Which layer of skin creates new skin cells? correct answers the deepest live layer of the
epidermis that produces new epidermal skin cells and is responsible for growth.
Where does epithelialization begin? correct answers Epidermis
What are intrinsic factors that affect the development of wounds? correct answers Circulation
(O2 Saturation, skin blood supply)
General Health of the patient
Comorbidities
Diabetes
Vascular disease
Immunocompromised Conditions
Respiratory Conditions (COPD)
Condition of the skin - age (fragile)
Infection
Nutritional status
Hydration status
Location of the wound
Obesity
What are extrinsic factors that affect the development of wounds? correct answers Mechanical
stress (cut, friction, pressure)
Mobility
Transfers, bed mobility, gait
Shear
Friction
,Pressure areas
Hygiene
Maceration of Skin
Incontinence
Perspiration
Skin to skin contact (skin folds)
Pressure areas
Decreased mobility impact when patient has:
Contractures
Decreased ROM and/or Strength
Proper fit
AD (care & use leading to pressure area i.e. Crutches)
Braces
Prosthetics and Orthotics
Bandages
What is autolytic debridement? What type of bandaging or dressing is used to achieve this?
correct answers mechanisms (digestion) to remove nonviable tissue by establishing a moist
wound environment that rehydrates dry eschar and necrotic tissue.
Use of semiocclusive or occlusive hydrocolloid, hydrogel, or transparent dressings to keep
eschar wet until it liquifies (3-7 days)»No limit on size of necrotic area»Not performed on
infected wounds
Advantages: Dressing promotes debridement/ Wound debrides itself/ Non-invasive/ Painless
Disadvantages: Risk of infection/ Slow acting
, what does decubiti mean? correct answers Pressure Ulcers - AKA: Bed sore, Pressure sore,
Decubiti ulcer
Causes: Compression of soft tissue over bony prominences = ischemia: Friction/shear=
TRANSFERS/BED MOBILITY!! Irreversible damage can be caused in 2 hours (supine)
*Likely Locations of Decubiti:*
-If sitting (even if in wheelchair)- Scapula, spinous processes coccyx, ischial tuberosities,
popliteal region, calcaneus
-If supine: Occiput, spinous processes, sacrum, calcaneus, olecranon, scapula
-If sidelying: Fibula head, medial or lateral malleoli, femoral condyle, greater trochanter, side of
head, humeral head
-If prone: Anterior knee, humeral head
What are the characteristics of arterial insufficiency wounds? correct answers lower 1/3 of leg,
distal toes, dorsal foot, over bony prominences
smooth edges, well defined, deep, severe pain, diminished or absent pulses, dependent rubor,
skin is thin and shiny; hair loss; yellow nails
no granulation presence 2 to lack of blood supply, surrounding skin is cool, pain in elevated
positions, relieved with hanging foot down, may have history of claudication
Dependent rubor= skin becomes deep red
Causes: Tissue ischemia caused by insufficient blood flow to an area, Arterial stenosis,