Integumentary 2

what is the most common cause of PAD

atherosclerosis

risk factors for arterial ulcers (be able to name 3)

• HTN

• high cholesterol

• high triglycerides

• tobacco

• obesity

• diabetes

• family hx

• increased age

• inflammatory diseases

symptoms that are associated with PAD (and arterial wounds)

• intermittent claudication

• painful, resting pain, night cramps

• leg numbness/weakness

• diminished pulse

• hair loss/slow growing toe nails

• ischemia

• atrophy/cramps

arterial wounds

edges well defined and circular with a dry wound base and scant drainage.

dressing selection for arterial wounds

gel, gel sheets, vaseline gauze

risk factors for venous ulcers (be able to name 3)

• age

• family hx

• female sex

• history of DVT

• obesity

• poor calf muscle pump

• pregnancy

• immobility/ sedentary life

• sitting or standing for long periods

venous wound presentation

irregular edges and shaped wound that is wet with moderate to heavy drainage. Often located at the medial part of the lower leg and is painful

dressing selection for venous wounds

dry gauze/pad, alginate, or foam WITH compression

gold standard treatment for venous insufficiency

compression, best when accompanied with elevation and exercise (helps venous return)

Role of physical therapy for all wounds

• TIME

• refer to wound specialist

• educate on the benefits of exercise

• encourage good nutrition (protein for wound healing)

• further pt education

pt education for venous wounds

• edema control

• compression

• elevation

• avoid salty foods

• exercise/muscle pump

diabetic wound risk factors (know 3)

• arterial disease (arteriosclerotic)

• impaired immune response

• neuropathy

• abnormal foot function

• inadequate foot wear

diabetic wound characteristics

Round, punched out wound with regular borders that has scant to minimal drainage. The peri-wound will be dry with scaly skin and thick toenails.

wet wound dressing selection

dry gauze, alginate, foam

dry wound dressing selection

gel, gel sheet, vaseline gauze

infected wound dressing selection

silver/iodine antimicrobial dressing

diabetic foot wound management

• off-loading

• diabetic shoes

• CROW boot for deformities

• diabetic management education/diabetes clinic

Pressure injury wound risk factors (know 3)

• prolonged pressure/immobility

• friction/shear force

• pt tissue tolerance (nutrition, aging, moisture, etc)

stage 1 pressure injury

• non-blanchable erythema of intact skin

• area may be painful and differ from surrounding area

stage 2 pressure injury

• partial thickness injury

• exposed dermis

• shallow open wound with red/pink wound bed

• can present as intact or open blister

stage 3 pressure injury

• full thickness injury with skin loss

• exposed adipose AND subcutaneous tissue

• underlying fascia NOT exposed

stage 4 pressure inury

• full thickness wound with exposed fascia, bone, tendon, or muscle

• extensive necrosis

unstageable pressure injury

• type of full thickness wound with an unknown depth

• wound obscured by slough or eschar

deep tissue pressure injury

• dark purple discoloration of intact skin

• blood-filled blister or epidermal separation