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31 Cards in this Set

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what are the (6)* steps of wound healing?
Can I Care And Eliminate Cuts:

Coagulation;
Inflammation;
Collagen synthesis;
Angiogenesis;
Epithelialization;
Contraction
Can I Care And Eliminate Cuts
Another name for angiogenesis?

what growth factor is responsible for it?
Granulation


VEGF: Vascular Endothelial GF
how long after closure of primary surgical wound does epithelialization occur?
24 - 48 hours
what cells are responsible for wound contraction?
Myofibroblasts
what type of surgical wound classification is: Gross spillage from the GI tract?
Contaminated
what is considered a "Clean-Contaminated" surgical wound?
the respiratory, GI or GU tract was entered w/o spillage of contents
with Primary (First) Intention wounds, how long after surgery does wound strength reach its maximum?

what is the percentage of maximum strength compared to uninjured skin?
3 months

70 - 80% of normal skin
what is a Second Intention wound?

How is it dressed?
closure of wound not approximated by sutures

Dressed w/ packing of moist gauze and covered w/ sterile dressing
what is a Third Intention wound?

give example
a "Delayed Primary" where there is gross contamination of incision site, but closed w/ sutures

Example: Ruptured appendix -
skin and sub-q is not closed for 3 - 5 days after bacterial contamination is decreased
If surgical site infection occurs w/i 24 hours, what are the (2) MC bugs?

when is an infection apparent w/ other bugs?
Streptococcus
or
Clostridium

other bugs: 4 - 5 days post-op
what (3) operative sites are usually contaminated by Staphylococcus?
"A man's STAPH is his HEAD, HEART and BONE"

HEAD: Neurological or ophthalmic surgery

HEART: CV/thoracic surgery

BONE: Orthopaedic surgery
what bug type is usually the cause of post-op contamination for surgery on: GI, GU, OB/GYN cases?
Gram-Negative Bacilli
(and anaerobes)
what bug type is usually the cause of post-op contamination for surgery on head and neck procedures of oral mucosa?
Streptococcus
MCC of post-op fever w/i first 24 hours
Atelectasis
what are the (5) "W's" of post-op fever?
(in order)
Wind (Atelectasis);

Water (UTI);

Wound Infection;

Walking (DVT);

Wonder drugs
Antibotic Prophylaxis:

in general
Cefazolin
Antibotic Prophylaxis:

GI surgery / appendectomy
Cefoxitin
Antibotic Prophylaxis:

Urological procedure
Ciprofloxacin
Antibotic Prophylaxis:

Head and Neck
(2)
Cefazolin or Clindamycin

and

Gentamicin
Antibotic Prophylaxis:

Gram-positive cocci
First and Second generation Cephalosporins
Antibotic Prophylaxis:

Gram-negative rods

(2 possible)
Third generation Cephalosporins

or

Aminoglycosides
Antibotic Prophylaxis:

Anaerobes

(2 possible)
Metronidazole

or

Clindamycin
Antibotic Prophylaxis:

MRSA
Vancomycin
Name and define the (4) classic signs of infection
Calor - Heat, warmth

Dolor - pain

Rubor - redness

Tumor - swelling
what in a wound stimulates angiogenesis?
the Clot
What cells does Thrombin stimulate?
(4)
Endothelial cells;

Fibroblasts;

Monocytes;

Platelets
what is characteristic of the second phase of wound healing?

when does this occur?
Fibroblastic response to form collagen

(occurs on day 3)
what occurs in the Third phase of wound healing?

when does this occur?
Remodeling of tissue

(occurs 3 weeks after wound onset)
if person has vocal cord injury why is a Teflon injection used?
to cause a Chronic Granulomatous reaction which will stimulate fibrous tissue formation (approximating vocal cords)
where does epithelialization occur from?
Hair follicles

(and sebaceous glands)
in calculating burn surface areas, what amount is given to the:
1. Upper extremity
2. Lower extremity
3. Trunk and Abdomen
Rule of 9:

each UE = 9%

each LE = 18%

Trunk = 36% (divided into 4 quadrants of 9 each)