6: wound healing Flashcards Preview

Soft Tissue Surgery > 6: wound healing > Flashcards

Flashcards in 6: wound healing Deck (50):
1

3 layers of the skin

Epidermis
hypodermis
dermis

2

Series of thin muscles under the skin in dogs and cats

panniculus

3

Why is the panniculus so important during surgery

failure to preserve will cause loss of blood supply and wound dehiscence

4

provide blood supply to skin
run parallel to skin

Cutaneous arteries

5

Major blood supply to the skin

subdermal plexus

6

Why is the subdermal plexus important

must be preserved to maintain blood supply

7

Coagulation times

<5 min

8

Inflammatory stage time

0-24 hours

9

debridement stage time

2-5 days

10

Repair stage

4-21 days

11

Maturation stage times

21 days - 2 years

12

3 stages of primary coagulation

1. damaged endothelium exposes collagen fibers to blood elements
2. Biding of subendothelial collagen with von Willebrand factor
3. Platelets form platelet plug

13

Secondary coagulation

series of factors react resulting in formation of fibrin meshwork around wound

14

Intrinsic path numbers

12, 11, 9, 8

15

Extrinsic pathway numbers

3, 7

16

Common path numbers

10, 5, 2, 1

17

Which is necessary for wound healing, macrophages or neutrophils

macrophages

18

First leukocyte to enter wound
numbers increase from 24-48 hours
degrade and clear bacteria

Neutrophils

19

Required for healing of wounds
predominate 2-5 days after injury
phagocytize necrotic tissue

Macrophages

20

Removal of necrotic tissue and debris by macrophages
Most important thing we can do to help heal a wound

debridement

21

End of debridement stages is characterized by influx of

fibroblasts into the wound

22

what marks the proliferative stage

influx of fibroblasts
rapid accumulation of collagen

23

when epithelial cells proliferate and move across a wound until they contact each other

contact inhibition

24

Cells that contain actin and myosin fibers that exert tensile forces on the ECM resulting in closure of the defect

Myofibroblasts

25

How does collagen remodel

according to tensile forces

26

How is tensile strength changed during maturation phase

minimally

27

How does the source of wound strength change over time

as the suture starts to absorb, the tissue strength should increase

28

Intrinsic wound factors (7)

hypoproteninemia
anemia
malnutrition
uremia
diabetes mellitus
hyperadrenocroticisim
infection

29

Extrinsic wound factors (4)

mechanism (shear, crush)
foreign material
irradiation
antiseptics

30

How are wounds classified

based on time and contamination

31

Class 1 wound

0-6 hours
minimal contamination

32

Class 2 wound

6-12 hours
moderate contamination

33

Class 3 wound

>12 hours
gross contamination
never close

34

Clean wound

surgical procedure
not entering GI or respiratory tract

35

Clean-contaminated surgery

GI or respiratory tract entered
minor break in asepesis

36

Contaminated surgery

Gi with gross contamination,
inflammation
major break in sepsis

37

Dirty surgery

devitalized or necrotic tissue
gross debris
Pus

38

When should you use antimicrobials

class 2-3 wound
Clean-contaminated to dirty surgeries

39

What should you always do with bite wounds

open them

40

First step in addressing an open wound

clip the fur and put sterile lube on it

41

First and most important aspect of contaminated wound treatment

removal of trash via mechanical lavage using saline

42

after removal of trash you should

debride the wound

43

Wet bandages

1. layer of saline soaked gauze
2. dry laparotomy sponges on top
3. vet wrap over all of it

44

active drain

preferred
just for support
make vacuum in wound to remove fluid

45

Passive drain

gravity
2-5 days at most

46

Wound closure stages

Primary
Delayed primary
late secondary
second intention

47

Primary would closure

immediate closure of wound
<6 hours

48

Delayed primary wound closure

after 6 hours
before granulation >2 days

49

Late secondary wound closure

after appearance of granulation tissue >2 days

50

Second intention wound closure

no surgical closure
dependent on wound healing