1st Exam. Part 9. WOUND

Question 1

Any break or discontinuity in layers of skin or tissue of organ

Answer 1

wound

Question 2

(2) Closed wounds

Answer 2

1. Contusion
2. Abrasion

Question 3

(4) Open wound

Answer 3

1. Laceration
2. Puncture
3. Penetrating
4. Avulsion

Question 4

unbroken skin, caused by crushing of underlying tissue

Answer 4

closed wound

Question 5

damaged soft tissues without breaks in skin, trauma is caused by blunt force trauma

(bleeding is more observed in this type of wound)

Answer 5

Contusion

Question 6

break in the skin that involves the dermis, trauma is caused by scraping or friction (ALT)

Animal continuously licks the paws that results in _____

Answer 6

Abrasions

Question 7

skin is penetrated or broken

Answer 7

Open wound

Question 8

slender or straight cut cause by sharp objects

clean edges

Answer 8

Incision

Question 9

irregular edges and tearing of skin and underlying tissues;

torn wound edges

Answer 9

Laceration

Question 10

caused by pointed objects;

deep

Answer 10

Puncture

Question 11

body cavities are affected at a deeper level

Answer 11

Penetrating

Question 12

partially and fully torn skin that tends to bleed a lot and causes great trauma

Answer 12

Avulsion

Question 13

wounds that are located in the limbs

Answer 13

degloving wounds

Question 14

Phases of wound healing (3)

Answer 14

1. Inflammatory
2. Proliferation
3. Remodeling

Question 15

• Occurs within minutes after initial wound
• Starts with vasoconstriction then vasodilation
• Wound is rinsed and filled with blood-collagen and fibrin constituents
• Cytokines are produced in this stage
• Scab formation (platelets)
• Active bleeding of the wound
• Clot formation
• Scab formation

Answer 15

INFLAMMATORY phase

Question 16

occurs 3-5 days after initial injury
- Epithelium regulates collagen fiber
- Migration of collagen, fibroblasts and the like

• Fibrin network : scaffold for wound, support for collagen, attracts more platelets
• “ Itchy phase“
• Re-epithelialization
• Resorption of blood collagen
• Angiogenesis occurs
• Epithelial proliferation and migration
• Longest phase
• Wound contraction : wound is smaller due to re-epthilialization, centripetal movement of epithelial cells

Answer 16

PROLIFERATION phase

Question 17

• Growth of new epithelial cells
• Reorganization of collagen to provide a sturdier support
• 14-21 days of remodeling
• Tissue layers are not as strong as original tissue

[ Scar matures > Wound strengthens > Complete
Healing & __________ ]

Answer 17

REMODELING phase

Question 18

Duration of wound healing may depend on (4)

Answer 18

1. Wound type
2. Wound mgt.
3. Microbiological factors
4. Physiological factors

Question 19

_______ may be used for wound management

Answer 19

General anesthesia

Question 20

1. Initial Management
2. Debridement
3. Suturing
4. Bandaging (+/- Drainage)
5. Antiseptics/Antibiotics

Answer 20

Wound management

Question 21

• Stabilize the patient
• Physical examination
• Wash, clip and shave
• Removal of gross debris

Answer 21

Initial management

Question 22

• Removal of foreign material, necrotic, damaged or if infected tissues such as wound edges

Answer 22

Debridement

Question 23

For cases of _______, wound edges should be as clean as possible so healing and apposition could occur as clean as possible

Answer 23

laceration

Question 24

(3) types of Debridement

[ SEM ]

Answer 24

1. Surgical
2. Enzymatic
3. Mechanical

Question 25

debridement that uses sharp scissors or scalpel require anesthesia

Answer 25

Surgical

Question 26

Debridement that selectively removes non viable tissues, fine debridement, Indicated in patients with increases anesthesia patients (trypsin and chymotrypsin)

Answer 26

Enzymatic

Question 27

uses adherent bandages, contaminated tissue remains even after surgery

Answer 27

Mechanical

Question 28

Following _____ and _____, decide whether to close wounds by sutures or not

Answer 28

excision and debridement

Question 29

(3) Categories of Wound Healing

Answer 29

1. First intention / Primary wound closure 2. Second intention / Secondary wound closure 3. Third intention / Tertiary wound closure

Question 30

Stitch wound that is already debrided (minor wound or surgery) Use of surgical stapler non absorbable or absorbable suture materials

Answer 30

First intention / Primary wound closure

Question 31

Performed mainly for wounds located at limbs (avulsion); Used for skin with much tension Simple bandaging but no surgical procedures or suturing Intervention of wound by medical approach Longer time for wound to heal

Answer 31

Second intention / Secondary wound closure

Question 32

re-epithelialization first before wound closure

Answer 32

Third intention / Tertiary wound closure

Question 33

- It is important to know the size and type of suture material

Answer 33

Suturing

Question 34

What kind of suture should be used in SKIN?

Answer 34

Non-absorbable sutures

Question 35

What kind of suture should be used in INTERNAL ORGANS

Answer 35

Absorbable sutures

Question 36

Suture: The higher the number = the ____ the diameter

Answer 36

smaller

Question 37

infection could be more common in this type of suture

Answer 37

Monofilament / Multifilament

Question 38

- Reduce or eliminate the dead space; - Protects wound from external trauma and bacteria - Absorbs secretion such as EXUDATE (allow characterize the lesion); should press against dead space; - Decreases edema and hemorrhage ; immobilizes wound and promote healing; - Vehicle for antibiotics and antiseptics ; should be applied not too loosely or tight

Answer 38

Bandaging

Question 39

exit point for blood, pus or serum accumulation

Answer 39

Drainage

Question 40

uses gravity or capillary action

Answer 40

Passive drainage

Question 41

____ rubber causes additional inflammation

Answer 41

Latex

Question 42

vacuum, uses NEGATIVE pressure

Answer 42

Active drainage

Question 43

- Container switch vacuum - Drainage is faster - Extra apparatus is required which results to discomfort

Answer 43

Active drainage