Flashcards in wound management Deck (67):
What is debridement?
the removal of necrotic tissue by excision
What is lavage?
the flushing of a wound to remove foreign material, wound exudate, and contamination
VTNE ?: Should antimicrobials be added to crystalloids for a wound lavage?
when lavaging, what is the best type of solution to use?
Sterile saline 0.9%
when lavaging, what types of soaps and antiseptic scrubs should be used and why?
none because most solutions can be damaging to tissues
what is granulation tissue?
new tissue formed in the repair of soft tissue (scab)
how many PHASES are there of wound healing and what are they, in order?
what phase of wound healing takes place directly after the injury?
what takes place that marks the end of the inflammatory phase?
when WBCs leak into the wound
what is the role of bleeding within a wound?
helps clean out the wound by washing away surface bacteria
what is the role of a bloodclot within a wound?
it stabilizes the edges of the wound
what phase of wound healing begins around 6 hours after an injury takes place?
what types of WBCs are seen during the debridement phase and what is their purpose?
phagocytic cells like neutrophils and monocytes; clean up the wound by removing necrotic tissue, bacteria, and foreign material
when does the lag phase take place?
first 3-5 days post injury
what takes place during the lag phase?
the body gathers materials to promote healing
what phase begins after the clot has formed and necrotic/foreign material has been removed?
what has to take place before the repair phase can begin?
foreign material (including necrotic material) has to be removed
what produces collagen that will later mature into a scar?
what phase of wound healing is associated with an invasion of fibroblasts?
at what phase of wound healing does epithelialization occur?
what is the final phase of wound healing?
what is another name for maturation phase?
when does the maturation phase of healing take place?
around 3 weeks post injury and can continue for several years
name 3 types of debridement
layered, en bloc, enzymatic
what phase is essential to prepare for the repair phase and why?
lag phase, this gathers all the cells that are needed to promote healing and tissue repair
which type of debridement is conservative and begins at the superficial layers?
which type of debridement completely excises the wound?
en bloc debridement
what form of debridement uses chemical based products to dissolve necrotic tissues?
what are the STAGES of wound healing, in order?
-exudative (inflammatory and debridement phases)
-collagen (lag and repair phases)
what are the 4 closure methods for a wound?
primary closure is also known as what?
first intention healing
contraction/epithelialization is also known as what?
second intention healing
secondary closure is also known as what?
third intention healing
what type of closure is used wound is closed 3-5 days after injury, before granulation tissue develops?
third intention healing/ secondary closure
what type of closure is used when the wound is allowed to heal without surgical closure?
second intention healing/ epithelialization
what type of closure is involved when the wound is closed before 3-5 days post injury, before granulation tissue develops?
delayed primary closure
what is contamination?
the introduction of infectious microbes into a wound
what type of closure is used when the wound is closed with sutures within the same day as the injury?
first intention healing/ primary closure
what is a degloving injury?
when the skin/tissue is removed by trauma
what is the color of poor granulation tissue and why does it have this color?
white, due to high amount of fibrous tissue with a low number of capillaries
what is infection?
the invasion and multiplication of microorganisms in body tissue causing local cellular injury.
how can you tell the difference between a contaminated wound and an infected wound?
the bacterial count and WBC count is much higher in an infected wound
what is dessication?
what are some benefits of bandaging a wound?
protects from further contamination, prevents wound dessication, minimizes surrounding edema, absorbs wound exudates and debris, promotes wound retention of CO2 and creation of an acidic environment, keeps wound warm
what is an abrasion?
a partial thickness wound of the epidermis
what is a laceration?
sharply incised edges with minimal tissue trauma, can be superficial (skin) or deep (muscle or tendon)
what is an avulsion laceration?
a laceration where the tissue is torn away from surrounding structures
what is the purpose of using a drain in wound management?
to eliminate dead space, provide wound drainage and prevent further contamination
what are the 2 types/categories of drains?
active and passive
what is the purpose of an open drain?
AKA passive drain
allows for wound fluid to drain from the skin and to treat or prevent abscesses from bite wounds and other injuries
what is the purpose of a closed drain?
AKA active drain
allows for drainage of additional fluids and provides constant negative pressure
when is the ideal time to remove an open drain?
when is the ideal time to remove a closed drain?
depends on amount of fluid that is being drained
example of open drain
example of closed drain
Jackson-Pratt (JP) drain
2 types of degloving injuries
anatomic and physiologic
how long can abdominal or chest compression bandages be left on?
no longer than 4 hours
what are decubitus ulcers?
AKA bed sores
ulceration on the skin as a result of compression of tissue between a bony prominence and a hard surface the patient is laying on
what are some ways to prevent decubitus ulcers?
adequate padding, rotate patient every 2-4 hours throughout the day, examine pressure points daily, give physical and hydrotherapy 3-4 times a day
how many degrees of burns are there?
4 (1st- superficial, 4th- severe)
which burn is superficial and doesn't blister?
first degree burn
which burn is burned throughout all layers of the dermis and appears white, black, leathery, firm, and depressed?
third degree burn
which burn is superficial and blisters with fluid accumulation?
second degree burn
what is the slowest method of debridement?
which heals by reepithelialization, abrasions or lacerations?
what is iatrogenic degloving and how does it occur?
degloving/sloughing of skin that occurs due to the fault of the technician or doctor. occurs by giving certain drugs perivascularly which will cause necrosis if not given directly IV