Wound Care Exam Questions With 100% Correct Answers Latest 2024 (Verified by Experts)

23. Types of wound healing? PRIMARY CLOSURE (or first intention) : caused by cutting with a sharp instrument, with little tissue damage wound is minimally contaminated . and can be closed with a needle, The ideal timing for primary closure is within 6—8 h. SECONDARY CLOSURE : takes place when wound are left open and unopposed due to edema or other causes; they are closed by new tissue formation and re-epithelialization. Secondary closure allows for treatment of necrotic and grossly contaminated wounds, Wounds closed by secondary intention heal more slowly. TERTIARY CLOSURE : Considered when the wound is too contaminated to be sutured or when there is no severe damage to tissues. Certain wounds need to be closed after 4-5 days of observation and cleansing 24. Discuss phases of wound healing? Phase 1: Hemostasis Phase: Hemostasis, the first phase of healing, begins at the onset of injury, and the objective is to stop the bleeding by blood clotting system. Phase 2:Inflammatory Phase: During Phase neutrophils enter the wound to destroy bacteria and remove debris. macrophages arrive to continue clearing debris. These cells also secrete growth factors and proteins that attract immune system cells to the wound to facilitate tissue repair. This phase often lasts four to six days and is often associated with edema, erythema (reddening of the skin), heat and pain. Phase 3: Proliferative Phase: The Proliferative phase features 1) increase collagen synthesis; 2) contraction of the wound margins; and 3) (epithelialization). 4) new blood vessels are formed. The Proliferative phase often lasts anywhere from four to 24 days. Phase 4: Maturation/Remodeling Phase: the new tissue slowly gains strength and flexibility. Here, collagen fibers reorganize, often lasting anywhere from 21 days to two years. 5. Discuss factors affecting wound healing? LOCAL FACTORS : _blood supply ( venous stasis , tissue ischemia ) _infection ( bacteria , fungi or yeast , mycobacteria ) _medications ( steroids, topical antibiotics) _trauma _ulcer type ( pressure ulcers , neuropathic ulcers, venous ulcer and arterial ulcer) SYSTEMIC FACTORS : _nutrition (deficiency of protein and vitamins. _age _illness( endocrine disease : diabetes & Cushing disease) _systemic medication ( corticosteroids , aspirin and other NSAIDS ) 26. Discuss causes and clinical picture of arterial ulcer? *Causes : caused by arterial insufficiency may be related to smoking, cardiac disease, diabetes and hypertension. arterial insufficiency lead to trophic changes and ulceration. *Clinical picture: • Wounds will most frequently be located on : lateral malleoli, dorsum of feet, toes. The majority of patients with arterial insufficiency also have diabetes. • Trophic changes are present and include abnormal nails growth, decreased leg and foot hair, and dry skin. • Skin is cool on palpation • Wounds are painful • (dry gangrene) may develop • Other signs of arterial insufficiency will be evident: decreased pulses, pallor on leg elevation, and rubor when dependent.