Lecture Notes: Wound Care and Pain Physiology

Vocabulary flashcards covering skin assessment terms, phases of wound healing, types of wound closure, complications of healing, and the physiological processes and types of pain.

Pallor

A skin assessment finding indicating impaired circulation.

Erythema

Red skin indicating increased capillary blood flow associated with inflammation.

Stasis ulcers

Wounds that develop when venous insufficiency exists, generally in lower extremities, allowing deoxygenated blood to pool in the veins.

Sinus Tracts

A channel or tunnel that develops between $2$ cavities or between an infected cavity and the surface of the skin, also known as a fistula.

Surgical incisions

Wounds intentionally made with sharp instruments that are linear with more defined edges.

Inflammatory Phase

Healing phase that occurs when the wound is fresh and includes both hemostasis and phagocytosis.

Reconstruction Phase

Also referred to as the Proliferation Phase, it begins when the wound starts to heal and lasts for about $21$ days after the injury.

Maturation Phase

Known as the remodeling phase, this occurs when the wound contracts and the scar strengthens.

Primary intention

Wound closure for clean wounds with little tissue loss where edges are approximated and closed using sutures, glue, staples, or stitches.

Secondary intention

Wound closure used when there is greater tissue loss and irregular wound edges that cannot be brought together.

Tertiary intention

Wound closure where the wound is left open for a time to allow granulation tissue to form before it is sutured closed.

Hypoxemia

A factor affecting healing where a lack of $O_2$ to the wound from the bloodstream causes impaired healing.

Ischemia

A lack of blood supply to an area caused by extra tension on wounds.

Necrosis

Death of tissue due to a lack of blood supply.

Wound dehiscence

A serious complication occurring when partial or complete separation of the outer layers of the wound occurs.

Evisceration

A life-threatening complication where an abdominal wound reopens and abdominal contents or organs protrude.

Sanguineous

Wound drainage that consists of blood.

Serosanguineous

Wound drainage that appears pink in color.

Serous

Wound drainage that is clear or slightly yellow fluid.

Nociception

Observable activity in the nervous system that allows people to detect pain through a series of $4$ physiological processes.

Transduction

The first process of nociception where a thermal, mechanical, or chemical stimulus is converted into electrical impulses at the peripheral pain nerve fiber.

Transmission

The process of nociception where impulses travel to the spinal cord via myelinated A-delta fibers or unmyelinated C fibers.

Perception

The stage of nociception where the brain interprets the quality of pain and the person becomes aware of the pain.

Modulation

The final stage of nociception where neurons activate inhibitory mediators like endorphins, serotonin, and GABA to help produce an analgesic effect.

Acute/Transient pain

Protective pain with an identifiable cause and short duration, which often slows overall recovery.

Chronic/Persistent pain

Non-protective, prolonged pain that varies in intensity and may result in disability.

Chronic Episodic pain

Pain that occurs sporadically over an extended period of time, such as migraine headaches.

Idiopathic Pain

Chronic pain that either lacks an identifiable cause or is perceived as excessive for the extent of the condition.

Somatic Pain

Nociceptive pain arising from bone, joint, muscle, skin, or connective tissue, often described as aching or throbbing.

Visceral pain

Nociceptive pain arising from internal organs such as the GI tract or pancreas, characterized by aching or cramping.

Neuropathic Pain

Pain caused by a lesion or disease of the somatosensory nervous system, such as a peripheral nerve injury.