Integument Flashcards

1
Q

Phases of wound healing?

A

Inflammatory phase Proliferative phase Maturation and remodeling phase

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2
Q

What is required for optimum collagen production?

A

vitamin C

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3
Q

scars retain what % of tensile strength of normal skin

A

70-80%

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4
Q

Phases of wound healing

A

InflammatoryProliferativeMaturation/remodeling

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5
Q

Inflammatory phase of wound healing

A

Last up to 5 days, hemostasis, coagulation, MMPs, serine proteases, leukocyte margination, macrophages start to move in

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6
Q

Proliferative phase of wound healing

A

5-20 days, granulation tissue forms4 processes: neovascularization/angiogenesis, fibroplasia (MMP 1,2,3 facilitate migration of fibroblast which secrete fibronectin forming loose ECM) and collagen deposition (type 3 laid first which is weak baby collagen and slowly replaced with strong type 1 collagen), epithelialization (guided by type 1 collagen), wound contraction (skin peripheral to a full thickness defect advances in a centripedal fashion toward the center of the wound)

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7
Q

Maturation/remodeling

A

type 1 collagen replaces type 3, takes from day 20 to one year

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8
Q

Wound contraction rate

A

0.6-0.75 mm /day

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9
Q

Contracture

A

loss or inhibition of motion or function as a result of excessive scar tissue or muscle atrophy or fibrosis

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10
Q

What is required for optimum collagen production

A

vitamin C

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11
Q

When does tensile strength increase rapidly?

A

after day 4-5 at which fibroplasia and early collagen deposition noted

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12
Q

What do fibroblasts make?

A

collagen

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13
Q

What is intussceptive growth?

A

process of epithelial proliferation and collagen deposition that occurs within the stretched skin to bolster and restore cutaneous areas that are under significant tension

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14
Q

How long does wound contraction take?

A

6 weeks, square and rectangular incisions contract more effectively than circular ones

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15
Q

3 weeks after injury, what is tensile strength of scar?

A

20% of final strength

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16
Q

Scars retain what % of tensile strength of normal skin?

A

70-80%

17
Q

Formation of granulation tissue in cats vs. dogs

A

cats 19 days, dogs 7.5 days

18
Q

How are wounds classified according to degree of contamination? List and describe.

A

Clean- atrumatic, surgically created under aseptic conditions

Clean contaminated- minor break in aseptic surgical technique, contamination is minimal and easily removed

Contaminated- recent wound related to trauma with bacterial contamination from street, soil or oral cavity; surgical wound with major break in asepsis

Dirty/infected- older wound with exudate or obvious infection

19
Q

What are the 3 grades of open fractures?

A

Grade I- small break in skin caused by bone penetrating through

Grade II- soft tissue trauma contiguous with the fracture, often caused by external trauma

Grade III- extensive soft tissue injury, commonly in addition to a higher degree of comminution of the bone

20
Q

which type of lavage solution, compared to the others, was shown to have more mild cytotoxic effects on fibroblasts, hence making it a preferred flushing solution?

A

LRS

21
Q

what concentration of chlorhexadine is recommended for lavaging wounds?

A

0.05%

22
Q

Benefits of using sugar in open wound? Drawback?

A

osmotic action causing bactericidal effect; draws macrophages to wound, accelerates sloughing of devitalized tissue, cheap

Drawback- cuases more effusion, tus requiring more frequent bandage changes

23
Q

Advantages of honey as a wound dressing?

A

decreases edema, accelerates sloughing of necrotic tissue, provides rich cellular energy source, antibacterial properties b/c of high osmolarity, acidity and H2O2 content

24
Q

list 4 types of wounds that do not typically require the need for antibiotics

A

Clean wounds

superficial wounds <6 hrs old

contaminated wound that can be converted to clean wound with primary closure

wounds with a healthy granulation bed

25
Q

Describe how to estimate surface area affected by burn wounds

A

head/neck=9%

each forelimb=9%

each rear limb=18%

dorsal trunk=18%

ventral trunk=18%

26
Q

how do you characterize a 1st degree burn?

A

superficial; epidermis only

27
Q

characteristics of 2nd degree burn?

A

epidermis and superficial or deep part of dermis affected

28
Q

characteristics of 3rd degree burn?

A

full thickness, affecting entire epidermis and dermis

29
Q

characteristics of 4th degree burn?

A

full thickness with extension to muscle/tendon/bone

30
Q

what percent BSA affected has been shown to have a poor prognosis with burns?

A

>50%

31
Q

recommended fluid rate during the first 24 hrs in burn patients?

A

1-4 ml/kg BW x % total body surface area affected

32
Q

At what time point after a burn does the patient’s fluid status often stabilize, making them at higher risk for overload and edema?

A

48 hrs

33
Q

T/F- in human burn injury, prompt removal of the burn eschar is correlated with improved survival?

A

true