Summary
Samenvatting Heelkunde
- Course
- Institution
omvat alle lessen en eigen samengestelde powerpoints met extra info
[Show more]
Seller
Followmarthebraem
Reviews received
Content preview
Verpleegkundig Redeneren & HandelenTheorie Heelkunde
Inleiding............................................................................................................................11
Anatomie en fysiologie......................................................................................................11
1 Het proces van de normale wondheling..........................................................................11
1.1 Inleiding......................................................................................................................................11
1.2 Inflammatoire fase.....................................................................................................................11
1.2.1 Vasodilatatie........................................................................................................................11
1.2.2 Vasoconstrictie....................................................................................................................11
1.2.3 Vasodilatatie........................................................................................................................12
1.3 Granulatiefase............................................................................................................................12
1.4 Maturatiefase.............................................................................................................................12
1.4.1 Bindweefselreorganisatie....................................................................................................12
1.4.2 Wondretractie.....................................................................................................................12
1.4.3 Epithelialisatie......................................................................................................................12
1.5 Littekenvorming..........................................................................................................................13
1.6 Definitie van een wonde.............................................................................................................13
1.6.1 Acute wonden......................................................................................................................13
1.6.2 Chronische wonden.............................................................................................................13
1.7 Factoren die de wondgenezing belemmering.............................................................................13
1.7.1 Factoren eigen aan de wond................................................................................................13
1.7.2 Voedingstoestand................................................................................................................14
1.7.3 Onderliggende pathologie...................................................................................................14
1.7.4 Psychologische toestand en lichaamsbeeld.........................................................................14
1.7.5 Medicijnen en behandeling.................................................................................................15
1.7.6 Leeftijd.................................................................................................................................15
1.7.7 Roken en druggebruik..........................................................................................................15
1.8 Kenmerken van een chronische wonde......................................................................................15
2 Verschillende types wondgenezing.................................................................................15
2.1 Genezing per primam.................................................................................................................16
Primaire wondgenezing................................................................................................................16
2.2 Genezing per secundam.............................................................................................................16
Secundaire wondgenezing............................................................................................................16
2.3 Regeneratieve wondheling.........................................................................................................16
3 Wondclassificatie...........................................................................................................17
1
,3.1 Inleiding......................................................................................................................................17
3.2 Uitzicht en vorm.........................................................................................................................17
3.2.1 Continuïteit van de huid......................................................................................................17
3.2.2 Diepte..................................................................................................................................17
Erosie............................................................................................................................................17
Partial tickness skin loss: verlies van epidermis............................................................................17
Full tickness skin loss: verlies van epidermis en dermis................................................................17
Full tickniss skin loss met blootliggende botten............................................................................17
Brandwonde 1e graad...................................................................................................................17
Brandwonde 2e graad...................................................................................................................17
Brandwonde 3e graad...................................................................................................................17
Brandwonde 4e graad...................................................................................................................17
3.3 Uitgebreidheid............................................................................................................................17
Brandwonden...............................................................................................................................17
3.4 Oorzaak.......................................................................................................................................18
3.4.1 Intentionele wonde.............................................................................................................18
3.4.2 Accidentele of traumatische wonde....................................................................................18
3.4.3 Bestralingswonde................................................................................................................18
3.4.4 Mechanische wonde............................................................................................................18
Snijwonde...................................................................................................................................................18
Steekwonde................................................................................................................................................19
Schaafwonde..............................................................................................................................................19
3.4.5 Chemische wonde................................................................................................................19
3.4.6 Fysische of thermische wonde.............................................................................................20
3.4.7 Ulcus cruris..........................................................................................................................20
3.5 Infectiegraad...............................................................................................................................20
3.5.1 Contaminatie.......................................................................................................................20
3.5.2 Kolonisatie...........................................................................................................................20
3.5.3 Kritische kolonisatie.............................................................................................................20
3.5.4 Evolutie van kolonisatie tot infectie.....................................................................................21
3.5.5 Infectie.................................................................................................................................21
3.5.6 Onderzoek van de wond......................................................................................................22
Lokale tekenen van infectie.......................................................................................................................22
Cultuurafname van wondvocht.................................................................................................................22
Biofilms.......................................................................................................................................................22
3.6 Kleur...........................................................................................................................................23
2
,4 Principes van wondzorg..................................................................................................23
4.1 Inleiding......................................................................................................................................24
4.2 Theorie van vochtige wondgenezing..........................................................................................24
4.3 Wondbedvoorbereiding volgens het TIME-principe...................................................................24
4.3.1 Tissue management.............................................................................................................24
4.3.2 Infection management.........................................................................................................24
4.3.3 Moisture imbalance.............................................................................................................24
4.3.4 Edge of the wound...............................................................................................................25
4.4 Wondreiniging en wondontsmetting..........................................................................................25
Wondreiniging..............................................................................................................................25
Wondontsmetting.........................................................................................................................25
WAR-score....................................................................................................................................26
5 De chirurgische wonde...................................................................................................26
5.1 Inleiding......................................................................................................................................26
5.2 Observatie van chirurgische wonden..........................................................................................26
5.3 Classificatie van chirurgische wonden naar infectierisico...........................................................26
5.3.1 Zuivere wonden...................................................................................................................26
5.3.2 Zuiver-besmette wonden.....................................................................................................27
5.3.3 Besmette wonden................................................................................................................27
5.3.4 Vuile geïnfecteerde wonde..................................................................................................27
5.4 Classificatie van postoperatieve wondinfecties naar locatie (POWI)..........................................27
5.4.1 Oppervlakkige incisionele postoperatieve wondinfectie.....................................................27
5.4.2 Diepe incisionele postoperatieve wondinfectie...................................................................28
5.4.3 Postoperatieve wondinfectie van organen en anatomische ruimten..................................28
5.5 Factoren die de chirurgische wondheling belemmeren..............................................................28
5.6 Verwijderen van hechtingen.......................................................................................................28
6 Wondbehandeling..........................................................................................................29
6.1 Inleiding......................................................................................................................................29
6.2 Debridement...............................................................................................................................29
6.2.1 Definitie...............................................................................................................................29
6.2.2 Indicatie en contra-indicatie................................................................................................30
6.2.3 Soorten debridement..........................................................................................................30
Autolytisch debrideren...............................................................................................................................30
Osmotisch debrideren................................................................................................................................30
Chirurgisch debrideren...............................................................................................................................31
Mechanisch debrideren.............................................................................................................................31
3
, Enzymatisch debrideren.............................................................................................................................32
Biochirurgisch debrideren..........................................................................................................................32
6.3 Het ideale wondverband............................................................................................................33
Inhibeert het fysiologisch wondhelingsproces niet......................................................................33
Bewaart de vochtige omgeving en laat gasuitwisseling toe..........................................................33
Biedt thermische isolatie..............................................................................................................33
Biedt mechanische bescherming..................................................................................................33
Is vrij van specifieke contaminanten.............................................................................................33
Is patiëntvriendelijk......................................................................................................................33
Is kosteneffectief..........................................................................................................................33
Laat inspectie van de wond en een correcte wondevaluatie toe..................................................33
Kan langere tijd ter plaatse blijven...............................................................................................34
6.4 Soorten wondverbanden............................................................................................................34
6.4.1 Anti-infectieuze middelen....................................................................................................34
Samenstelling.............................................................................................................................................34
Werkingsmechanisme................................................................................................................................34
Indicaties....................................................................................................................................................34
Contra-indicaties........................................................................................................................................34
Ongewenste effecten.................................................................................................................................34
Voorzorgen.................................................................................................................................................34
Praktisch.....................................................................................................................................................34
Samenstelling.............................................................................................................................................35
Werkingsmechanisme................................................................................................................................35
Indicaties....................................................................................................................................................35
Contra-indicaties........................................................................................................................................35
Gebruiksaanwijzing....................................................................................................................................35
Vaak ten onrechte gebruikt.......................................................................................................................35
6.4.2 Primaire wondverbanden (actief)........................................................................................35
Doel............................................................................................................................................................35
Voordelen...................................................................................................................................................35
Nadelen......................................................................................................................................................35
Indicaties (TIME).........................................................................................................................................35
Behandeling infectie..................................................................................................................................36
Indicaties (kleur).........................................................................................................................................36
Voorbereiding en gebruik..........................................................................................................................36
Indicaties....................................................................................................................................................36
Indicaties....................................................................................................................................................36
4
The benefits of buying summaries with Stuvia:
Guaranteed quality through customer reviews
Stuvia customers have reviewed more than 700,000 summaries. This how you know that you are buying the best documents.
Quick and easy check-out
You can quickly pay through credit card or Stuvia-credit for the summaries. There is no membership needed.
Focus on what matters
Your fellow students write the study notes themselves, which is why the documents are always reliable and up-to-date. This ensures you quickly get to the core!
Frequently asked questions
What do I get when I buy this document?
You get a PDF, available immediately after your purchase. The purchased document is accessible anytime, anywhere and indefinitely through your profile.
Satisfaction guarantee: how does it work?
Our satisfaction guarantee ensures that you always find a study document that suits you well. You fill out a form, and our customer service team takes care of the rest.
Who am I buying these notes from?
Stuvia is a marketplace, so you are not buying this document from us, but from seller marthebraem. Stuvia facilitates payment to the seller.
Will I be stuck with a subscription?
No, you only buy these notes for $17.27. You're not tied to anything after your purchase.
Can Stuvia be trusted?
4.6 stars on Google & Trustpilot (+1000 reviews)
84190 documents were sold in the last 30 days
Founded in 2010, the go-to place to buy study notes for 14 years now