Sutures Flashcards
what type of wound has a more successful closure?
a fresh wound
who are the first responders that immediately begin the healing process?
pro inflammatory cytokines released by platelet aggregation
wounds greater than a width of a dime _____ heal well on their own if at all?
WILL NOT
3 basic principles of wound repair
1.minimize trauma to tissue
2. minimize tension on wound edges (approximate!)
3. accurately approximate wound edges & landmarks, especially vermillian borders of lips
inflammatory phase of wound healing
begins immediately and lasts 5 days
proliferative phase of wound healing
within 24 hours has sealed the wound from surface water not emersion
continues for approx 6 months
**at 24 hrs the surgically closed wound is sealed to shower water
remodeling phase of wound healing
approx 2 more years
orderly phases of wound healing
inflammation
granulation tissue
wound contraction
collagen accumulation/remodeling
close the wound
-fresh wound hours old
-large clean wound
-over cartilage or bone
-to reduce scarring
-to reduce bleeding
-surgically debrided & irrigated wounds
Don’t close the wound!
-days old or contaminated wound (unless in cosmetic area)
-abscess that are drained
-wounds that have opened after previous repair or dehiscence
-foreign bodies in wound
from what direction does the wound heal best?
from the bottom going up
what doesn’t work well in abscesses?
local anesthetics d/t generally acidic (H+) environment of the abscess fluid
*lidocaine is mildly acidic & blocks the sodium channels of depolarization
what has a greater chance of infection?
the more suture in the wound
where do sutures always pull out?
sutures in muscle & fat
for best cosmetic results:
close wound parallel to langer’s lines (provides least tension)
