How can I explain Pathophysiology?

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Hi there! I'm in careplan limbo. We have to complete a pre-printed patient worksheet and I am having the hardest time explaining the anatomy and physiology of a dehisced chronic leg wound. The pt has a compromised immune system, smokes, htn, etc.. so I'm assuming that would be the explanation???

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Specializes in Cath/EP lab, CCU, Cardiac stepdown.

But how does that affect the wound? How is it related to wound healing?

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Specializes in Critical Care, ED, Cath lab, CTPAC,Trauma.
Hi there! I'm in careplan limbo. We have to complete a pre-printed patient worksheet and I am having the hardest time explaining the anatomy and physiology of a dehisced chronic leg wound. The pt has a compromised immune system, smokes, htn, etc.. so I'm assuming that would be the explanation???

What do you mean by dehisced?

Wound dehiscence is one of the most common complications of surgical wounds, involving the breaking open of the surgical incision along the suture. Typically, the sutures or closures around wound edges should stay intact while new tissue, known as "granulation tissue," starts forming to help heal the wound. However, when wound dehiscence occurs, the edges starts to separate and the wound reopens instead of healing closed as planned.

What surgery did the patient have to the leg?

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Specializes in Neuro, Telemetry.

Don't focus on the wound dehiscence as your patho. Focus on the surgery and focus on wound dehiscence as a complication. Or write your patho on the patients primary disease process and you can include how it affects wound healing. Your priority patho should not be on a wound as there isn't really a body process that causes the wound in most cases.

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I disagree. There are a number of very important things involved in delayed or disrupted wound healing. Suggest very strongly that you look at the NANDA-I 2015-2017 (the current edition) at page 403 (delayed surgical recovery) for some hints EVEN THOUGH since this is a chronic wound there was no surgery involved. For example, think of the reasons pressure ulcers are hard to heal (in addition to the pressure part).

Meantime, look at:

What do you know about the reasons chronic wounds develop? Is this a venous stasis ulcer or an arterial insufficiency ulcer-- what are their differences and risk factors? Are these conditions being remedied? If so, what can you (the nurse, by which I mean, not just following the medical plan of care, which you will do anyway) do to remedy them?

What do you know about the physiological steps a wound must complete before it heals? ***HUGE HINT***If this requires certain local conditions within the tissues, building components (proteins or hematological factors), or vitamins, are these optimized in this patient?

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Specializes in Cath/EP lab, CCU, Cardiac stepdown.

With a compromised immune system and decreased perfusion to the wound from smoking and hypertension the healing is affected. Oh boy if the patient has diabetes too. As part of your pathophysiology you can talk about how those factors are affecting the wound healing. If it heals properly and in a timely manner it's much less likely to have complications.

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Specializes in Cath/EP lab, CCU, Cardiac stepdown.

Infection is also a major concern

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Thank you for the replies. A little background may help...

The pt had surgery on his lower leg following a car accident in September. The dehiscence occurred post-op, infection and pain were not properly managed at home so he was hospitalized. The pt was sent to rehab to be managed. He has been in this facility since November and off antibiotics for a week (although I suspect MRSA, just waiting for test results). The medical diagnosis in his chart is "lower extremity wound infection due to dehiscence post surgery".

As far as my nursing diagnosis and interventions I am going to focus on what will promote his healing, and prevent any further complications. I'm pretty confident that the delay in healing is due to his other medical problems, HIV, HTN, previous sarcoma in other leg, etc.

The one thing I am stuck on is filling in the blank for: "Explain the anatomy and physiology of the system the disease has affected". I can't figure out if I need to explain what the wound is doing to affect his body, or what his other problems are doing to cause delay in healing.

Maybe I'm over thinking. It's such a tiny piece to this project that has me halted!!

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Specializes in Critical Care, ED, Cath lab, CTPAC,Trauma.

Ok I get it...let me see.

The sarcoma on the other leg has nothing really to do with this leg...however the HTN and HIV does.

I would interpret this as describing the A/P of wound dehiscance and infection and how HTN (circulation) and HIV delays further healing. Is this patient also diabetic?

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Specializes in Critical Care, ED, Cath lab, CTPAC,Trauma.

Thia link may help....Dehisced Wounds

Did you message your instructor for clarification?

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Specializes in Critical Care, ED, Cath lab, CTPAC,Trauma.
http://www.wounds-uk.com/pdf/content_9491.pdf
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Thia link may help....Dehisced Wounds

Did you message your instructor for clarification?

Thank you! I will go with how the other problems will delay healing. I'm waiting to hear back from my instructor.

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