Wound Closure and Bx

Question 1

What should you have before stepping into OR?

Answer 1

hat
mask
shoes

Question 2

Why is important to close the wound?

Answer 2

hemostasis
prevent infxn
preserve fxn
restore appearance
min pt disocomfrot

Question 3

What is phase 1 of wound healing? How long?

Answer 3

initial lag phase

days 0-5days

Question 4

What is phase 2 of wound healing? How long?

Answer 4

fibroplasia phase -rapid increase in wound strength

days 5-14days

Question 5

What is phase 3 of wound healing? How long?

Answer 5

final maturation phase - further connective tissue remodeling (80% of normal skin strength)
day 14- complete healing

Question 6

What sutures should be used during phases 1 and 2?

Answer 6

non absorbable skin stuure or stpales

Question 7

What if pt passes the time allotted for primary intention?

Answer 7

gauze + cephalexin x5days

return on day 3 and close w/non asorbable sutures

Question 8

What suture should be used for face? When to remove?

Answer 8

simple interrupted: 5 -6

subcuticular: 4-5
remove: 3-5days

Question 9

What suture should be used for scalp? When to remove?

Answer 9

simple interrupted: 4

10 days

Question 10

When to remove sutures for: upper body and hand? Lower body? Over joint?

Answer 10

upper body: 7-10days
lower body: 10-14days
over joint; 14-21days

Question 11

When can tapes and strips be used?

Answer 11

reinforcement to sutres

does not provide skin-edge eversion

Question 12

When can tissue adhesives be used?

Answer 12

facial, scalp that are les sthan 8cm and 0.5cm deep

Question 13

What is good about tissue adhesives?

Answer 13

fast
painless
no suture
low cost

Question 14

What is bad about tissue adhesives?

Answer 14

takes 7 days for sterngth
early dehiscence
expensive

Question 15

When is bx contraindicated?

Answer 15

infxn
inflammation
injury
coagulpathy

Question 16

When can excision be used?

Answer 16

malignant lesion
benign growth causing irritation
removal of subcutaneous growth - sebaceous cysts, lipoas

Question 17

When can punch bx be used?

Answer 17

malignant lesion

subcutaneous growths -sebaceous cysts, lipomas

Question 18

When can shave bx be used?

Answer 18

malignant
subcutaneous growths - sebacous cysts, lipoas
bening appearing lesions and comsetic is important

Question 19

What is the procedure sequence for bx?

Answer 19

PARQ signed
mark site
workspace prep
alcohol prep
anesthetic
\+/-sutures prep (betadine)
procedure
dress wound

Question 20

What should you avoid when chosing a bx site?

Answer 20

cosmetic area
old lesions
ulcerated lesion
poor circualtion