Wound Care Made Incredibly Visual!

210 Pages·2011·33.662 MB·English

by  Lippincott

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Staff The clinical treatments described and recommended
in this publication are based on research and
consultation with nursing, medical, and legal authori-
Publisher ties. To the best of our knowledge, these procedures
J. Christopher Burghardt reflect currently accepted practice. Nevertheless,
they can’t be considered absolute and universal
Clinical Director
recommendations. For individual applications, all
Joan M. Robinson, RN, MSN recommendations must be considered in light of the
Clinical Project Manager patient’s clinical condition and, before administra-
tion of new or infrequently used drugs, in light of the
Beverly Ann Tscheschlog, RN, MS
latest package-insert information. The authors and
Clinical Editior publisher disclaim any responsibility for any adverse
Joanne M. Bartelmo, RN, MSN effects resulting from the suggested procedures, from
any undetected errors, or from the reader’s misunder-
Product Director standing of the text.
David Moreau
© 2012 by Lippincott Williams & Wilkins. All rights
Product Manager
reserved. This book is protected by copyright.
Rosanne Hallowell No part of it may be reproduced, stored in a retrieval
system, or transmitted, in any form or by any means—
Editor
electronic, mechanical, photocopy, recording, or
Jaime Stockslager Buss, MSPH, ELS otherwise—without prior written permission of the
Copy Editors publisher, except for brief quotations embodied in
critical articles and reviews, and testing and evalua-
Jerry Altobelli, Amy Furman
tion materials provided by the publisher to instructors
Editorial Assistants whose schools have adopted its accompanying
Karen J. Kirk, Jeri O'Shea, Linda K. Ruhf textbook. For information, write Lippincott Williams &
Wilkins, 323 Norristown Road, Suite 200, Ambler, PA
Art Director 19002-2756.
Elaine Kasmer
Printed in China.
Designer
Lynn Foulk WCIV2E010511
Design Assistant
Kate Zulak
Illustrators
Esteban Cabrera, Judy Newhouse,
Bot Roda, Betty Winnberg
Vendor Manager
Cindy Rudy Library of Congress Cataloging-in-P ublication
Data
Manufacturing Manager
Beth J. Welsh Wound care made incredibly visual. — Second
Edition.
Production Services p. ; cm.
SPi Global Includes bibliographical references and index.
1. Wounds and injuries—Nursing—
Handbooks, manuals, etc. 2. Wounds and
injuries—Nursing—Atlases. I. Lippincott
Williams & Wilkins, issuing body.
[DNLM: 1. Wounds and Injuries—nursing—
Atlases. 2. Wounds and Injuries—nursing—
Handbooks. WY 49]
RD93.95.W69 2011
617.1—dc22
ISBN 978-1-60913-620-8 (pbk.) 2010051104
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Contents
The year’s best dressed iv
Contributors and consultants vi
1
Skin anatomy and physiology 1
2
Wound healing 9
3
Wound assessment 23
4
Wound care procedures 39
5
Acute wounds 59
6
Pressure ulcers 85
7
Vascular ulcers 109
8
Diabetic foot ulcers 135
9
Malignant wounds 149
10
Atypical wounds 157
1 1
Wound care products 165
Selected references 195
Credits 197
Index 199
iii
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My favorite part of any
awards show is the parade
down the red carpet, where
the stars always dress to the
nines. And this year’s Wound
Care Made Incredibly Visual
Awards were no different.
From Al Ginate to
Hydro Colloid, all of the
stunning wound care
stars were there to
celebrate the
importance of proper
wound care in managing
patient health.
iv
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And, who’s that
Take note of the way that
stunning celebrity? It’s
this pop icon is dressed. When you
Best dressed, who’s
see it, you know that you’re about
always decked out for the
to witness the best documentation
occasion of telling
that money can buy.
readers how to best apply
wound care dressings.
When this character
arrives on the scene, she
will demand your Special
attention—and so will
your bariatric patients!
Tomorrow night
we’ll take you inside
the awards for a
look at the Wound
Care winners!
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Contributors and consultants
Debbie Berry, RN, MSN, CPHQ, CWCN, CCCN Jennifer L. Pettis, RN, WCC, RAC-MT
Vice President of Quality and Risk Consultant
Northside Hospital Clifton Park, New York
St. Petersburg, Florida
Michelle C. Quigel, RN, BSN, CWOCN
Laura A. Conklin, RN, MSN, MSA, ONC, Wound, Ostomy, Continence Nurse
CWS, LNCC, FCCWS, DIP. AAWM Holy Redeemer Hospital and Medical
Professor Center
Wayne County Community College Meadowbrook, Pennsylvania
District
Tracy A. Robinson, RN, BSN, CWOCN
Detroit, Michigan
Home Health Nurse
Evonne Fowler, RN, CWON MacNeal Home Care
Certified Wound and Ostomy Nurse Berwyn, Illinois
San Gorgonio Hospital
Tracey J. Siegel, MSN, RN, CWOCN, CNE
Banning, California
Instructor
Elizabeth R. Fudge, RN, MS, CWON Middlesex County Community College
Wound/Ostomy RN Nursing Program
Wellstar Cobb Wound Care Center Edison, New Jersey
Wellstar Cobb Hospital
Jennifer Smoltz, RN, MSN, CWOCN, ACNP-BC
Austell, Georgia
Advanced Practice Nurse
Julia Isen, RN, MS, FNP-C University of Virginia Health System
Assistant Clinical Professor Charlottesville, Virginia
UCSF Medical Center, Mt. Zion Campus
San Francisco, California
vi
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Anatomy
2
Physiology
6
Beauty Vision quest
8
may be only
skin deep, but
in my line of
work, that’s
important!
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2 Skin anatomy and physiology
Anatomy
Skin
The skin, or integumentary system, is the largest organ in the body. It
accounts for about 6 to 8 lb (2.5 to 3.5 kg) of a person’s body weight and has a
surface area of more than 20 square feet. The living cells in the skin receive
oxygen and nutrients through an extensive network of small blood vessels.
Collaboration
is key. Skin is Cross section of the skin
made up of
Stratum corneum
separate
layers that Stratum granulosum
function as a
single unit. Stratum spinosum
Dermal Stratum basale Pore of
papillae sweat gland
Krause’s
end-bulb
Free
Epidermis
nerve ending
Meissner’s
corpuscle
Sebaceous
gland
Arrector pilli
Dermis muscle
Ruffini’s
corpuscle
Collagen fiber
Hair bulb
Eccrine
Subcutaneous sweat gland
tissue
(hypodermis) Sensory
nerve fibers
Autonomic
Artery nerve fibers
Vein
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