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Flashcards in wound management Deck (67):
1

What is debridement?

the removal of necrotic tissue by excision

2

What is lavage?

the flushing of a wound to remove foreign material, wound exudate, and contamination

3

VTNE ?: Should antimicrobials be added to crystalloids for a wound lavage?

no

4

when lavaging, what is the best type of solution to use?

Sterile saline 0.9%

5

when lavaging, what types of soaps and antiseptic scrubs should be used and why?

none because most solutions can be damaging to tissues

6

what is granulation tissue?

new tissue formed in the repair of soft tissue (scab)

7

how many PHASES are there of wound healing and what are they, in order?

5 phases

-inflammatory
-debridement
-lag
-repair
-maturation

8

what phase of wound healing takes place directly after the injury?

inflammatory

9

what takes place that marks the end of the inflammatory phase?

when WBCs leak into the wound

10

what is the role of bleeding within a wound?

helps clean out the wound by washing away surface bacteria

11

what is the role of a bloodclot within a wound?

it stabilizes the edges of the wound

12

what phase of wound healing begins around 6 hours after an injury takes place?

debridement phase

13

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

14

when does the lag phase take place?

first 3-5 days post injury

15

what takes place during the lag phase?

the body gathers materials to promote healing

16

what phase begins after the clot has formed and necrotic/foreign material has been removed?

repair phase

17

what has to take place before the repair phase can begin?

foreign material (including necrotic material) has to be removed

18

what produces collagen that will later mature into a scar?

fibroblasts

19

what phase of wound healing is associated with an invasion of fibroblasts?

repair phase

20

at what phase of wound healing does epithelialization occur?

repair phase

21

what is the final phase of wound healing?

maturation phase

22

what is another name for maturation phase?

remodeling phase

23

when does the maturation phase of healing take place?

around 3 weeks post injury and can continue for several years

24

name 3 types of debridement

layered, en bloc, enzymatic

25

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

26

which type of debridement is conservative and begins at the superficial layers?

layered debridement

27

which type of debridement completely excises the wound?

en bloc debridement

28

what form of debridement uses chemical based products to dissolve necrotic tissues?

enzymatic debridement

29

what are the STAGES of wound healing, in order?

-exudative (inflammatory and debridement phases)
-collagen (lag and repair phases)
-maturation (maturation)

30

what are the 4 closure methods for a wound?

-primary
-delayed primary
-contraction/epithelialization
-secondary

31

primary closure is also known as what?

first intention healing

32

contraction/epithelialization is also known as what?

second intention healing

33

secondary closure is also known as what?

third intention healing

34

what type of closure is used wound is closed 3-5 days after injury, before granulation tissue develops?

third intention healing/ secondary closure

35

what type of closure is used when the wound is allowed to heal without surgical closure?

second intention healing/ epithelialization

36

what type of closure is involved when the wound is closed before 3-5 days post injury, before granulation tissue develops?

delayed primary closure

37

what is contamination?

the introduction of infectious microbes into a wound

38

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

39

what is a degloving injury?

when the skin/tissue is removed by trauma

40

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

41

what is infection?

the invasion and multiplication of microorganisms in body tissue causing local cellular injury.

42

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

43

what is dessication?

extreme dryness

44

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

45

what is an abrasion?

a partial thickness wound of the epidermis

46

what is a laceration?

sharply incised edges with minimal tissue trauma, can be superficial (skin) or deep (muscle or tendon)

47

what is an avulsion laceration?

a laceration where the tissue is torn away from surrounding structures

48

what is the purpose of using a drain in wound management?

to eliminate dead space, provide wound drainage and prevent further contamination

49

what are the 2 types/categories of drains?

active and passive

50

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

51

what is the purpose of a closed drain?

AKA active drain
allows for drainage of additional fluids and provides constant negative pressure

52

when is the ideal time to remove an open drain?

3-5 days

53

when is the ideal time to remove a closed drain?

depends on amount of fluid that is being drained

54

example of open drain

Penrose drain

55

example of closed drain

Jackson-Pratt (JP) drain

56

2 types of degloving injuries

anatomic and physiologic

57

how long can abdominal or chest compression bandages be left on?

no longer than 4 hours

58

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

59

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

60

how many degrees of burns are there?

4 (1st- superficial, 4th- severe)

61

which burn is superficial and doesn't blister?

first degree burn

62

which burn is burned throughout all layers of the dermis and appears white, black, leathery, firm, and depressed?

third degree burn

63

which burn is superficial and blisters with fluid accumulation?

second degree burn

64

what is the slowest method of debridement?

enzymatic debridement

65

which heals by reepithelialization, abrasions or lacerations?

abrasions

66

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

67

with which drugs can we see iatrogenic degloving injuries if not administered properly?

ketamine (IV only), barbituates (IV only), Vitamin K (SQ but is small amounts in multiple locations)