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Flashcards in Wounds Deck (13):
1

Clean wound

- Surgical prep
- GI tract not entered
- Primary closure
- No abx

2

Clean- contaminated wound

- Surgical prep, enter GI tract
- Primary closure
- Cefazolin abx

3

Contaminated wound

- Trauma with foreign material or spillage of GI contents
- Debridement, irrigation
- Secondary closure
- Oflaxaxin abx

4

Dirty and infected wound

- Pus at site
- Necrosis
- Debridement, irrigation, secondary closure
- Augmentin

5

First intention healing

- Suturing or other closure of wound
- Wound to MD in 12 hrs
- Best aesthetic and fxn outcome

6

Second intention healing

- Healing through granulation
- Increased scarring
- Wounds contaminated with debris and bites

7

Tertiary intention healing

- Closure after 3-4 days
- Allows close monitoring
- Increased blood flow to wound to encourage healing
- Immunocomp pts

8

Substate phase of healing

- Coagulation: fibrin, thromoin and compliment attract inflammation cells
- Platelets attract leukocytes
- Interleukins, histamin, serotonin and bradykinin cause constriction then dilation

9

Proliferative phase

- Fibroplasia and matrix deposition
- Collagen and proteoglycans form CT matrix
- Angio genesis in 4 days
- Epitheliazation- keep moist

10

Remodeling phase

- Collagen fiber maturation
- Lysis and contraction
- Fibroblasts and leukocytes

11

Infectious agent

Bacteria creating toxic metabolites leading to tissues destruction
- Skin aerobes- strep and staph
- Clostridium in dead tissue
- Opportunistic pathogens in immunocompromised

12

Susceptible host

- Age- reduced cell fxn
- Immunosuppression- increased susceptibility
- Steroid- suppress inflammation
- Stress, pain
- Smoking- Vasoconstriction

13

Closed, unperfused space

- Perfusion and oxygenation very important
- Lack affects natural ability to fight infection
- Hypercapnia and acidosis increase risk
- Narrow outlets- gall bladder, appendix
- Potential spaces