Alterations in Wound Healing, Pressure Injuries, Skin Infections, and Burns

Comprehensive vocabulary flashcards covering wound anatomy, phases of healing, chronic ulcer types, pressure injury staging, inflammatory skin conditions, and burn management.

Epidermis

The outer layer of skin that creates a protective, waterproof barrier and helps prevent fluid loss and infection.

Dermis

The layer of skin containing blood and lymph vessels, nerves, hair follicles, and sweat glands, responsible for supplying oxygen and nutrients to skin tissue.

Hypodermis

The deeper subcutaneous skin layer made mainly of connective tissue and fat that cushions the body and contains sensory nerves and blood vessels.

Hemostasis and Inflammation Phase

The initial wound-healing stage characterized by vasoconstriction, clotting cascade activation, fibrin mesh stabilization, followed by vasodilation and neutrophil migration to clear bacteria and damaged tissue.

Proliferation Phase

The wound-healing phase beginning around day 3 and lasting weeks, characterized by angiogenesis, granulation tissue formation, fibroblast activity, and epithelialization.

Tissue Remodeling Phase

The final healing phase beginning around day 21 and lasting up to a year, during which type III collagen is replaced by stronger type I collagen, excess vessels regress, and wound edges contract.

Hypertrophic Scar

An abnormal scar resulting from excess collagen formation that remains confined within the original wound borders and may shrink over time.

Keloid

An abnormal scar characterized by excess tissue that extends beyond the original wound boundaries and may continue to grow.

Arterial Ulcer

A chronic wound occurring on toes or areas with poor arterial blood supply, presenting with a deep, punched-out look, smooth well-defined borders, and surrounding cool, pale, hairless skin.

Venous Ulcer

A chronic, typically shallow wound that commonly appears on the medial lower leg and is frequently accompanied by lower-extremity edema.

Diabetic Ulcer

A chronic wound commonly occurring on weight-bearing areas of the foot, often rendered less noticeable to the client due to peripheral neuropathy.

Undermining

Tissue destruction or damage extending laterally beneath intact skin along the margins or edges of a wound.

Tunneling

A narrow passage or tract extending from the wound bed into surrounding deeper tissues.

COCA

A clinical mnemonic used to document and evaluate wound drainage: Color, Odor, Consistency, and Amount.

STONEES

A mnemonic identifying signs of chronic wound infection: Size becoming larger, Temperature increasing, Os (bone) exposed, New breakdown, Erythema, Exudate, and Smell.

Ankle-Brachial Index (ABI)

A noninvasive vascular assessment tool used to assess lower-extremity arterial flow; a value below $0.9$ indicates arterial perfusion impairment.

Pressure Injury

Localized damage to the skin and/or underlying tissue resulting from prolonged, intense pressure or pressure combined with shear, typically over bony prominences.

Braden Scale

A standardized risk assessment tool for pressure injuries that evaluates sensory perception, moisture, activity, mobility, nutrition, and friction/shear.

Stage 1 Pressure Injury

A localized area of intact skin displaying persistent, nonblanchable erythema over a pressure area.

Stage 2 Pressure Injury

Partial-thickness loss of skin with exposed dermis, appearing as a shallow, moist, pink or red wound bed or as an intact or ruptured serum-filled blister.

Stage 3 Pressure Injury

Full-thickness skin loss where subcutaneous fat may be visible, often with granulation tissue, rolled edges, slough, or eschar, but without exposed muscle, tendon, cartilage, or bone.

Stage 4 Pressure Injury

Full-thickness skin and tissue loss with directly visible or palpable fascia, muscle, tendon, ligament, cartilage, or bone.

Unstageable Pressure Injury

A full-thickness pressure injury in which the extent of tissue damage cannot be confirmed because the wound bed is obscured by slough or eschar.

Deep Tissue Pressure Injury (DTPI)

Intact or nonintact skin featuring localized, persistent nonblanchable deep red, maroon, or purple discoloration, or epidermal separation presenting as a blood-filled blister.

Biofilm

A structured community of microorganisms embedded in a self-produced sticky extracellular matrix adhering to the wound surface, increasing resistance to antimicrobials.

Infection Continuum

The clinical progression of microorganisms in a wound characterized sequentially as contamination, colonization, local infection, spreading infection, and systemic infection.

Cellulitis

A bacterial infection of the dermis and subcutaneous tissues characterized by spreading erythema, warmth, localized edema, and tenderness.

Impetigo

A superficial contagious bacterial skin infection presenting with itchy sores that rupture, ooze, and form characteristic honey-yellow crusts, often around the nose and mouth.

Anaphylaxis

A severe, life-threatening systemic hypersensitivity reaction marked by respiratory distress, throat constriction, hypotension, and hives, requiring immediate intramuscular epinephrine.

Necrotizing Fasciitis

A severe, rapidly progressive soft-tissue infection marked by intense pain disproportionate to exam findings, bullae, edema, crepitus, and systemic toxicity requiring emergency surgical intervention.

Coagulation Zone

The central zone of a thermal burn closest to the heat source where cellular proteins have coagulated and tissue destruction is irreversible.

Stasis Zone

The intermediate zone surrounding the burn center characterized by compromised blood flow, where tissue ischemia can either recover or progress to necrosis based on resuscitation.

Hyperemia Zone

The outermost peripheral area of a burn characterized by vasodilation and increased perfusion, which typically recovers without permanent structural damage.

Superficial Partial-Thickness Burn

A burn involving the epidermis and papillary dermis, characterized by pink or red moist tissue, painful blistering, and intact capillary refill.

Full-Thickness Burn

A burn causing complete destruction of the epidermis and dermis, presenting with a dry, leathery, white, brown, or charred appearance, with absent capillary refill and loss of sensation in the center.

Parkland Formula

A traditional resuscitation formula calculating fluid requirements as $4\,\text{mL} \times \text{weight (kg)} \times \%\,\text{TBSA}$, administering half in the first $8\,\text{hours}$ from burn onset and half over the following $16\,\text{hours}$.

Escharotomy

A surgical incision through nonviable, inelastic burn eschar to relieve constriction and prevent compartment syndrome or chest wall compromise in circumferential burns.

Fasciotomy

A surgical incision that opens the deep muscle fascia to decompress high tissue pressures inside a muscular compartment, indicated in deep or high-voltage electrical injuries.

Autograft

Skin taken directly from a donor site on the client's own body to achieve permanent coverage of an excised wound or burn.

Skin Tear

An acute traumatic separation of skin layers caused by shear, friction, falls, or adhesive removal, commonly seen in older adults with epidermal atrophy.

Wound Dehiscence

The mechanical separation or splitting open of previously approximated margins along a surgical incision line.

Wound Evisceration

The emergency protrusion of internal organs or abdominal viscera through an opened, dehisced surgical wound.

Negative-Pressure Wound Therapy

An advanced wound care system that applies continuous or intermittent subatmospheric vacuum suction through a sealed dressing to evacuate fluid and stimulate granulation.