indications mechanical debridement, infected wounds, several types
Autolytic type and contraindications (Natural) infection, immunosuppressed, dry gangrene, dry ischemic
Enzymatic type and contraindications (enzyme to necrotic tissue) ischemia, dry gangrene, clean granulated wounds
Mechanical type and contraindications (nonselective) clean granulated
Sharp type and contraindications (selective w/o anesthesia) clean, advanced cellulitis w/ sepsis, infection threatens life, pt on anticoagulants
Surgical type and contraindications (non-selective, wide excision) cardio-pulm disease, DM, severe spasticity, pt cant tolerate, short life expectancy, QOL won't be improved.
Created by: carter28