Case Study 1 for a&P Essay

Altered nutrition, more than the body requirements related to consumption of excess calories as evidence by the

Throughout the procedure, I was able to interact with the patient and communicate effectively with him, discussing his pertinent health history as well as his experience in dealing with his chronic wound. Such communication and patient interactions bring an abundance of positive feelings to any clinical situation. I also felt positively about the decision of the nurse and healthcare provider in the use of barrier cream to prevent further maceration of the peri-wound skin,

• In addition to wound dressings and debridement, a minor surgical procedure that enhances the growth of healthy tissues in a wound, the center also provides techniques that have been proven to facilitate the healing process, such as Doppler pulse evaluation to determine the blood flow available to help a wounded area regenerate; transcutaneous oxygen monitoring to record the level of oxygen available to the wound; and hyperbaric oxygen therapy (HBOT), thought to be the most effective therapy for non-healing wounds.

Nancy was an 80 year-old woman who was cooking dinner for her and her grandson. When the unthinkable happened, the long sleeved shirt that she was wearing caught fire. She yelled for help! Her grandson came to her rescue and helped her. 911 were called immediately. When the paramedics arrived on the scene, they evaluated Nancy and took her to the hospital due to her injuries. She sustained burns to the anterior and posterior right upper arm as well as the anterior and posterior thorax. Parts of her skin were black and charred and some parts of her skin had blisters. She was admitted into the hospital where doctors did further testing and treatment to her burns. Due to Nancy’s burns, her skin was severely affected.

The first couple of paragraphs include an explanation of what is considered a complex wound and the current available treatments. It is beneficial that the authors include an explanation of what the problem is so that the reader can have a better understanding of why this issue is of concern. The paragraphs then transition towards the types of treatments available for the problem and a description of why the current treatments are not sufficient for restorative care.

Different doctors support different types of grafts, as each graft has its own set of advantages and disadvantages (Li et al. 2011).

Skin grafts have and will continue to positively impact a broad population of patients as a person of any age, gender, socioeconomic status, and geographic location can suffer burn injuries. It is important to understand the history of skin grafts to understand where advancements in skin grafts are headed. The purpose of this study will be to create a general literature review on the evolution of skin grafts through the 20th and 21st century.

Harper, Young, and McNaught, (2014) explain the four distinct phases of wound healing that are identified as hemostasis, inflammation, proliferation and tissue remodeling. Hemostasis is the body’s response to prevent exsanguinations; thusly, the cascading response to injury causes constriction of blood vessels but if continued, leads to tissue hypoxia and acidosis. The next stage of healing is inflammation. This stage is a result of cells that inhibit and prevent infection and once the resulting threat of infection is gone, inflammation will subside. Prolonged inflammation can lead to chronic wound formation. The next stage of healing is proliferation which consists of angiogenesis, formation of granulation tissue, collagen deposition, epitheliazation and wound retraction. It is during this stage the extracellular matrix is laid down forming

The epidermis is considered dead, so any time you touch something, a little skin is peeled off, and new skin is replaced. Now, if something major happens, like a cut, that is a different story.

• Pain and increased risk of infection in areas of the body with poor blood flow.

This objective is the second most important because detection and proper medical care of burn infections are crucial to ensuring the patient’s health and preventing further damage to the affected area.

On the night of April 2nd, 2016, in Destin, Florida, I jumped off of a lifeguard stand and hit a sharp metal pole which tore my skin open a little above my right ankle. The way in which my foot was cut open is medically defined as a laceration. A laceration is a cut through one or more layers of skin. The laceration I suffered was definitely a cut through multiple layers of my skin. As you can see in the image on the right, a doctor repaired my wound by tying the two flaps of skin together using 5 stitches. The picture was taken 3 days after the stitches were sewn. As you can see, the top flab of skin was so stretched out and traumatized that it began to develop into another gash of its own. About a week later the gash developed into a scab with a valley in the middle which opened up into another open wound. Since this wound was already present for more than 8 hours (about 10 days), my safest option was to allow for the wound to heal from the inside out.

The tissue that will replace her epidermis and dermis is dense fibrous connective tissue that does not have the same properties of the tissue type that it replaces. The Scar tissue will replace both her epidermis and her dermis layers, this tissue will lack the flexibility of the original tissue and will be thick, strong and tough. Her new fibrous scar tissue will lack nerves, she will have a great deal of sensation loss due to the nerve loss. In addition, to nerve loss, she will lose sweat glands, and her apocrine glands along with the loss of sensation, she will lose the ability to sense pressure along with heat. In addition, to that the new scar tissue will lack hair, since all the hair follicles were destroyed.

Skin grafts- A skin graft is a piece of unburned skin which is surgically removed to cover a burned area

The nurse verified the patient’s identity and expected procedure with his mother. The patient was talkative and cooperative when we brought him to the operating room. I watched the anesthesiologist sedated the patient with gas. After the patient was sedated, the nurse inserted the PIV and the anesthesiologist intubated the patient. After the patient was positioned on the table and prepped with betadine, on his hand and possible donor skin graft sites, the surgeon began the procedure. First, the surgeon debrided the wound on the patient's hand. After examining the wound and decided the amount of kin needed, the surgeon harvested skin from the patient's upper inner arm. The surgeon then prepped the donor skin and stitched it onto each affected finger. After the skin graft was finished the patient's hand was bandaged and covered with a cast. The whole procedure lasted about four