Dermatology Examination - Wound Healing

These flashcards cover key concepts related to wound healing, types of wounds, procedures, and assessment criteria.

What are the three classifications of wound intention?

Primary intention, secondary intention, and tertiary intention.

What defines a clean-contaminated wound?

A wound where respiratory, gastrointestinal, genital or urinary tracts are entered in a controlled and clean manner.

What is an example of a wound that should heal by secondary intention?

Wounds that are not sutured and should heal from the bottom-up.

What are the ABCDE-EFG’s of melanoma?

Asymmetry, Border irregularity, Color variegation, Diameter >6mm, Evolution, Elevated, Firm to Palpation, Growing progressively over weeks.

What factors influence the rate of wound recovery?

Extent of injury, type of damage, intrinsic factors such as comorbidities, circulation, nutrition, and hydration.

What does a yellow wound color indicate?

Clean and remove yellow layer, then cover with moisture-retentive dressing.

What are indicators of a clean wound?

No inflammation, no infection, no break in sterility, and typically results from surgery.

What is the significance of assessing temperature of a wound?

Temperature assessment can help identify the presence of infection or lack of blood flow.

When should primary intention closure be performed?

When wound edges are approximated by a provider using sutures, glue, staples, or steri-strips.

What are the signs of infection in a wound?

Purulent drainage, foul odor, erythema, warmth, tenderness, elevated temperature, edema, non-healing.

What is the definition of a wound?

A wound is a disruption of normal skin structure/function and underlying tissue.

What defines a contaminated wound and how is it typically closed?

A contaminated wound involves fresh trauma or GI spillage; it is typically left open.

What defines a dirty wound and how is it typically closed?

A dirty wound has infection or debris present, such as an animal bite or abscess; it is typically left open.

What are the key assessment principles during wound evaluation?

Assess the patient, not just the wound, by observing, smelling, listening, and touching.

What can a fruity odor in a wound indicate?

A fruity odor suggests a Pseudomonas infection.

Which part of the hand is best used to assess a wound's temperature?

The back of the hand is best for evaluating wound warmth.

What occurs during the Hemostasis phase of wound healing?

Platelets form a clot and vasoconstriction occurs.

What occurs during the Inflammation phase of wound healing?

White blood cells (WBCs) clean debris and infection.

What occurs during the Epithelialization phase of wound healing?

Keratinocytes migrate to cover the wound.

What occurs during the Fibroplasia phase of wound healing?

Collagen deposition and angiogenesis (new blood vessel formation) occur.

What occurs during the Maturation phase of wound healing?

Remodeling of collagen and scar formation occur.

What are the key cells involved in wound healing?

Keratinocytes, fibroblasts, endothelial cells, macrophages, and platelets.

What are some extrinsic factors that can influence wound healing?

Infection, smoking, aging, certain medications (e.g., chemo, steroids), and radiation.

What critical lab values are important for assessing wound healing?

Albumin, blood glucose, and hydration markers.

What does a red wound color indicate and how should it be managed?

A red wound is healthy and granulating; it should be covered and kept moist with a transparent or hydrogel dressing.

What does a black wound color indicate and how should it be managed?

A black wound indicates necrosis or eschar; it requires referral for debridement or specialist care.

What attributes are monitored during wound healing assessment?

Location, size (length x width x depth), age, exudate (color, odor, consistency), pain, temperature, granulation tissue, new epithelium, and wound edges.

What are signs of impaired wound healing?

Necrosis/eschar, hematoma/hemorrhage, and undermined edges.

Describe tertiary (delayed primary) intention wound healing.

The wound is initially left open, then closed after 4-6 days, often requiring debridement and antibiotics (e.g., animal bites, infected wounds).

What defines a superficial wound in terms of layers involved, pain, and infection risk?

Involves the epidermis only, is painful, and has low infection risk.

What defines a partial thickness wound in terms of layers involved, pain, and infection risk?

Involves the epidermis and upper dermis, is painful, and has low infection risk.

What defines a full thickness wound in terms of layers involved, pain, and infection risk?

Extends through the dermis into subcutaneous tissue or deeper, has variable pain, and high infection risk.

What is a key risk associated with abdominal full-thickness wounds?

The risk of bowel evisceration if the omentum is exposed.

What are the key risk factors for melanoma?

Fair skin, light hair/eyes, presence of 50 or more nevi, and a family history of melanoma.

What are clinical patterns used for melanoma diagnosis?

Clinical pattern recognition ('ugly duckling' sign) and the ABCDE-EFG rule.

What does 'A' stand for in the ABCDE-EFG rule for melanoma and what does it mean?

Asymmetry: Uneven halves.

What does 'B' stand for in the ABCDE-EFG rule for melanoma and what does it mean?

Border: Notched or irregular.

What does 'C' stand for in the ABCDE-EFG rule for melanoma and what does it mean?

Color: Varied (red, white, blue, black).

What does 'D' stand for in the ABCDE-EFG rule for melanoma and what does it mean?

Diameter: Greater than 6mm.

What does 'E' (first) stand for in the ABCDE-EFG rule for melanoma and what does it mean?

Evolution: Changes over time.

What does 'E' (second) stand for in the ABCDE-EFG rule for melanoma and what does it mean?

Elevated: Raised above the skin.

What does 'F' stand for in the ABCDE-EFG rule for melanoma and what does it mean?

Firm: Hard on palpation.

What does 'G' stand for in the ABCDE-EFG rule for melanoma and what does it mean?

Growing: Rapid increase in size.

What is recommended for self-skin assessment?

Perform monthly self-checks focusing on new or changing lesions using the ABCDE-EFG criteria and the ugly duckling principle.