PHTH 7577: practical pictures

pressure wound on the heel- mainly partial thickness but don't know how deep the eschar goes so it depends.

what is this?

hemosiderin staining (the brown staining part) and hyprkeratosis (dry thick part of the skin)

what does this show?

pressure wound on buttocks- full thickness, undermining from 11 to 2, tunneling at 6, lots of eschar

what is this?

pressure wound on the buttocks- full thickness (anytime there is undermining it is full thickness), there is undermining from 2 to 5, there is possibly some pink granulation tissue which indicates that it is unhealthy and there is a possible infection

what is this?

diabetic foot wound

what is this?

venous insufficiency wound on the lower leg- there is 40% granulation tissue, 60% nonviable, it's relatively circular, there is hemosideran staining (the dark parts)

what is this?

clean the wound, the debride the slough (sharps, pulse lavage, or enzymatic if really tough), pack the tunnels wth roll gauze, pack the wound with gauze, use barrier cream around the edges, use adhesive foam padding for secondary dressing.

how would you care for this wound?

unstageable pressure wound.

what wound is this?

need to debride in order to stage the pressure wound. Then pack the wound and dress it as you would depending on what stage the pressure wound is at.

what would you do to care for this wound?

stage 3 pressure wound. There's undermining from 11 to 2. Theres tunneling at 8.

what wound is this?

clean and debride the slough with sharps, wiping it, or pulse lavage. Next pack the tunnel with roll gauze, then pack the rest with hydrofiber (if wet) or hydrogel (if dry), could also pack with gauze. For a secondary dressing, use a foam pad.

how would you care for this wound?

stage 1 pressure wound. None blanchabel, intact skin. Can use barrier cream or just put a foam pad on it or hydrocolloid bandage

what wound is this and how do you care for it?

stage 2 pressure wound (think of an intact blister or sun burn). Can use barrier cream or just put a foam pad on it or hydrocolloid bandage.

what wound is this and how do you care for it?

Call the doctor as they may need to stitch up the wound. If the doctor wants to keep it open, pack it with gauze and then use a foam pad as a secondary dressing.

what would you do with this wound.

would debride it and clear the infection. Can use fibroblasts, collagen if it looks like its going to heal good. depends on what's under after you debride it.

how do you care for this wound.

diabetic pressure ulcer?

what type of wound is this?

debride the slough and clean it. Can use fibroblasts and collagen. Pack it with foam. Use the foam heal pad or the unna boot as a contact layer. Then use a secondary dressing to cover it (gauze or foam)

how do you care for this wound?

veinous insufficiency ulcer with hemosideran staining. The pink skin is good (shows that it is healing)

what type of wound is this?

debride with pulse lavage, use collagen and fibroblasts to stimulate healing. Then cover it with the foam pad.

how would you care for this wound?

venous insufficiency wound

what type of wound is this?

there's granulation tissue, so you want the whole wound to become granulation tissue. Debride it with pulse lavage or ultrasound, then cover it with a foam padding.

how would you care for this wound?

This is a stable escharg cap. This mean you do not touch it, YOU PROTECT IT. Cover it with a foam heal cap.

how do you care for this wound?

diabetic pressure ulcer

what wound is this?

how do you care for this wound?