Surgical Asepsis, Pressure Injuries, and Wound Healing

Practice flashcards covering the principles of surgical asepsis, risk factors and stages of pressure injuries, and the phases and types of wound healing based on lecture notes.

Post-operative pain

Acute pain resulting from a surgical procedure that can potentially turn chronic.

Cancer Pain

Pain caused by the disease itself, its treatment, or a combination; it can be acute or chronic and involves the existential life and death dimension of cancer.

Principles of Surgical Asepsis

Rules to prevent microorganism transfer, including knowing what is sterile, knowing what is not sterile, keeping sterile and non-sterile separate, maintaining a sterile field, and using hand hygiene.

Sterile field height rule

Sterile items must be kept above the waist; anything below the waist is considered "contaminated."

Shear

Sliding movement of skin and subcutaneous tissue while underlying bone/muscle does not move; damage occurs at deeper fascial levels over bony prominences.

Friction

Two forces sliding but unable to move; it affects the epidermis (top layer), appears red and painful, and often occurs in restless patients.

MASD

Defined as inflammation/erosion of skin caused by moisture, which reduces skin resistance to pressure, friction, and shear.

Nonblanchable erythema

Redness of the skin that does not fade when pressed; a characteristic finding in Stage 1 pressure injuries.

Stage 1 pressure injury

Intact skin with a localized area of nonblanchable erythema; color changes may be present but are not purple or maroon.

Stage 2 pressure injury

Partial-thickness skin loss with exposed dermis; the wound bed is pink/red and moist, and may present as a ruptured or intact blister.

Stage 3 pressure injury

Full-thickness skin loss where adipose tissue and granulation tissue are visible; undermining and tunneling may occur, but fascia, bone, and muscle are not exposed.

Stage 4 pressure injury

Obscured full-thickness skin and tissue loss with exposed fascia, muscle, bone, tendon, or ligaments; often includes epibole, undermining, and tunneling.

Unstageable pressure injury

Full-thickness skin and tissue loss that cannot be confirmed because the depth is obscured by slough or eschar.

Deep-tissue pressure injury

Intact or non-intact skin with localized area of persistent nonblanchable deep red, maroon, or purple discoloration; may reveal a dark wound bed or blood-filled blister.

Primary Intention

Healing of a clean surgical incision where skin edges are approximated (closed); involves low risk of infection and minimal scar formation.

Secondary Intention

Healing of wounds involving tissue loss (burns, Stage 2 pressure injuries, or severe lacerations) that are left open to fill with scar tissue; takes longer and has a greater infection risk.

Tertiary Intention

Healing process where a wound is left open for a period to allow granulation tissue to form before being sutured closed.

Partial-thickness wound repair

Repair of shallow wounds involving the loss of epidermis and possibly dermis; consists of the inflammatory response, epithelial proliferation/migration, and reestablishment of epidermal layers.

Full-thickness wound repair

Repair of wounds extending to the dermis (Stage 3 and 4 pressure injuries) through four phases: hemostasis, inflammatory phase, proliferation, and remodeling/maturation.

Hemostasis

The phase of wound repair that controls blood loss and establishes bacterial control; involving blood vessel constriction and platelet gathering to form clots.