Flashcards in Wound Healing Deck (20):
What are the three types of wounds?
What are surgical wounds?
Incision - cut into or make an opening into tissue
Excision - removal of tissue
What is a chronic wound?
Develop last over time due to pathophysiological conditions
What is a traumatic wound?
Mechanic, thermal, or chemical destruction
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)
WhT are the wound healing types?
First intention (primary)
Secondary intention (granulation)
Third intention (tertiary)
What is primary wound healing?
Gentle handling of tissue
Minimal tissue damage
Bring edges together
ASAP after surgery
What is granulation healing?
Healing occurs with proper cleaning and dressing changes of wound
Wound fills in gradually
Extensive scar tissue
Contraction of surrounding tissue
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
What are the classifications of a surgical wound?
Clean wound class 1
Clean contaminated class 2
Contaminated class 3
Dirty class 4
When should the nurse classify the wound on the documentation sheets?
Always at end of surgical procedure
What would put a wound in class 1?
Elective surgical procedure with wound made under ideal surgical conditions
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
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
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
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
What factors can affect wound healing?
Fluid and electrolyte balance
Inflammatory and immune responses
What intraoperative factors can affect wounds?
Length of surgery
Location of wound
Foreign bodies in wound
Elimination of dead space in wound
What is a keloid?
Abnormal deposit of collagen in healing skin wound
Causes large dense scar
What are adhesions?
Fibrous bands in peritoneal cavity holding two structures together.