Chapter 36 – Wounds
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• Factors Affecting Skin Integrity
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o Genetics And Heredity v/ v/
o Age
o Chronic Illness And Their Treatments
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o Medications - Antibiotics, Decreased Immune System Drugs, v/ v/ v/ v/ v/ v/
Steroids (Increase Bp), And People With A Sugary Base, Like
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Diabetics, TendTo Have An Increased Risk Of Infection
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o Poor Nutrition v/
Types Of Wounds
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o Wounds Are Either Intentional Or Unintentional
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▪ Intentional
• Trauma That Occurs During Therapy v/ v/ v/ v/
• Example: Operations Or Venipunctures v/ v/ v/
▪ Unintentional
• Accidental
• Example: A Person May Fracture An Arm In An Automobile Collision v/ v/ v/ v/ v/ v/ v/ v/ v/ v/
o Classifying Wounds By Depth v/ v/ v/
▪ Partial Thickness: Confined To The Skin, That Is, The v/ v/ v/ v/ v/ v/ v/ v/
DermisAnd Epidermis; Heal By Regeneration
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▪ Full Thickness: Involving The Dermis, Epidermis, Subcutaneous Tissue,
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AndPossibly v/ v/
Muscle And Bone; Require Connective Tissue Repair v/ v/ v/ v/ v/ v/
o Wounds Contamination v/
▪ Clean Wounds: Infected Wounds In Which There Is Minimal
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Inflammation And The Respiratory, Gastrointestinal, Genital
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AndUrinary Tracts Are Not Entered. Clean Wounds Are
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Primarily Closed Wounds.
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▪ Clean-Contaminated Wounds: Surgical Wounds In Which v/ v/ v/ v/ v/
The Respiratory, Gastrointestinal, Genital Or Urinary Tract Has
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Been Entered. Such Wounds Show No Evidence Of
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Inflammation. v/
▪ Contaminated Wounds: Include Open, Fresh, Accidental Wounds v/ v/ v/ v/ v/ v/
And Surgical Wounds Involving A Major Break In Sterile
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, TechniqueOr A Large Amount Of Spillage From The
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Gastrointestinal Tract. Contaminated Wounds Show Evidence Of
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Inflammation.
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▪ Dirty Or Infected Wounds: Include Wounds Containing Dead
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Tissue And Wounds With Evidence Of A Clinical Infection,
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SuchAs Purulent Drainage.
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o Types Of Wounds
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▪ Incision
• Cause: Sharp Instrument (Ex: Knife/Scalpel) – Surgical/Cut
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• Open Wound; Deep Or Shallow; Once The Edges Have Been
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, Sealed Together As A Part Of Treatment Or Healing, The
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• Incision Becomes A Closed Wound
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Nur 155 Exam 3
Review Notes
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, ▪ Contusion
• Cause: Blow From A Blunt Instrument – Baseball Bat
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• Closed Wound; Skin Has v/ v/ v/
Ecchymosis (Bruised) Because Of
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Damaged BloodVessels
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▪ Abrasion
• Cause: Surface Scrape, Either Intentional (Dermal v/ v/ v/ v/ v/
Abrasion To Remove Pockmarks) Or
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Unintentional(Scraped Knee From A Fall)
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• Open Wound Involving The Skin v/ v/ v/ v/
▪ Puncture
• Cause: Penetration Of The Skin v/ v/ v/ v/
And Often The Underlying
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Tissues By A Sharp Instrument,
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Either Intentional Or
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Unintentional (Goes In &
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ComesOut – Traps Bacteria)
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• Open Wound v/
▪ Laceration
• Cause: Tissues Torn v/ v/
Apart,Often From
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Accidents (Ex:
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Machinery)
• Open Wound; Edges Are Often Jagged v/ v/ v/ v/ v/
▪ Penetrating Wound v/
• Penetration Of The Skin And The Underlying Tissues, v/ v/ v/ v/ v/ v/ v/
Usually Unintentional (Ex: From A Bullet Or Metal Fragments)
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• Open Wound v/
o Different Ways To Close A Wound
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▪ Before Closing A Wound Make Sure Its Clean
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▪ Sutures- 7-10 Days (Jagged Laceration)
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• When Taking Off, Hold v/ v/ v/
Knot With Tweezers, Cut
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One Side Closest To The
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Skin And Pull Longest
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Sidev/
– This Prevents The
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DirtySuture From Being
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PulledThrough Skin
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(Avoids Contamination).
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• Used For Deep Tissue Wounds v/ v/ v/ v/
• Absorbent Sutures v/
AreUsed Deep In The
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