N120, Integumentary System sp 2, 2015 PP wk 3.pdf

N120, Integumentary System sp 2, 2015 PP wk 3.pdf -...

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Integumentary System Zoya Minasyan,RN, MSN-Edu
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Wound Healing Regeneration Replacement of lost cells and tissues with cells of the same type Ability to regenerate depends on cell type. Constantly dividing cells that rapidly regenerate Skin, bone marrow, lymphoid organs, as well as mucous membrane cells of the urinary, reproductive, and GI tracts Stable cells such as liver, bone, kidney, and pancreas regenerate in response to injury. Permanent cells such as neurons and skeletal and cardiac muscle do not divide. Neurons are replaced by glial cells or stem cells. Skeletal and cardiac muscle will be repaired with scar tissue.
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Wound Healing Repair Healing as a result of lost cells being replaced with connective tissue The inflammatory reaction may be greater than in primary healing. This results in more debris, cells, and exudates. The debris may have to be cleaned away ( debrided ) before healing can take place. More common than regeneration More complex than regeneration Occurs by primary, secondary, or tertiary intention
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Wound Healing Repair Primary intention Includes three phases Initial phase Granulation phase Maturation phase and scar contraction Initial phase Lasts 3 to 5 days Edges of incision are aligned. Blood fills the incision area, which forms matrix for WBC formation. Acute inflammatory reaction occurs. Granulation phase Lasts 5 days to 3 weeks Fibroblasts migrate to site. Wound is pink and vascular. Surface epithelium begins to regenerate.
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Types of Wound Healing A, Primary intention. B, Secondary intention. C, Tertiary intention. Tertiary intention usually results in a larger and deeper scar than results from primary or secondary intention
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Wound Healing Repair Maturation phase and scar contraction Begins 7 days after injury and continues for several months/years Fibroblasts disappear as wound becomes stronger. Mature scar forms. Secondary intention Wounds that occur from trauma, ulceration, and infection have large amounts of exudates and wide, irregular wound margins with extensive tissue loss. Edges cannot be approximated. Results in more debris, cells, and exudates Tertiary intention Delayed primary intention due to delayed suturing of the wound Occurs when a contaminated wound is left open and sutured closed after the infection is controlled
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Before and After Granulating A, Wound clean but not granulating (note lack of red cobblestone appearance), suggesting heavy bacterial contamination or other impediments to wound healing. B, Same wound granulating after 1 week of topical antibiotic use (note healthy red cobblestone appearance).
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Wound Classification Classified by Cause Surgical or nonsurgical Acute or chronic Depth of tissue affected Superficial, partial thickness, full thickness Color Red Yellow Black May have two or more colors
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Wound drainage Describe any drainage (exudates)
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  • Fall '17
  • Chronic wound