spinal cord injury 13 - skin

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Author:
shmvii
ID:
214685
Filename:
spinal cord injury 13 - skin
Updated:
2013-04-20 18:07:07
Tags:
spinal cord injury 13 skin
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Description:
spring rosen & karpatkin
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  1. what percent of SCIs get pressure sores?
    68%
  2. pressure sores are responsible fo _% deaths in SCIs
    7-8%
  3. SCIs w pressure sores in one site, __% get them in more than 1
    50%
  4. 5 intrinsic factors that lead to pressure sores
    • decreased tissue resistance to pressure
    • loss of sensation
    • anatomical arrangement/amount of body's padding over a spot
    • spasticity - can pull limbs together, moving flesh off a pressure point, leaving body exposed
    • loss of vol mvmnt
    • ... it's a lower resistance to pressure 2/2 lack of skin integrity, muscle mass, tone...
  5. 5 extrinsic factors that cause pressure sores
    • pressure
    • maceration (from urine or a spill.... remember, no sweating below level of injury)
    • bacteria - ex. from urine
    • cold
    • heat
  6. when will you get a stinky fluid from a pressure sore?
    ulcerative stage - stage IV
  7. staging of pressure sores
    • I - hyperemia (excess of blood, reddening)
    • II - ischemia
    • III - necrosis
    • IV - ulceration
    • sinus = tunneling
    • closed bursa
  8. nutritional effect of pressure sores
    • malnutrition
    • decreased vitamins
    • negative ntrogen balance
    • anemia
    • dehydration
    • electrolye imbalance
  9. general tx for pressure sores
    • blood transfusions
    • excise slough
    • debride
    • high protein diet
    • vitamins
    • high caloric diet
    • high fluid intake
    • (got to rebuild the body)
  10. specific things put into or on a wound
    • saline
    • antibiotics
    • betadine
    • hydrogen peroixde
    • granulated sugar (it absorbs fluid and can be removed in a clump)
    • sawdust (works like sugar)
    • UV
    • US
    • maggots
    • gold leaf
    • debrisan
    • collagenase - assist in destroying extracellular structures in pathogenesis of bacteria
    • elase
  11. dressings for pressure ulcers
    • sterile packing -idioform
    • telfa
    • gauze
    • waterproof adhesive
    • wet to dry
  12. 3 techniques for eval of pressure sores
    • photos
    • tracings
    • measurements
  13. 2 types of grafts
    • full thickness: take the epidermis, the dermis, sweat glands...
    • partial thickness - w/o sweat glands, not as successful

    can stretch out the skin and augment it with gauze
  14. skin flap
    • stretching neighboring skin to cover a wound
    • skin maintains blood supply from the original location

    a "rotational flap" is like this, but it's rotated
  15. primary closure
    pull edges together and swe them up. not so strong, wil reopen if pressure returns

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