Wound Care, Dermatology, and Burn Management

Comprehensive vocabulary flashcards covering epidermal and dermal histology, wound assessment systems, burn classifications, ulcer pathophysiology, and wound care interventions.

Stratum basale

The deepest epidermal layer whose primary function is growth and creation of stratified epithelium.

Stratum spinosum

The epidermal layer that provides strength and toughness to the skin.

Stratum granulosum

The epidermal layer that provides a water-resistant protective layer.

Stratum lucidum

The epidermal layer found exclusively in the thick skin of the palms and soles.

Stratum corneum

The most superficial epidermal layer that provides protection against friction and abrasion.

Keratinocytes

The type of cells located in the epidermis that make up most of the epidermal tissue.

Fibroblasts

Cells located in the dermis whose primary role is to produce connective tissue and collagen.

Ectoderm

The embryologic layer that produces the epidermis.

Mesoderm

The embryologic layer that produces the dermis and hypodermis.

Dermal papillae

Structures that increase friction and attachment between the epidermis and dermis.

Eccrine sweat glands

Sweat glands whose primary functions are sweat production and temperature regulation.

Apocrine sweat glands

Sweat glands commonly found in the pubic and axillary regions that produce odor as a result of bacterial breakdown of secretions.

Wagner classification

A grading system used to assess the depth and severity of diabetic foot ulcers.

Wagner Grade 0

A classification grade indicating intact skin in a patient at risk.

Wagner Grade 1

A classification grade indicating a superficial ulcer.

Wagner Grade 2

A classification grade indicating an ulcer extending into tendon or deeper structures.

Wagner Grade 3

A classification grade indicating a deep ulcer with abscess or osteomyelitis.

Wagner Grade 4

A classification grade indicating localized gangrene of part of the foot.

Wagner Grade 5

A classification grade indicating extensive gangrene of the foot.

$10\,\text{g}$ monofilament test

A clinical sensory assessment used to screen for loss of protective sensation.

$128\,\text{Hz}$ vibration testing

A tuning fork frequency test commonly used to screen for peripheral neuropathy, where inability to detect vibration suggests nerve dysfunction.

Epibole

Rolled or irregular wound edges that interfere with closure.

Eschar

Dead tissue that remains attached to the wound, preventing accurate staging of a pressure injury because wound depth is obscured.

Maceration

Overhydrated or soggy skin.

Granulation tissue

New vascular connective tissue that develops during wound healing.

Type III collagen

A form of collagen that provides an early scaffold for granulation tissue and transitions toward type I collagen during healing.

Polymorphonuclear leukocytes (PMNs)

White blood cells that migrate to the injury site during the inflammation phase.

Phases of tissue injury repair

The four sequential stages of wound repair: hemostasis, inflammation, proliferation, and maturation.

Wound pH

The approximate pH of an open wound, documented as $7.2\text{ to }8.3$.

Healthy skin pH

The acidic surface pH of intact skin, documented as $4.0\text{ to }5.8$.

Elevated blood glucose (> $180\,\text{mg/dL}$)

A physiological state that impairs or delays wound healing, damages capillaries via adherence of glucose molecules, and affects peripheral nerves early.

Negative pressure wound therapy (NPWT)

A therapeutic modality designed to support healing and reduce edema.

Complete decongestive therapy (CDT)

A comprehensive treatment regimen comprising skin care, exercise, elevation, compression, and manual lymph drainage.

Edema

Excess fluid accumulation in tissues, which normally relies on veins for $90\%$ of fluid reabsorption and lymphatics for $10\%$.

Pressure relief intervals

Scheduled repositioning recommended every $3\,\text{minutes}$ every $30\,\text{minutes}$ for seated patients, and every $2\,\text{hours}$ for supine patients.

Rule of nines

A clinical tool used for estimating the total body surface area (TBSA) affected by burns.

TIME framework

A clinical wound assessment acronym standing for Tissue, Infection or inflammation, Moisture, and Edges.

Pulse grading scale

A vascular assessment scale where 0 is absent, 1+ is barely palpable, 2+ is diminished, 3+ is normal, and 4+ is bounding.

Superficial burn

A burn injury affecting only the epidermis.

Superficial partial-thickness burn

A burn involving damage to the epidermis and the superficial dermis.

Deep partial-thickness burn

A burn extending into deeper dermal tissue that damages the reticular dermis and more skin appendages.

Full-thickness burn

A burn destroying both the epidermis and dermis, causing an absence of sweating because sweat glands have been destroyed.

Diaphoresis

Excessive sweating.

Severe burn thresholds

Burn criteria defined as greater than $20\%$ TBSA in adults, greater than $10\%$ TBSA in children and older adults, or greater than $5\%$ TBSA for full-thickness burns.

Electrical burn

A burn classified as severe regardless of size due to the risk of deep tissue damage not visible at the skin and complications such as rhabdomyolysis.

Escharotomy

A surgical incision through eschar performed to relieve constriction and preserve distal perfusion.

Cutaneous functional units

Specific skin regions needed for joint movement.

Heterotopic ossification

Bone formation in abnormal soft tissue locations, with increased risk observed in burns exceeding $20\%$ TBSA.

Arterial ulcer

An ischemic wound caused by inadequate tissue perfusion that should be kept dry when dry stable tissue is present and vascular status is insufficient.

Venous ulcer

A lower extremity wound primarily caused by venous insufficiency and elevated venous pressure.

Ankle-brachial index (ABI)

A vascular assessment measure used to evaluate lower extremity arterial perfusion before interventions such as debridement.

Antiseptics

Agents with broad antimicrobial activity used to reduce or inhibit microorganisms, differing from antibiotics which target specific susceptible organisms.

Povidone-iodine

An iodine-based antiseptic solution used in wound care.

Bacitracin

A topical antibacterial agent whose primary antibacterial target is gram-positive bacteria such as Staphylococcus and Streptococcus.

Acetic acid

An antimicrobial solution noted at a concentration greater than $3.0\%$ for targeting Pseudomonas.

Topical corticosteroids

Topical anti-inflammatory agents that can slow wound healing and cause thinning of the dermis and subcutaneous tissues.

Hypochlorous acid (HOCl)

An antimicrobial agent used in wound care, chemically distinct from hydrochloric acid (HCl).

Tunneling and Undermining

Distinct forms of wound tissue loss where tunneling forms a narrow channel and undermining extends horizontally beneath the wound edge.

Capillary refill edema grading

Refill and recovery intervals classified as immediate for grade 1+, $7\text{ to }8\,\text{seconds}$ for grade 2+, $10\text{ to }12\,\text{seconds}$ for grade 3+, and $20\,\text{seconds to }1\,\text{minute}$ for grade 4+.