Trauma blisters

quickster2008's version from 2015-12-07 17:40


Question Answer
blister is separation of what layersdermal & epidermal layers
bulla> 1.0 cm skin lesion filled with air or fluid
most common cause of blistersfriction
tx for blisterspie crust, non adherent compression dressing(adaptic), shoe gear modifications
2 types of fracture blistersserous & hemorrhagic
serous vs hemorrhagic blisterserous-disruption of epidermal layer, clear fluid, hemorrhagic-disruption of epidermal-dermal junction, blood
tx for serous vs hemorrhagic blisterserous-lance(pop blister), hemorrhagic-de-roof(remove top of blister)
subungual hematomanail bed & subungual vascular disruption
? % of subungual hematoma associated with distal phalanx fracture20
tx for subungual hematoma<25% evacuate blood by cautery & needle, >25% nail plate avulsion
types of simple nail bed lacerationtransverse or linear
simple nail bed laceration tx1. irrigate 2. absorbable suture 3. non adherent dressing 4.splint or nail template to prevent
types of complex nail bed laceratioincrushing force, stellate
tx of complex nail bed laceration1. irrigate 2. absorbable sutures 3. biological dressing(vs non adherent dressing in simple)
a splint or nail template is used in simple nail laceration tx to prevent onycholysis
rosenthal clasificationzone 1=distal to phalanx 2=distal to lunula(nail root-proximal portion of nail right before skin) 3=proximal to lunula
rosenthal zone 1 tx1. I&D 2. may heal by secondary intention(non adherent dressing) 3. large defects may require skin graft
types of skin grafts for zone 1 tx1. STSG(split thickness skin graft) 2. pinch graft 3. biologic dressing
zone 2 tx1. I&D 2. Plantar V->Y advancement 3. adjacent medial & lateral V->Y flaps 4. distal symes amp
risk vs benefits of distal symes ??
zone 3 txdistal symes amputation
laceration/degloving injuriesunplanned wounds through skin epidermis & dermis
straight vs complex laceration/degloving injuriessimple straight wounds-well approximated edges(made in OR) complex-jagged edges & crush component
laceration/degloving injuries are unplanned wounds through what layer of skinepidermis & dermis
tx for degloving laceration1. Irr 2. local anesthesia 3. excise jagged edges to create linear wound 4. suture w/3.0-4.0 nylon 5. remove 10-14 for dorsal lacs 6. remove 21 days for plantar lacs
remove sutures after ? days for laceration degloving injuries10-14 days for dorsal lacs, 21 days for plantar lacs
tx for degloving are typically done in OR or clinical settingOR
biggest thing that you have