ANSWERS (GRADED A+)
Initial Assessment Goals - ANSWER-1. etiologic factors 2. systemic factors and
comorbidities 3. recommendations for management 4. determine phase of healing
5.determine goals of topical therapy
Hyperglycemia impairs... - ANSWER-leukocyte function when >180; collagen synthesis;
development of tensile strength; epithelial resurfacing
Random BG goals - ANSWER-<140
A1C goal for wound healing - ANSWER-<7
Nutrients essential for collagen synthesis - ANSWER-Zinc, glutamine, 1-arginine
Unplanned weight loss parameters indicative of malnutrition - ANSWER-greater than or
equal to 2.5% within 30 days; greater than or equal to 10% in 180 days; 5% in longterm
care settings
Lab values indicative of malnutrition - ANSWER-Albumin <3.5; transferrin <100; pre-
albumin <19.5; total lymphocyte count >1500
Recommended caloric intake for wound healing - ANSWER-30-35 cal/kg/day
Recommended protein intake for wound healing - ANSWER-1.25 - 1.5 g/kg/day
Recommended fluid intake - ANSWER-30ml/kg/day
Factors that interfere with healing - ANSWER-1.hyperglycemia 2. malnutrition 3. poor
perfusion/oxygenation 4. immunosuppression 5. comorbidities such as renal failure,
liver failure, multisystem trauma, smoking, advanced age
Common location of herpes zoster virus - ANSWER-follow the dermatome, don't cross
midline
Which patient population may show muted signs of infection - ANSWER-1.
immunosuppressed 2.altered perfusion
Phases of partial-thickness wound healing - ANSWER-1.epidermal resurfacing
2.restoration of normal layers/thickness and normal skin function
, Phases of full-thickness wound healing - ANSWER-1. hemostasis 2. inflammatory 3.
proliferative (granulation tissue formation, epithelial resurfacing) 4. maturation
ISTAP skin tear classification Type 1 - ANSWER-No skin loss; flap can be repositioned
to cover wound bed
ISTAP skin tear classification Type 2 - ANSWER-Partial flap loss
ISTAP skin tear classification Type 3 - ANSWER-Total flap loss
Indications for transfer to burn center - ANSWER-1. > 10% TBSA full-thickness burns 2.
>10-20% TBSA partial-thickness burns 3. High risk area (face, hands, feet) 4. Perineal
burn (high risk infection) 5. age <10 or >50
Etiologic factors for wounds - ANSWER-1.Surgical 2.Traumatic 3.Thermal
4.Autoimmune 5.Neoplastic 6.Allergic 7.Chemical 8.Microbial
Hidradenitis suppurativa definition - ANSWER-lesions involving the sweat glands
typically due to inflammation or infection.
Hidradenitis suppurativa characteristics - ANSWER-typically found in the axilla or
perineal area; painful; indurated lesions; foul smelling drainage
Hidradenitis suppurativa treatment - ANSWER-tissue dissection to remove involved
sweat glands and hair follicles
Necrotizing Fasciitis characteristics - ANSWER-petechial rash, edema, erythema,
blisters, crepitus, leukocytosis, low serum sodium, severe pain, rapid progression (up to
2.5 cm/hr)
Staphylococcal Scalded Skin Syndrome Characteristics - ANSWER-severe denudation
of large skin surfaces
Who is affected by SSSS - ANSWER-Usually neonates
SSSS treatment - ANSWER-Antibiotic therapy
Community acquired MRSA Characteristics - ANSWER-Skin and soft tissue lesions;
look like a spider bite (pustular lesion with purplish hue surrounded by erythema and
induration)
Viral lesions characteristics - ANSWER-small vesicles that rupture to reveal yellow-red
and painful base
Common location of herpes simplex virus lesions - ANSWER-mouth and perineal area