Wound healing Flashcards Preview

Surgery I > Wound healing > Flashcards

Flashcards in Wound healing Deck (66):
1

Term: Closed wound

Contusion or crushing injury

2

Term: Open wound

Abrasions + Avulsions + Incisions + Lacerations

3

Term: Clean wound

Surgically created under aseptic conditions

4

Term: Clean-contaminated

Surgical wound into respiratory + alimentary + urogenital tract

5

Term: Contaminated

Open, acute, accidental or surgical wounds with a major break in sterility

6

Term: Crush wound

Result of body part being subject to high degree of force

7

Term: Contusion

A blod to the skin which blood vessels are damaged and rupture

8

Term: Abrasion

Damage to the epidermis and portions of the dermis by blunt trauma or shearing forces

9

Term: Avulsion

Loss of skin by tearing of tissue from attachments

10

Term: Incision

Sharp object that has minimal adjacent tissue damage

11

Term: Laceration

Irregular wound created by tearing of the tissue

12

Term: Puncture

Penetrative injury with minimal skin damage + variable underlying tissue damage

13

What are the four stages of wound healing?

Inflammatory
Debridement
Repair
Maturation

14

What kind of response is the inflammatory phase of healing?

Protective tissue response

15

What four big things occur during the inflammatory phase of healing?

Vascular constriction for 5 to 10 min
Vascular dilation
Extrinsic pathway activation by thomboplastin
Platelet aggregation + clot formation

16

What is the inflammatory phase causes vasoconstriction?

Catcholamine
Serotonin
Bradykinin
Histamine

17

What is occurring with in the inflammatory tissue in that inflammatory phase?

Localized when fibrin + plasma exudate plug the lymphatics
Clot dries --> scab forms

18

How long is the inflammatory phase?

3 to 5 days

19

What is the debridement phase characterized by?

Exudate

20

What is in the exudate in the debridement phase?

WBC's + Necrotic tissue + Wound fluid

21

At what point do neutrophils show up to the injury?

6 hours post insult

22

At what point do monocytes show up to the injury?

12 hours post insult

23

What cell type is essential for wound healing?

Monocytes

24

How long does it take monocytes to become macrophages at the injury site?

24 to 48 hours

25

What four functions do macrophages provide at the injury site once they are activate?

Secrete collagenases + GF
Recruit mesenchymal cells
Stimulate angiogenesis
Modulate matrix production

26

At what point post-injury does the repair phase occur?

3 to 5 days

27

What occurs during the repair phase?

Fibroblasts migrate to the wound
Followed by angiogenesis
Type 3 collagen is deposited

28

What time point post injury is the max amount of collagen present?

2 to 3 weeks

29

What happens to the type 3 collagen in the wound

converts to type 1

30

What structurally makes up granulation tissue?

Capillaries + FIbroblasts + Fibrous tissue

31

What occurs at the maturation phase?

Wound strength is at its maximum

32

What % of original tissue strength is regained?

80%

33

What happens in the maturation phase?

Granulation tissue loses some of its cellularity

34

When is the most rapid increase in the strength of the wound during healing?

During days 7 to 14

35

What is moist wound healing?

Occlusive bandage to facillitate healing
Low oxygen tension within wound
Increase local temperature to site of wound

36

What are the advantages to moist wound healing

Optimal environment for healing
Hastens debridement + granulation formation
Limits infection
Less scars and no scabs
Less painful

37

How much does epithelialization increase by with moist wound healing?

twice as fast

38

What is the disadvantage of moist wound healing?

Bacterial COLONIZATION of wound surface + foliculitis + maceration of wound border

39

What Four big things affect wound healing?

Age + Serum protein level + Disease + Obestit

40

What level of serum protein do we start to see healing issues?

Below 1.5 to 2 g/dl

41

What diseases cause a decrease in a patients ability to heal?

Hepatic disease
Hyperadrenocorticism
Diabetes mellitus

42

What is different about the way cats heal?

Cutaneous wounds close slower
Slower by second intention
Produce less granulation tissue
Heal more by contraction of wound edges

43

What are some underlying tissue types that DO NOT support granulation tissue?

Periosetum + Tendon + Nerve sheath

44

What are common external factors applied to patient to help/harm with wound healing?

Radiation therapy
Corticosteroids
Chemotherapy
Hyperbaric oxygen therapy

45

What does radiation therapy do to wound healing?

Inhibits all stages of wound healing by affecting angiogenesis

46

What does corticosteroids do to wound healing?

Depress all stages of wound healing and increase change of infection

47

What are the fundamentals of wound management

Stabilize patient
Cover wound till you can address it
Clip and clean area
Debride dead or necrotic tissue
Lavage wound
Perform appropriate wound closure

48

What are the tips for a good surgical debridement?

Start superfically and progress deeper
Sharp dissection techniques
Debribe muscle till it bleeds
Remove any and all contaminated fat

49

What is autolytic debridement?

Creation of moist wound environment to facilliate increase endogenous enzymes

50

Which is more prefered surgical or autolytic debridement?

Autoylytic

51

Which is faster surgical or autolytic debridement?

Surgical

52

What do you use on a wet bandage?

Hypertonic saline

53

What is bandage debridement?

Place ment of dressings that are allowed to dry on the wound

54

When is bandage debridement most effective?

Early stages of wound healing
-- or --
Infected wounds

55

What is the down side to bandage debridement?

Very painful, can damage surrounding healthy tissue

56

What is the advantage of enzymatic debridement?

Poor anesthetic canadiates

57

What are the disadvantages of enzymatic debridement?

Must reamin contact for adequate time to acheive result
Local tissue irritation

58

What is biosurgical debridement?

Maggot therapy

59

When is primary wound closure appropriate?

Clean or clean contaminated wounds that have been converted to clean wounds

60

When is primary wound closure recommended?

Wounds that require immediate closure

61

What is an important consideration when it comes to primary closure?

Close without a lot of tension

62

When does delayed primary closure occur?

2 to 5 days post injury

63

When is delayed primary closure appropriate?

Clean contaminated + Contaminated wounds with questionable health (Edema + skin tension)

64

What is an important consideration of delayed primary closure?

Debride tissue and lavage wound before closure

65

When is secondary intention healing appropriate?

Wounds unsuitable for closure
Large skin defects or extensive tissue devitalization

66

How does healing occur with secondary intention healing?

Via granulation tissue + wound contraction + epithelialization