1. MNA Mosby’s Long Term Care Assistant Chapter 35 Wound Care

2. Wound Care Skin is body’s first line of defense
Wound is a break in the skin or mucous membrane
Portal of entry for microbes

3. Types of Wounds Abrasion Contusion Incision Laceration
Penetrating wound
Puncture wound
Scraping or rubbing away of skin
Closed wound caused by blow to body. bruise
Open, clean straight edges
Open, torn, jagged edges
Open, Skin is pierced
Open, made by sharp object

4. Types of Wounds
Abrasion

5. Types of Wounds
Contusion

6. Types of Wounds
Incision

7. Types of Wounds
Laceration

8. Types of Wounds
Penetrating
Wound

9. Types of Wounds
Puncture
Wound

10. Portal of entry for microbes
Skin Tears
Break or rip in skin
Thin fragile skin
Slight pressure can cause a tear
Causes:
friction, shearing
Holding too tightly
Removing tape, band aide
Bumping against something
Portal of entry for microbes

11. Leg and Foot Ulcers Edema - swelling Gangrene - death of tissue
Circulatory Ulcers – open wounds on legs and feet due to  blood flow
Venous Ulcers (Stasis Ulcers) - open wounds on legs and feet due to  venous return. Blood pools in feet and legs

12. Leg and Foot Ulcers Causes: Risk Factors: Chronic diseases Obesity
Inactivity
Risk Factors:
Hx of blood clots
Mobility
Age

13. Leg and Foot Ulcers Prevention and TX TED Hose
Avoid constricting clothing
Good foot care
Reposition Q2H
Feet
Protective devices
Observation

14. TED Hose Elastic stockings Thrombus – blood clot Sizes:
Embolus – traveling blood clot
Anti Thromboemboletic Hose
Sizes:
Knee high
Thigh high

15. TED Hose
Apply Ted Hose
Remove for 30 minutes every 8 hours (Qshift) for foot care and Circ Checks

16. Heat and Cold Applications
Promote healing and comfort
Reduce tissue swelling

17. Heat and Cold Applications
Observe skins q5 minutes
Apply no longer then minutes
Hot: never higher then 106 F
Cold: never lower then 50 F

18. Heat Applications Relieves pain Relaxes muscles
Decreases joint stiffness
Promotes healing
Reduces tissue swelling
Blood vessels dilate (widen)
Blood flow increases
More blood = more O2 = faster healing
Can cause burns

19. Heat Applications Moist: Hot compress Hot soaks Sitz Baths Dry:
Aquathermia pad
Soft pad
Body part immersed in water
Perineal and rectal area immersed in water
Like a heating pad

20. Sitz Bath Placed on toilet seat
Observe for signs of dizziness or fainting.

21. Cold Applications Blood vessels constrict (get smaller) Reduce pain
Blood flow decreases
Can cause pain, burns blisters and poor circulation
Reduce pain
Prevent swelling
Decrease circulation
Decrease bleeding
Numbs

22. Cold Applications
Cold Compresses
Ice bags
Ice collers
Ice Gloves

23. Remember…… Older persons require special skin care.
Protein is an essential nutrient for skin repair
Follow Standard Precautions

24. Review
Swelling?
edema

25. Review
Incision

26. Review
A closed wound caused by a blow to the body ?
contusion

27. Review
Embolus ?
Traveling blood clot

28. Review
gangrene ?
Death of tissue

29. Review
Thrombus ?
Blood clot

30. Bony prominence Review Skin tears usually occur over a
_______________.
Bony prominence

31. Review
Contusion

32. Review
Elastic stocking are called
___________________.
TED hose

33. Review
Puncture
Wound

34. Review
Ted Hose (elastic stocking) are used to increase circulation
True or False

35. Review
Penetrating
Wound

36. Review
Ted Hose (elastic stocking) are used to hold dressings in place
True or False

37. Review
Ted Hose (elastic stocking) are used to promote healing
True or False

38. Review
Abrasion

39. Review
Ted Hose (elastic stocking) are used to prevent injury
True or False

40. Review
Protein is the most important nutrient for wound healing.
True or False

41. Review
Severely underweight?
A. obesity
anemia
paralysis
emaciation

42. Review
Laceration

43. Review
Constrict means
Get smaller, narrow

44. Heat applications Review Relaxe muscles Decrease joint stiffness
Relieve pain
Relaxe muscles
Decrease joint stiffness
Promote healing
Reduce tissue swelling

45. Weakness, dizziness and faintness
Review
During a sitz bath, you need to carefully observe the person for
Weakness, dizziness and faintness

46. Review
NPO PC AC
Qid
Tid
Nothing by mouth
After meals
Before meals
4x day
3x day

47. Questions??