Primary Wound Closure Flashcards
Which of the following is true?
• The skin consists of three layers: epidermis, dermis, and hypodermis
• The vascular supply is separated into two layers: cutaneous plexus and subdermal plexus
• Dogs have a greater density of collateral subcutaneous vessels throughout
• Cats have a smaller number with wider distribution of cutaneous perforators than dogs
D true
A (only 2, epidermis and dermis)
B (three layers: superficial/subpapillary, middle/cutaneous, and deep/subdermal/subcutaneous)
C (known in the trunk)
Which of the following is true?
• At 14 days a wound is 10-15% as strong as normal unincised skin
• At 3-4 weeks the repair is 30%
• Healed incisions are 70-80%
• Wounds in cats are only half as strong as those in dogs at 10 days post-op
C true healed incisions = 70-80%
A (5-10%) at 14 days
B (25%) at 3-4 weeks
D (7 days) when cats 1/2 of dogs wound strength
True or false: by 14 days there is no difference in cutaneous perfusion between dogs and cats?
True
Which is true?
• On distal limbs, skin is closed parallel to lines of tension.
• Geriatric patients have decreased cutaneous perfusion
• Malnutrition that results in decreased albumin and potassium levels will prolong wound healing.
• Necessary dietary components for a healthy immune system include glutamine, arginine, zinc, n-3 fatty acids, vitamin E, and lack of n-6 fatty acids.
B true
A (where the skin is more taut, more loose skin is available around the circumference of the limbs compared with the proximal-distal direction)
C (hemoglobin, not K+)
D (appropriate n-6:n-3 fatty acid ratio.)
What is the peripheral char penetration of skin with each device?
• radiowaves
• CO2 laser
• monopolar electrocautery
- radiowaves, - 0.171
- CO2 laser - 0.215
- monopolar electrocautery, - 0.255
Which is true regarding suture selection?
• Reverse-cutting needles are recommended for intradermal suturing
• The square knot has better knot security than the aberdeen knot
• Suture in the subcutaneous tissue can result in more incisional inflammation
• Size of the bites does not affect incidence of infection
C true
A (taper)
B aberdeen > square
D (humans: small is better)
Which of the following correctly matches suture to tensile strength loss?
a. Glycomer loses 40% in 3 weeks
b. Polyglactin 910 loses 25% in 14 days
c. Poliglecaprone 25 loses 25% in 14 d
d. Polypropylene loses 15% in 14 days
B polyglactin 910 25% lost in 14d (vicryl)
A glycomer looses 60% in 3 weeks (biosyn)
C poliglecaprone 25 60% lost in 14 days
D polypropylene 0 (not applicable)
Which of the following is false regarding cutaneous suture patterns?
• A continuous cruciate provides a stronger closure compared to simple continuous and prevents eversion
• Interrupted horizontal mattress has the potential for tissue strangulation
• Simple continuous is appropriate for layers under tension
• Interrupted vertical mattress is stronger than interrupted horizontal mattress
C false
dehiscence of skin could result with continuous if one area fails
interrupted patterns allow adjustment of tension along wound edge
true/false: Absorbable suture that maintains strength for long periods may be preferred in patients with uremia, excess glucocorticoids, or advance age
true
all have delayed healing potential
The “golden period” after a wound is ____ hours because minimally contaminated can have bacteria multiply to _____ per gram of tissue or milliliter of exudate
3-6 hrs
10^5
t/f: Vertical pattern bites are unlikely to compromise vascular supply to wound edge
true
Dog ears smaller than ___ will regress in about 132 days in people.
8mm
1) in dogs with 5% lidocaine patches applied to normal skin, systemic absorption was detected within? • A) 6hours • B) 12 hours • C) 18 hours • D) 24 hours
B 12
When was a steady state reached? 24-48 hours
What layer of skin the hair follicle in?
dermis and superficial hypodermis
Name the 3 vascular plexuses of the skin
S-C-S
subpapillary
cutaneous
subdermal
