Pressure Injuries
What is a stage 1 Pressure injury categorized by?
What is: Intact skin with localized area of non-blanchable erythema.
What are the three phases of wound healing, and what occurs in each phase?
What is: Inflammatory phase (hemostasis and inflammation)
proliferative phase (granulation and tissue formation),
maturation phase (remodeling of collagen and strengthening of the tissue).
What is psoriasis, and what are its common treatments?
What is: Psoriasis is a chronic autoimmune skin disorder characterized by red, scaly plaques
Treatments include topical corticosteroids, vitamin D analogs, phototherapy, and systemic medications
What is the difference between herpes simplex virus type 1 (HSV-1) and type 2 (HSV-2) in terms of common sites of infection?
What is: HSV-1 typically causes oral infections, such as cold sores, while HSV-2 primarily causes genital infections; both can cause infections in other areas.
What is the purpose of using alginate dressings in wound care?
What is:
Alginate dressings are used for wounds with moderate to heavy exudate as they can absorb significant amounts of fluid and form a gel-like substance, promoting a moist healing environment and aiding in debridement.
Describe the clinical presentation and treatment focus for a Stage 2 pressure injury?
What is: Partial-thickness skin loss with exposed dermis, presenting as a shallow open ulcer or a blister; treatment focuses on maintaining a moist wound environment and preventing infection.
Explain the difference between first intention and second intention wound healing, including examples of each.
What’s is:
First intention (primary) healing occurs in clean, surgical wounds with edges that are approximated; second intention
Secondary intention (secondary) healing occurs in wounds with tissue loss, such as pressure ulcers, where the wound heals by granulation, contraction, and epithelialization.
Describe the pathophysiology and clinical presentation of eczema
What is: Eczema, or atopic dermatitis, is a chronic inflammatory skin condition resulting from a combination of genetic, immunologic, and environmental factors
It presents with pruritic, erythematous, and scaly lesions.
Describe the presentation and treatment of cellulitis.
Cellulitis is an acute bacterial infection of the dermis and subcutaneous tissue, presenting with redness, swelling, warmth, and pain
Treatment includes systemic antibiotics, such as cephalexin or clindamycin.
Explain the purpose of using hydrocolloid dressings in wound care.
What is:
Hydrocolloid dressings maintain a moist wound environment, promote autolytic debridement, and protect the wound from external contaminants; they are used for partial and full-thickness wounds with low to moderate exudate.
What are the hallmark features of a Stage 3 pressure injury, and what complications may arise?
What is : Full-thickness skin loss with visible adipose tissue, granulation tissue, and possible tunneling; complications include infection and delayed healing.
Describe the role of collagen in wound healing and the impact of nutritional deficiencies.
What is : Collagen provides structural support to the wound and is essential for tissue strength and integrity; deficiencies in vitamin C, protein, and other nutrients can impair collagen synthesis and delay healing.
Explain the differences between bullous pemphigoid and pemphigus vulgaris in terms of pathophysiology and clinical presentation.
What is:
Bullous pemphigoid is an autoimmune blistering disorder with subepidermal blisters caused by autoantibodies against hemidesmosomes
Pemphigus vulgaris involves intraepidermal blisters due to autoantibodies against desmoglein, presenting with flaccid blisters and erosions.
What are the clinical manifestations of impetigo, and what organisms commonly cause it?
What is: Impetigo presents with honey-colored crusted lesions, primarily on the face and extremities; it is commonly caused by Staphylococcus aureus and Streptococcus pyogenes.
Describe the types of exudate and their clinical significance in wound assessment.
What is:
Types of exudate include serous (clear, watery), sanguineous (bloody), serosanguineous (clear and blood-tinged), purulent (thick, yellow/green, indicates infection)
Exudate type and amount provide information about the wound's healing status and potential complications.
How does the presence of slough or eschar impact the staging and management of a pressure injury?
What is : Slough or eschar obscures the wound bed, making the pressure injury unstageable until it is removed to assess the depth and extent of tissue damage.
Discuss the significance of wound dehiscence and factors that increase its risk.
What is: Wound dehiscence is the partial or complete separation of wound edges
Risk factors include infection, poor nutrition, obesity, excessive strain on the wound, and certain medical conditions
What are the clinical features and risk factors for developing melanoma?
What is:
Melanoma is characterized by asymmetric, irregularly bordered, multi-colored lesions that can change in size and shape
Risk factors include excessive UV exposure, fair skin, a history of sunburns, and a family history of melanoma.
Explain the epidemiology and management of methicillin-resistant Staphylococcus aureus (MRSA) skin infections.
What is: MRSA is a resistant strain of Staphylococcus aureus that commonly causes skin and soft tissue infections
Management includes incision and drainage of abscesses and antibiotic therapy based on susceptibility testing
What are the types of wound debridement, and when is each type indicated?
What is:
Types of wound debridement include surgical (for large, necrotic tissue), mechanical (wet-to-dry dressings), enzymatic (topical enzymes), autolytic (using body's own enzymes), and biological (maggot therapy); the choice depends on the wound type, location, and patient condition.
Discuss the role of the Braden Scale in preventing pressure injuries and the key factors it assesses.
What is: The Braden Scale is a tool used to predict pressure injury risk, assessing six factors: sensory perception, moisture, activity, mobility, nutrition, and friction/shear.
What is the role of negative pressure wound therapy (NPWT) in wound healing, and what types of wounds benefit most from this treatment?
What is: NPWT involves applying a vacuum dressing to promote wound healing by removing exudate, reducing edema, and enhancing perfusion; it is beneficial for chronic wounds, large open wounds, and wounds with significant exudate.
Discuss the mechanism of action and side effects of systemic retinoids used in treating severe acne.
What is:
Systemic retinoids, such as isotretinoin, reduce sebaceous gland size and sebum production, normalize keratinization, and have anti-inflammatory properties
Side effects include teratogenicity, mucocutaneous effects, and potential liver enzyme elevation.
What are the signs and symptoms of necrotizing fasciitis, and why is early intervention critical?
Necrotizing fasciitis presents with severe pain, erythema, edema, and rapid progression to tissue necrosis
Early intervention with surgical debridement and broad-spectrum antibiotics is critical to prevent systemic toxicity and death.
Discuss the role of biofilms in chronic wounds and the strategies used to manage them.
What is: Biofilms are communities of bacteria encased in a protective matrix that adhere to the wound surface, contributing to chronic infection and delayed healing
Management includes debridement, antimicrobial dressings, and systemic antibiotics when necessary.