Wound Healing Flashcards
Differentiate acute vs chronic wound.
Acute wound: 3-4 weeks
Chronic Wound: 4 to 6 weeks
A stellate wound configuration, that is more than 1cm in depth, that is more than 6 hours is ____ (prone, not prone) to tetanus infection?
Tetanus prone
Other possible tetanus prone: mechanism of injury via missile, crush, burn, frostbite, with signs of infection, devitalized tissue, and contaminants
Classify this wound. Atraumatic, uninfected, no entry to GU, GI, or respiratory tract, primarily closed, or drained with closed drainage
Class I - Clean, 2-5% infection rate
Classify this wound: involves normal but colonized tissue, there are minor breaks in sterile technique, entry to GU, GI or respiratory tract without significant spillage
Class II - clean-contaminated, 8-11% infection rate
Classify this wound: contains foreign or infected material, traumatic wounds, open, fresh, accidental wounds, gross spillage from GIT, entry to infected tissue, bones urine, or bile
Class III - contaminated, 15% infection rate
Classify this wound: old traumatic wound with retained devitalized tissue and those that involve existing clincal infection or perforated viscera, organism causing postoperative infection were present in the operative field before operation
Class IV - dirty, 28-40% infection rate
What are the phases of wound healing and it corresponding time course?
- Hemostasis and inflammation - from injury to 7 days
- Proliferation - 5 days to 3 weeks
- Maturation and remodeling - 3 weeks to 1 year
____left open to heal spontaneously after wound toilet and surgical debridement, beneficial in heavily contaminated wounds, and usually treated with “wet-to-dry” dressing
Secondary healing
____ wound is first cleaned and observed for a few days to ensure no infection is apparent and then it is surgically closed, used only for traumatic injuries, dog bites, lacerations from foreign bodies
Tertiary healing or delayed primary closure
Primary closure - approximate clean tissue without tension
Cite conditions where an acute contaminated wound can be left open
- Heavy bacterial inoculum (human bite)
- Long time lapse since wounding
- Crushed or ischemic tissue - severe contused avulsion injury
- Sustained high-level steroid ingestion
[days postwoundhealing]
Which cell matrix synthesis increases in the inflammation phase of wound healtin?
Collagen Type III
Fibrinectin
[days postwoundhealing]
Which cell matrix increases last? (Collagen)
collagen type I
[type of wound healing]
requires clean tissue to be approximated without tension
primary closure
[type of wound healing]
healing by primary intention
primary closure
In primary closure, the final result of the scar depends largely on _____
how well the dermal approximation
