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Excudate- Excudate is fluid that leaks out of blood vessels into nearby tissues. the fluid is made of cells, proteins, and solid materials. it's also referred to as pus.

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Maceration- softening of tissue caused by over exposure of moisture or soaking in fluid.

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Tertiary (Delayed) Intention Healing: left open (3-5 days) before closing to resolve edema, exudate, and/or infection.
Heals from bottom up. Scarring. Ex: Pressure injury.

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Debridement: removal of dead tissue

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Clean-contaminated: have no signs of infection during surgery but involve repairing an internal organ

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Collagen= a whitish protein substance that adds tensile strength to the wound

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Serous- clear watery drainage, common in naturally healing wounds.

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Hematoma: Collection of blood under the skin which the nurse can feel, different from a bruise

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Dehiscence: Partial or total separation of previously approximated wound edges, due to a failure of proper wound healing.

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Induration: thickening of the skin due to edema or inflammation.

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Almost free of all microorganisms. Not used during a surgical procedure but outside of surgery.

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full thickness wound: a wound that reaches beyond the dermis; reaches to fat, bone, muscle, tendons.

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Serous Fluid: A clear watery secretion

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The leakage of fresh blood from a wound

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Epithelialization : process where epithelial cells migrate upwards and repair the wounded area. Occurs in proliferative phase of wound healing.

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Regeneration - renewal of tissue

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Exudate is fluid that leaks out of blood vessels into nearby tissues. The fluid is made of cells, proteins, and solid materials.

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Sterile,
space free of micro-organisms. completely clean.

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Laceration: a deep cut  or tear in skin Amy R

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Laceration: a deep cut  or tear in skin Amy R

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Eschar is dark scabby dead skin that can form around a wound. It adheres to the wound bed and has a spongy leather like feel.

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Sir,

Scrub typhus is an acute febrile illness usually endemic in many parts of Asia including India, caused by a microbe Rickettsia tsutsugamushi (R. orientalis) and transmitted to humans by the bite of larval stage of infected trombiculid mites or chiggers. Though transmission occurs throughout the year in tropical areas, in India the peak occurs between October and February.[ 1] At the site of mite bite, an eschar of 5-20 mm in diameter develops. The occurrence varies from 46 to 92%, and influenced by the complexion of the patient. In this letter we stress the importance of eschar in diagnosing the scrub typhus fever.

A 42-year-old male farmer was admitted with the history of fever and generalized body ache of three days duration. On examination he was conscious and febrile. His vitals were stable. He had icterus, axillary lymphadenopathy and a punched out ulcer with blackened scab, the eschar, below the right clavicle []. The vicinity of the eschar was surrounded by erythema. His Weil-Felix test was positive with OXK 320. Biochemical investigations revealed deranged liver and renal function tests. Fever work up for malaria, leptospirosis and enteric was negative. His blood and urine culture was sterile. He was diagnosed as a case of scrub typhus. He was managed with high flow oxygen, doxycycline, azithromycin and supportive care. He responded well to treatment.

The eschar begins as a small papule, then enlarges, undergoes central necrosis, and eventually acquires a blackened crust with an erythematous halo that resembles a cigarette burn. Necrotic eschar at the inoculating site of the mite is pathognomic of scrub typhus as shown in the picture. Eschar heralds the onset of symptoms invariably as observed in this case and usually occurs at sites where skin surfaces meet or clothes bind, such as the axilla, groin, neck, waist, and at in uncommon sites like wrist joint, elbow joint and inguinal area.[ 2] Although eschars are important in the diagnosis of scrub typhus, the lesions are painless and without any itching sensation in most cases, causing the infection goes undetected. Dong-min Kim et al.[ 3] have suggested assessing the presence of draining lymph node enlargement which could be an important adjuvant method for the diagnosis.

Physicians sometimes encounter eschar-like crust lesions in clinical practice which is similar to a scab formed after trauma, and its size may be very small, which also delays recognition of eschar in many cases. Under such circumstances it is essential to search for eschar carefully on entire body, and suspect scrub typhus as prompt treatment is necessary to decrease mortality in this disease. Lee et al.[ 4] used PCR method to arrive at early diagnosis using eschar material and has differentiated other eschar-like crusted lesions.

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Sir, Scrub typhus is an acute febrile illness usually endemic in many parts of Asia including India, caused by a microbe Rickettsia tsutsugamushi (R. orientalis) and transmitted to humans by the bite of larval stage of infected trombiculid mites or chiggers.

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SLOUGH- yellow/white material in the wound bed. It is is usually wet but can be dry, soft texture, can be thick. It can present patchy over the surface of the wound and consists of dead cells that accumulate in the wound exudate.

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Undermining- damage beneath the skin surface where wound seems to have a rolled appearance. Should reference location with “o-clock”.

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Tunneling wounds: category of complex wounds that extend from the skin surface to various underlying tissue

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Cellulitis-common bacterial infection that causes redness, swelling and pain in the infected area of the skin

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Breaks in the skin allow bacteria to enter

Anyone can get cellulitis, but some factors can increase the risk of getting this infection. The following are risk factors because they allow bacteria to get through the skin:

Injuries that cause a break in the skin (like cuts, ulcers, bites, puncture wounds, tattoos, piercings)

Chronic skin conditions (like athlete's foot and eczema)

Chickenpox and shingles

Injection drug use

Other factors that increase someone's risk for cellulitis include:

Being overweight

Having limbs (feet, legs, hands, and arms) stay swollen (chronic edema), including swelling due to

Lymphedema (problems with the lymphatic system so it does not drain the way it should); the lymphatic system is a part of the body's immune system that helps move fluid that contains infection-fighting cells throughout the body

Coronary artery bypass grafting (having a healthy vein removed from the leg and connected to the coronary artery to improve blood flow to the heart)

Doctors diagnose cellulitis by how it looks

Doctors typically diagnose cellulitis by doing a physical examination and looking at the affected skin. Blood or other lab tests are usually not needed.

Antibiotics are needed

Cellulitis is treated with antibiotics. Most cellulitis infections can be treated with oral antibiotics (taken by mouth). More serious infections may need to be treated in the hospital with intravenous (IV) antibiotics, which are given directly into a vein.

If the infection is in the arm or leg, then keeping that limb elevated can help decrease swelling and speed up recovery.

Complications are uncommon, but can be serious

Complications from cellulitis are uncommon but can include serious infections in the following locations:

Bacteremia (blood)

Suppurative arthritis (joints)

Osteomyelitis (bone)

Endocarditis (Lining of the chambers of the heart and heart valves)

Cellulitis can cause thrombophlebitis (vein swelling if blood clots form close to the skin).

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Anyone can get cellulitis, but some factors can increase the risk of getting this infection.

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Purulent - pus from a wound . Bad - sign for infection

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Granulation tissue -red; highly vascular; new tissue. A very good thing!