8.6: Key Terms

abrasion

an area damaged by scraping

acute radiation syndrome (ARS)

an acute illness related to full-body exposure to high levels of radiation

acute wound

a wound that occurs suddenly and progresses through expected stages of healing

angiogenesis

a process where capillaries grow across the wound, increasing blood supply and oxygen

arthrofibrosis

scar tissue formed around a joint during the healing process, which limits range of motion

autolytic debridement

the process of using occlusive dressings to enhance the body’s own defense mechanisms to liquefy or soften necrotic tissue

avulsion

a forcible tearing off of skin or another part of the body

Bates-Jensen Wound Assessment Tool (BWAT)

an assessment tool to evaluate wound status and healing; it measures thirteen wound characteristics

blanching

the temporary whitening or lightening of the skin around the wound site upon applying pressure

Braden Scale

an assessment tool that evaluates the relative risk of a patient developing skin breakdown and pressure injuries. The scores can be used to tailor pressure injury prevention interventions to at-risk patients

burn

an injury to the skin caused by thermal, electrical, chemical, or electromagnetic energy

burn shock

a condition in which the circulatory system becomes dysfunctional and unable to compensate for the loss of blood, plasma, and fluid, even with aggressive fluid replacement

chemical burn

a burn caused by the reaction of human skin to toxic chemicals

chronic wound

a wound in which no healing occurs for at least three months

closed wound

a wound that does not have a break in the skin and occurs under the skin’s surface

cognition

the mental processes that take place in the brain such as thinking, language, learning, memory, perception, and attention

collagen

a whitish protein substance that adds flexible strength to the wound

contusion

a region of injured tissue or skin in which blood capillaries have been ruptured

debridement

the removal of slough or necrotic tissue and foreign material by various methods

decontamination

the removal of residual chemical or radiological particles

desiccation

unintentional wound or tissue dehydration

diabetic neuropathy

nerve damage that causes numbing sensations

electrical burn

a burn that occurs when an electrical source meets skin and transfers energy, damaging local tissue

enzymatic debridement

the application of commercially prepared enzymes that accelerate the body’s autolytic process (i.e., cell breakdown by enzymes contained in the affected tissue)

epibole

rolled or curled-under wound edges that slow or stop the wound-healing process

epidermis

the outermost layer of the skin consisting of epithelial cells

epithelialization

the development of new epidermis; the growth of skin cells over skin and wound surface; healing to close a wound

erythema

a change in skin color due to a change in blood flow

eschar

dead tissue that forms over healthy skin and then, over time, falls off or sheds

excoriation

the loss of the superficial layers of the skin, also known as a denuded area

exudate

a liquid that is secreted from a wound

fistula

an abnormal passage from one internal organ or vessel to another or an internal organ or vessel to the outside of the body

fluctuance

a tense area of skin with a wave-like or boggy feeling upon palpation

fluid resuscitation

the administration of IV fluids to ensure adequate intravascular fluid

foul purulent

a thick yellow to green exudate with odor

fourth-degree burn

a burn that involves everything from the epidermis down into bone or muscle

friction

a force created by two surfaces rubbing against each other

frostbite

a type of burn in which the water in tissues freeze and cause deep tissue injuries and necrosis

full-thickness (third-degree) burn

a burn involving all of the epidermis, dermis, and some of the subcutaneous fat and deeper structures

granulation tissue

delicate, new, reddish connective tissue and tiny blood vessels that bleed easily but provide the framework for scar tissue development

hematoma

a localized collection of blood under the skin that may appear reddish blue with swelling

hemostasis

the cessation of bleeding

hypoproteinemia

abnormally low amounts of serum protein from the diet

hypovolemic shock

a type of shock due to decreased fluid volume in blood vessels that impacts the blood flow and transport of oxygen to organs and tissues

incision

a surgical cut made in skin or flesh

induration

a thickened or hardened area

inhalation injury

an injury caused by breathing in particulates, such as heat and smoke from fires, or chemical burning of upper airways

intentional wound

a planned wound; the result of a treatment or therapy

laceration

a deep cut or tear in the skin or flesh

liquefaction necrosis

death of body tissues

localized wound healing factor

a factor that affects wound healing directly (i.e., desiccation, maceration, trauma, pressure, excessive bleeding and edema, and infection)

maceration

the softening of tissues caused by prolonged wetting or soaking

mechanical debridement

the application of external physical force to remove debris or necrotic tissue

Montgomery strap

a tie that attaches to an adhesive backing that holds a dressing in place

NPO

nothing by mouth

open wound

a break in the skin or mucous membranes, caused either intentionally or unintentionally

osteomyelitis

a bone infection

palmar method

a strategy for determining TBSA of small burns

Parkland burn formula

a commonly used formula for determining the amount of fluid resuscitation needed for patients who have been burned

partial-thickness (second-degree) burn

a burn involving the epidermis and some portion of the dermis

penetration

a wound caused by objects that pierce the skin and lacerate or damage adjacent tissue

phagocytosis

the movement of leukocytes and macrophages into the interstitial space to ingest bacteria and cellular debris

pressure injury

a localized ischemic lesion of the skin and underlying tissue caused by external pressure that impairs blood and lymph flow

primary intention healing

a type of healing in which the wound edges have been approximated with little to no tissue loss and show formation of nominal granulation tissue and scarring

puncture

a wound made by a pointed object

purulent

pus; tan to yellow exudate

Rule of Nines

a strategy for determining TBSA of large burns

sanguineous

relating to bloody exudate

secondary intention healing

a type of healing in which extensive wounds that have significant tissue loss make approximating edges difficult or not a good option

serosanguineous

relating to a mix of serous fluid and blood in exudate

serous

relating to thin, watery, clear exudate

shear

the sliding of one tissue layer over the other

skin grafting

transplanting a piece of healthy skin from one area of the body to another

slough

a nonviable layer of dead tissue that is a stringy, moist, and yellow, tan, gray, green, or brown

stable eschar

an area of eschar on the skin that is adherent, dry, and intact without fluctuance

superficial (first-degree) burn

a burn involving only the epidermis

superinfection

a secondary infection that is unrelated to the original infection and results from opportunistic colonization after immunosuppression

Surgical Site Event Risk Assessment (SSERA) model

an assessment tool to determine the relative risk of a patient developing a surgical site infection after a surgical procedure

systemic wound healing factor

factors that occur throughout the body and are not related to the wound itself (e.g., age, venous insufficiency, poor oxygenation, obesity, diabetes, medications, and smoking or alcohol use)

tertiary intention healing

delayed primary intention healing where the wound is left open for three to five days to allow edema or infection to resolve or to allow any exudate to drain

thermal burn

a burn related to temperature

tissue necrosis

tissue death

total body surface area (TBSA)

percentage of the body’s surface

trauma

injury caused by a blunt or blow force

tunneling

erosion in channels beneath intact skin surrounding a wound

ulcer

an open sore caused by poor blood flow

undermining

erosion beneath the skin’s surface beyond visible edges

unintentional wound

a wound from an unexpected trauma

Wagner Ulcer Classification System

an assessment tool to describe severity of diabetic foot ulcers

wound

an injury that causes a disruption of normal skin or tissue integrity

wound thickness

the amount of skin breakdown, fat exposure, and bone and/or muscle involvement in a wound