Exam 3 Wound Closure Flashcards Preview

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Flashcards in Exam 3 Wound Closure Deck (21)
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1
Q

Wounds closure general rules? (5)

A
Close anatomical layers
Approximate, don't strangulate
Use anatomical landmarks as guidelines
Eliminate dead space
Avoid tension across edges
2
Q

Primary Wound Closure/Healing by 1st Intention done when?

How?

Best for?

A

Closed w/i 24 hrs of injury, before development of granulation tissue

Edges are directly approximated

Best for clean, fresh, well-vascularized wounds

3
Q

Secondary Wound Closure/Healing by 2nd Intention is?

Best for?

A

Wound left open/allowed to close by epithelialization and contraction

Infected/contaminated wounds

4
Q

Tertiary Wound Closure/Healing by 3rd Intention is?

Best for?

A

Delayed primary closure
U several days post injury

Previously contaminated wounds

5
Q

Traumatic Wound management?

A
Cleanse surrounding skin
Remove hair
Epi for anesth/bleed control
Irrigation
Debridement
6
Q

Use of betadine/ABX soap in wound care?

A

Keep away from exposed tissue/out of the wound

7
Q

Do not use epi where?

A

Areas of P distal ischemia:

ears, digits, nose, penis

8
Q

Leave wounds open when? (5)

A
Human bites
> 8 hrs post (except for face)
Inflammed/infected
Crushed or ischemic tissue
High, sustained steroid use
9
Q

Scalp wound suture selection?

A
Skin = 4-0/5-0 microfil or staples
Deep = 4-0 absorb
10
Q

Face wound suture selection?

A
Skin = 5-0 to 7-0 monofil
Deep = 5-0 absorb
11
Q

Trunk/Extremity suture selection?

A
Skin = 4-0/5-0 monofil
Deep = 3-0/4-0 absorb
12
Q

Hand suture selection?

A
Skin = 5-0 monofil
Deep = 5-0 absorb
13
Q

Foot suture selection?

A
Skin = 3-0/4-0 monofil
Deep = 4-0 absorb
14
Q

Benefits of interrupted sutures?

Drawbacks?

A

Good for all wound types
Partial removal possible if infection

Slow to place

15
Q

Benefits of continuous sutures?

Drawbacks?

A

Good for clean wounds
Fast placement/removal

Infection compromises wound

16
Q

Wound dressing for clean wounds stay in place how long?

A

48 hrs to allow epithelialization

17
Q

Contaminated wounds dressed how?

A

Packed open

∆d Q 8-12 hrs

18
Q

Wound healing: Early phase includes? (2)

A

Days 0-4

1) Hemostasis:
Vasoconst/clotting
Cell recrutiment

2) Inflammation:
Vasodilation
WBC/PMN migration to cleanse
Macrophages @ day 3 stim fibroblasts/collagen

19
Q

Wound healing: Intermediate phase includes? (3)

A

Days 4-30

1) Epithelialization:
Reestablish barrier

2) Angiogenesis:
New capillaries

3) Fibroblasts:
Migrate/proliferate
Build matrix

20
Q

Wound healing: Late phase includes? (3)

A

1) Matrix deposition:
Glycans/Hyaluronic acid framework for collagen

2) Collagen synth:
Builds CT along stress lines of scar

3) Wound contraction:
Closes edges during collagen synth
Lasts ~15 days

21
Q

Wound healing: Final phase includes? (2)

A

Days 30 - 2 yrs

1) Scar remodeling/maturation:
Collagen continues to organize and becomes dense
Scar becomes avascular/acellular

2) Wound strength:
85% of strength @ 6 wks
90% @ 6 mo
Never reaches 100%