Integumentary Disorders Q 33

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Following a full-thickness (third-degree) burn of his left arm, a male client is treated with artificial skin. The client understands postoperative care of artificial skin when he states that during the first 7 days after the procedure, he will restrict:

  

    A. Range of motion

    B. Protein intake

    C. Going outdoors

    D. Fluid ingestion

    

    

Correct Answer: A. Range of motion

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To prevent disruption of the artificial skin’s adherence to the wound bed, the client should restrict range of motion of the involved limb. Skin grafting is the transfer of cutaneous tissue from one portion of the body to another, often used to cover large wounds. The rationale of skin grafts is to take skin from a donor site that will heal and transfer the skin to an area of need. After incorporation, skin grafts provide wounds with protection from the environment, pathogens, temperature, and excessive water loss like normal skin.

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Option B: Protein intake and fluid intake are important for healing and regeneration and shouldn’t be restricted. Additionally, since many of these patients remain immobile, nurses should ensure they are on deep vein thrombosis. Wound dressing changes should take place according to the preference of the surgeon. Once the wounds have healed, some patients may require physical therapy. Others may need to wear compression garments to prevent hypertrophic scarring.

Option C: Going outdoors is acceptable as long as the left arm is protected from direct sunlight. A tie over a bolster of petroleum-infused gauze, cotton balls, and non-dissolvable suture is frequently placed on smaller STSG recipient sites. A negative pressure wound vacuum is another viable option for areas that are difficult to bolster.

Option D: Split-thickness skin grafts typically become adherent to the recipient wound bed 5 to 7 days following skin graft placement. The dressings placed intraoperatively are kept in place until 5 to 7 days postoperatively to minimize shear and traction to the healing skin graft. At 5 to 7 days postoperatively, the dressings are taken down, and the skin graft inspected.

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