Wound Healing--Severe Dysplasia

Maria King has a wound healing by secondary intention. You educate the student nurse on primary, secondary, and tertiary intention.

Which statement best reflects the difference between primary, secondary, and tertiary intention and should be included in the teaching?

Primary intention typically occurs with surgical closure (sutures); secondary intention occurs when a full thickness wound is allowed to heal without a closure attempt; and tertiary intention occurs when wound closure is delayed. Tertiary intention is a combination of primary intention and secondary intention.

For which reasons may the healthcare provider leave a wound open to heal by secondary intention?

Large amount of exudate

Infection

Size of wound

Necrosis

You are educating the student nurse on the role of cytokines in wound healing.

Which statement by the student nurse indicates an understanding of the teaching?

“Cytokines are small proteins that modulate the wound healing process.”

Which factors impede the healing process?

Advanced age

Malnutrition

Smoking

Excessive edema

You educate Maria on diabetes and its effect on wound healing.

Which statements should be included in the teaching?

Pain sensation may be dulled due to sensory neuropathy caused by diabetes.

Diabetes may lead to a decreased ability to fight infection.

Persistent hyperglycemia may cause decreased tissue perfusion.

Maria’s metabolic status (diabetes) has a significant impact on her overall health. Education regarding controlling diabetes is critical for wound healing.

Which condition, attributed to uncontrolled diabetes, may have an impact on Maria’s wound healing process?

Impaired tissue perfusion due to acceleration of atherosclerosis

You are educating Maria on the extrafascial wound dehiscence that she experienced.

Which statement should you include in the teaching?

“Extrafascial wound dehiscence is the separation of the outer layers of a sutured wound while the underlying fascial layer remains intact.”

Which factors are associated with an increased risk of wound dehiscence?

Suture technique

Diabetes

High dose corticosteroid use

You are assessing Maria’s wound, which has been healing by secondary intention, and observe a mass of connective tissue.

You document the presentation of Maria’s wound. Which documented statement is consistent with Maria’s wound?

A large mass of granulation tissue has initiated on the surface of the wound.

Maria is concerned about scarring. You explain to her that scarring is a normal part of the healing process. You further educate her on the types of scarring that she may encounter.

Which type of scarring will Maria most likely experience?

Fibrosis