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CVNT2 > Wound Management > Flashcards

Wound Management Flashcards

(42 cards)

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1
Q

Why is wound classification important?

A

Ensures correct management of the wound and patient

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2
Q

What are the characteristics of a class 1 wound?

A

0-6 hours old
Clean laceration
Minimal contamination

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3
Q

What are the characteristics of a class 2 wound?

A

6-12 hours old

Significant contamination

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4
Q

What are the characteristics of a class 3 wound?

A

> 12hrs old

Gross contamination

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5
Q

What is a clean wound?

A

A wound created under sterile conditions (surgical)

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6
Q

What is a clean contaminated wound?

A

Wound with minimal contamination (easily removed)
Surgical penetration of a tract
Can close after appropriate treatment

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7
Q

What is a contaminated wound?

A

Wound with gross contamination with foreign debris

Can close after appropriate treatment

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8
Q

What is a dirty/infected wound?

A

Wound with infection >10^5 organisms per gram

Never close primarily

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9
Q

What is an incision wound?

A

Created by sharp objects, smooth edges with minimal surrounding trauma

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10
Q

What is an abrasion wound?

A

Created by blunt trauma/shearing force, damage to skin

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11
Q

What is an avulsion wound?

A

Tearing of tissue from attachment, avulsion of limbs, degloving

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12
Q

What is a laceration wound?

A

Irregular wound created by tearing, variable damage to tissues

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13
Q

What is a puncture wound?

A

Penetrating wound by sharp object, minimal superficial damage but substantial deeper damage

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14
Q

What are the 3 stages of wound healing?

A

Inflammatory phase
Proliferative phase
Maturation phase

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15
Q

When is the inflammatory phase of wound healing?

A

Within first 72 hours post-injury

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16
Q

What happens in the inflammatory phase of wound healing?

A

Haemorrhage within minutes of injury, then vasoconstriction

Vasodilation to release clotting elements into wound

WBCs leak from blood vessels into wound, initiating debridement

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17
Q

When does the early proliferative phase of wound healing begin?

Study These Flashcards
A

3-5 days post-injury

18
Q

What happens in the early proliferative stage of wound healing?

Study These Flashcards
A

Granulation tissue fills wound

Fibroblasts lay network of collagen in wound bed for strength

Epithelial cells from wound margins migrate to cover wound

19
Q

What happens in the maturation stage of wound healing?

Study These Flashcards
A

Remodelling phase -

Collagen fibres reorganise, remodel and mature to give wound tensile strength, forming scar tissue

20
Q

When does the maturation stage of wound healing occur?

Study These Flashcards
A

2-4 weeks post-injury

21
Q

What are the broad goals of wound healing?

Study These Flashcards
A

Full epithelialisation without scar formation in as minimal time as possible

Without re-occurrence/risk of breakdown

Cost effective as possible

22
Q

What are the 6 goals of wound management?

Study These Flashcards
A
  1. Prevent further contamination
  2. Remove foreign debris
  3. Debride dead/dying tissue
  4. Promote viable vascular bed
  5. Provide drainage
  6. Select appropriate method for closure
23
Q

How do you assess viability of tissue in wound healing?

Study These Flashcards
A

Colour, warmth, pain sensation, bleeding

24
Q

What is a primary wound closure?

When can sutures be removed?

Study These Flashcards
A

Closure for wounds with minimal tissue contamination/loss/trauma

Explore, lavage and debride wounds before closing

Sutures removed at day 10

25
What is a delayed primary wound closure?
For wounds which have gone beyond the 'golden period' (0-6 hours) Explore, lavage and surgically debride thoroughly
26
What is a secondary wound closure?
For heavily contaminated/dirty wounds Managed as open until granulation established, then wound edges are debrided and closed
27
What is secondary intention healing of a wound?
Wounds with significant tissue loss/contamination/ infection Managed as open wound Allowed to granulate and epithelialise
28
What factors make a wound suitable for closure?
Significant tissue to allow reconstruction without dehiscence No devitalised tissue No signs of infection/contamination Adjacent skin is healthy Functional structures will be affected by delayed closure
29
Why might you choose a non-adherent/passive/absorbent dressing (e.g. Allevyn)?
Absorbs fluid - suitable for exudative wounds Semi-permeable (breathable) Delivers moist environment
30
When might you choose a non-adherent/passive/MILDLY absorbent dressing?
Lightly exuding lesions, sutured wounds, superficial cuts and abrasions, light burns Allows epithelialisation and light absorption of exudate
31
How often should you change a wet to dry/dry to dry dressing?
Daily/twice daily depending on volume of exudate
32
How often should you change a dressing on a granulating wound?
Every 2-3 days
33
What are some of the limitations which can be encountered during wound care?
Cost (main) Infection Patient tolerance of nursing care Owner patience
34
What are the most important things to consider when triaging a wounded patient?
Any life-threatening concerns (pneumothorax, diaphragmatic hernias, ruptured bladder, head injuries) Hydration status TPMR Visual check of wounds/haemorrhage severity Respiratory effort or concerns
35
What are the main steps in cleaning and prep of a wound?
1. Cover and protect wound (sterile lube or saline-dampened swab) 2. Clip hair away from around wound 3. Flush wound with sterile technique 4. Investigation of wound can now be carried out
36
What equipment is required for flushing a wound?
``` Warm Hartmanns/saline Giving set 3-way tap 18/19G needle 20-30ml syringe Incontinence pads (lots) ```
37
How does nursing of an equine wound differ to cat/dog nursing?
Often involves radiographs/ultrasound More concern over tension on wound Quills sometimes used to release pressure Aim for minimal scar tissue Care with selection of topical ointments
38
Are these drains active or passive?
Active
39
Are these drains active or passive?
Passive
40
How often should a wound dressing be checked?
At least every 4-6 hours
41
When checking a wound dressing, what should you be looking for?
Damp/wet, slipping Patient interference and tolerance of dressing Tightening (swelling above/below elbow) Checking toes for moisture/temperature
42
When should wound management patients be discharged and allowed to go home?
ASAP - usually when dressing are being changed every 2-3 days and wound has made good progress

CVNT2 (47 decks)

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