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20 Cards in this Set
- Front
- Back
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Wound healing- 4 phases
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Inflammatory
Debridement Repair Maturation |
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Platelet initiates wound healing process
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releases growth factors process amplified and sustained by macrophages endothelial cells and fibroblasts
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Inflamatory phase
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blood fills wound and cleans surface
vasoconstriction occurs 5-10min vasodiilation occurs-clotting elements released clot formed, fibrin is wound strength scab formed |
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Debridement phase
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App. 6 hrs after injury
WBC's appear mostly neutrophils and monocytes Remove necrotic tissue, bacteria and foreign material from wound - Lag Phase |
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Repair phase
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3-5 days after injury, Fibroblasts into would - produce collegan that will mature in to fibrous or scar tissue
wound strength increased capillaries appear(red fleshy granulation tissue fills the wound underneath the scab) |
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Repair phase (cont)
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granulation tissue appears after 3-5 days
fills tissue defect protects wound provides barrier to infection provides asurface for new epithelial cells to form across provides a source of special fibroblasts(myofibroblasts) responsible for wound contraction. Epithelium formation 4-5 days faster if sutured or edges held close together |
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Wound debridment
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remove all contaminated, devitalized or necrotic tissue, surgical or en bloc]Enzymatic debridememt for wounds that are not suitable for surgical debridement
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Primary wound closure
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1st intention or appositional healing
suturing or grafting a wound soon after injury used for fresh clean sharplu incised wounds with minimal trama and minimal contamination. Treat within 6hrs of injury golden period |
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Delayed Primary Closure
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closure 1-3 days after injury, before granulation tissue appears- midly contaminated minimally traumatized wounds that require some debridment and cleaning
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Healing by contraction and epitheliazation
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2nd intention- indicated for dirty contaminated tramatized wounds- must have enough loose skin for contraction- new epethelium is fragile and easily abraded
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2ndary closure
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third intention, sutured 3-5 days safter injury, granulation tissue already present, indicated when wound severely contaminated or traumatized, contraction will not complete closure of wound or 2nd intention is undesireable
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Wound Bandaging
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protects wound from additional trauma and contamination(dries out)prevents wound dessication, prevents hematoma/seroma, obliterates deas space, immobilizes the wound, minimizes postoperative edema, exuberant granulation tissues, absorbs sound extulate, lifts away foreign material and loose tissue, provides acidic wnvironment promoting wound healing, keeps wound warm
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3 Bandage Layers - 1st Layer
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Primary Layer
direct contact with wound Non adherent - keep wound moist- enhances epitheliazation reduces inflammation reduces wound disruption |
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2. Secondary Layer
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Absorbent, padded, conforming layer of cast padding or roll cotton
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3. Tertiary Layer
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holding and protective layer- guaze elastic or adhesive tape. once wet bandage must be changed- should be nonocclusive(breathable)
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Wound Bandaging- Standard Proceedure for application
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Anchoring tape strips
primary bandage layer 2ndary bandage layer tertiary bandage layer- guaze Application of spling reflection and twist tape strips tertiary bandage layer - tape middle 2 toes exposed to assess color warmth and swelling |
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Casts
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fiberglass
fractures distal to elbow or stifle/immobilization- must extend one joint above or below any fracture or structure to be immobilized |
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bandages and splints
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Robert Jones
temporary immoblization - simple padded bandage - used to help reduce postoperative swelling of limbs little or no spliinting of the limbs |
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Chest Abdominal bandage
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standard 3 layers - apply firmly but dont constrict - effective for 1-2 hrs no longer than 4 hrs
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distal limb splints
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tongue depressors
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