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Flashcards in Wound Healing Deck (20):
1

What are the three types of wounds?

Surgical
Chronic
Traumatic

2

What are surgical wounds?

Incision - cut into or make an opening into tissue

Excision - removal of tissue

3

What is a chronic wound?

Develop last over time due to pathophysiological conditions

4

What is a traumatic wound?

Mechanic, thermal, or chemical destruction

5

What r the phases of wound healing? How long is each phase?

Phase 1 - Inflammation 0-4 days
Phase 2 - proliferation or fibroplastic (2-22 days)
Phase 3 - maturation or remodeling (21 days - 2 years)

6

WhT are the wound healing types?

First intention (primary)
Secondary intention (granulation)
Third intention (tertiary)

7

What is primary wound healing?

Surgical incision
Aseptic technique
Gentle handling of tissue
Minimal tissue damage
Bring edges together
ASAP after surgery

8

What is granulation healing?

Secondary intention
Healing occurs with proper cleaning and dressing changes of wound
Wound fills in gradually
Extensive scar tissue
Contraction of surrounding tissue

9

What is tertiary or third intention healing?

Wound contaminated to start with
Wound approximation delayed by three or more days after injury
May need debridement
Retention sutures

10

What are the classifications of a surgical wound?

Clean wound class 1
Clean contaminated class 2
Contaminated class 3
Dirty class 4

11

When should the nurse classify the wound on the documentation sheets?

Always at end of surgical procedure

12

What would put a wound in class 1?

Elective surgical procedure with wound made under ideal surgical conditions

Primary closure
No open wound drainage - closed system acceptable
No breaks in stere technique
No inflammation present
Alimentary, respiratory,genitourinary tracts, or oropharyngeal cavity not entered

Eg breast biopsy, herniorrhaphy

13

What would put a wound in class 2?

Primary closure, open wound drainage present
Minor break in technique ctrl occurred
No inflammation or infection present
Alimentary, resp and genitourinary tracts and oropharyngeal cavity entered under controlled conditions without significant spoilage or unusual contamination

Eh tracheostomy, nephrectomy

14

What would put a wound in class 3?

Open, fresh traumatic wound of less than 4 hrs duration.
Major break in technique occurred
Acute non purulent inflammation present
Gross spillage/contamination from gastrointestinal tract
Entrance into genitourinary/biliary tracts with infected urine or bile present

Eg. Bowel resection with spillage, appendectomy for acute appendicitis

15

What would classify a wound as dirty (class 4)?

Old traumatic or more than 4 hours duration from dirty source with retained necrotic tissue, foreign body, or fecal contamination

16

What factors can affect wound healing?

Circulatory status
Age
Nut status
Fluid and electrolyte balance
Hematology
Inflammatory and immune responses
Drug therapy
Radiation therapy

17

What intraoperative factors can affect wounds?

Length of surgery
Location of wound
Complications
Foreign bodies in wound
Elimination of dead space in wound

18

What is a keloid?

Abnormal deposit of collagen in healing skin wound
Causes large dense scar

19

What are adhesions?

Fibrous bands in peritoneal cavity holding two structures together.

20

What sutures have the highest occurrence of complications?

Silk or cotton