Wounds / Healing Flashcards Preview

SURGICAL CARE > Wounds / Healing > Flashcards

Flashcards in Wounds / Healing Deck (25):
1

Wound healing by primary intention

Clean incision, early suture, hairline scar

Fibrin plug > regrowth basal epidermis > lysis of fibrin, re-epithelialization > restoration to intact skin

2

Wound healing by secondary intention

Gaping irregular wound > Granulation > Epithelium grows over scar

large defect filled w fibrin clot >
new blood vessels / fibroblasts from dermis into fibrin >
collagen from granulation tissue > mature collagen and epidermis growth w scar

3

Wound healing by tertiary intention

Wound > increased granulation > late suturing with wide scar

4

General phases of wound healing

1. Hemostasis and Inflammation
- immediately >> first few days

2. Proliferation
- after first few days >>> several weeks

3. Maturation / Remodeling
- after 2-3 weeks >>> several months

5

Amount of protein needed / day for adequate wound healing

1gm of protein / kg / day

6

Normal ankle-brachial index

0.9-1.2

7

Normal toe-brachial index

0.65

8

Normal transcutaneous O2 measurement

60mmHg

9

Tx for venous ulcers

Compression therapy

Increase external pressure from 20 to 60mmHg

Applied over a wound dressing and usually consists of several layers to provide compression. (Unna boot)

10

Typically associated with moderate to severe pain which is made worse with leg elevation

Arterial ulcers

11

Present with “punched out” ulcer

Arterial ulcers

12

Tx for arterial ulcers

Treatment is with wound care and vascular surgery if possible. DO NOT COMPRESS

13

Ankle brachial index =

ankle BP divided by arm BP. Normal is 0.95 - 1.20

14

With lower extremity arterial disease, the BP at the ankle is ____ than BP at arm

lower than

15

An ABI less than ____ is associated with rest pain and less than____ with tissue necrosis

0.5

0.3

16

What may lead to an ABI higher than 1.20

calcified arteries

17

Wagner DFU classification of "superficial ulcer without subcutaneous involvement"

Grade 1

18

Wagner DFU classification of "extensive ulceration with exposed bone"

Grade 3

19

Wagner DFU classification of "penetrates through the subcutaneous tissue; may expose bone, tendon, ligament, or joint capsule"

Grade 2

20

Wagner DFU classification of "gangrene of toes or foot"

Grade 4

21

Wagner DFU classification of "gangrene of whole foot"

Grade 5

22

Ulcerative skin disease of uncertain etiology.
About half the patients will have Crohn’s disease, ulcerative colitis, rheumatoid arthritis

Pyoderma gangrenosum

23

Cause unknown, but most likely an inflammatory disorder with collagen degeneration, granulomata formation in the dermis, and microangiopathy. Seen in diabetics.

Necrobiosis lipoidica

24

Physiologic stress response in acute phase / first 24 hours of surgery

Peripheral vasoconstriction
Concomitant hypothermia
Shunting of blood and substrate to vital organs

25

Cytokines which play major role in inflammatory response to surgery

IL-1

IL-6

TNF alpha