Wound healing Flashcards by Raegan Chambers

Term: Closed wound

Contusion or crushing injury

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Term: Open wound

Abrasions + Avulsions + Incisions + Lacerations

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Term: Clean wound

Surgically created under aseptic conditions

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Term: Clean-contaminated

Surgical wound into respiratory + alimentary + urogenital tract

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Term: Contaminated

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

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Term: Crush wound

Result of body part being subject to high degree of force

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Term: Contusion

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

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Term: Abrasion

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

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Term: Avulsion

Loss of skin by tearing of tissue from attachments

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Term: Incision

Sharp object that has minimal adjacent tissue damage

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Term: Laceration

Irregular wound created by tearing of the tissue

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Term: Puncture

Penetrative injury with minimal skin damage + variable underlying tissue damage

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What are the four stages of wound healing?

Inflammatory
Debridement
Repair
Maturation

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What kind of response is the inflammatory phase of healing?

Protective tissue response

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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

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What is the inflammatory phase causes vasoconstriction?

Catcholamine
Serotonin
Bradykinin
Histamine

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

Localized when fibrin + plasma exudate plug the lymphatics

Clot dries –> scab forms

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How long is the inflammatory phase?

3 to 5 days

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What is the debridement phase characterized by?

Exudate

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What is in the exudate in the debridement phase?

WBC’s + Necrotic tissue + Wound fluid

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At what point do neutrophils show up to the injury?

6 hours post insult

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At what point do monocytes show up to the injury?

12 hours post insult

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What cell type is essential for wound healing?

Monocytes

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

24 to 48 hours

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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

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

3 to 5 days

What occurs during the repair phase?

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

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

2 to 3 weeks

What happens to the type 3 collagen in the wound

converts to type 1

What structurally makes up granulation tissue?

Capillaries + FIbroblasts + Fibrous tissue

What occurs at the maturation phase?

Wound strength is at its maximum

What % of original tissue strength is regained?

80%

What happens in the maturation phase?

Granulation tissue loses some of its cellularity

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

During days 7 to 14

What is moist wound healing?

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

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 ```

How much does epithelialization increase by with moist wound healing?

twice as fast

What is the disadvantage of moist wound healing?

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

What Four big things affect wound healing?

Age + Serum protein level + Disease + Obestit

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

Below 1.5 to 2 g/dl

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

Hepatic disease Hyperadrenocorticism Diabetes mellitus

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

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

Periosetum + Tendon + Nerve sheath

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

Radiation therapy Corticosteroids Chemotherapy Hyperbaric oxygen therapy

What does radiation therapy do to wound healing?

Inhibits all stages of wound healing by affecting angiogenesis

What does corticosteroids do to wound healing?

Depress all stages of wound healing and increase change of infection

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 ```

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

What is autolytic debridement?

Creation of moist wound environment to facilliate increase endogenous enzymes

Which is more prefered surgical or autolytic debridement?

Autoylytic

Which is faster surgical or autolytic debridement?

Surgical

What do you use on a wet bandage?

Hypertonic saline

What is bandage debridement?

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

When is bandage debridement most effective?

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

What is the down side to bandage debridement?

Very painful, can damage surrounding healthy tissue

What is the advantage of enzymatic debridement?

Poor anesthetic canadiates

What are the disadvantages of enzymatic debridement?

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

What is biosurgical debridement?

Maggot therapy

When is primary wound closure appropriate?

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

When is primary wound closure recommended?

Wounds that require immediate closure

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

Close without a lot of tension

When does delayed primary closure occur?

2 to 5 days post injury

When is delayed primary closure appropriate?

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

What is an important consideration of delayed primary closure?

Debride tissue and lavage wound before closure

When is secondary intention healing appropriate?

Wounds unsuitable for closure | Large skin defects or extensive tissue devitalization

How does healing occur with secondary intention healing?

Via granulation tissue + wound contraction + epithelialization

Wound healing Flashcards

(66 cards)