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28 Cards in this Set
- Front
- Back
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what ABX have anerobic coverage and are used for bowel surgery?
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cefoxitin and flagyl
or clinda and flagyl |
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what ABX have anerobic coverage and are used for vascular procedures?
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ancef
or clinda and vanco |
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what are the 4 wound phases and their time frames? what is the most important?
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inflamm 24 hrs
epithelialization- 48 fibroplasia- 72 contraction > 5 days **24-48 hours most impt. |
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what is granulation tissue?
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the initial tissue deposited within the forming scar and lays the matrix for giving the scar its strength
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how long does it take for a wound to have granulation tissue and achieve strength?
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one month
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what is primary intention?
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closing the wound using simple tissue approximation: sutres, staples
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what is secondary intention?
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wound is allowed to close with out sutures etc, this lets the wound epithelialize and granulate on its own
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what is the MC mechanism of wound closure?
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wound contraction
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what is delayed primary closure?
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performed by leaving surgical dressing and wound to heal by secondary intent. usually done at 72-96 hours post op
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what type of wound is delayed primary closure best for?
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a wound that was infected/contaminated initially
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name 7 inhibitors of wound healing?
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nutrition
anemia cancer steroids radiation hypoxia bacteria |
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give examples of dressings (5)
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wet to dry
aquagel dakins solution acetic acid VAC dressings |
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describe the body's response to a burn?
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injury-->
release of vasoactive substances: histamine, PG, arachnidonic acid--> increased vascular permeability--> edema formation--> intravascular vol decrease--> decreased blood flow to renal, GI, skin leading to multi system organ damage--> decreased CO = decreased O2 to organs |
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why do burn patients get hypothermia?
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skin barrier is lost, edema forms, and fluid is lost from the wound surface
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a burn that extends into the dermis (not through) ?
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2nd degree
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in this class of burn, healing occurs within a few days as the injured epidermis peels off and reveals new skin?
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first degree
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this type of burn involves only epidermis?
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1st degree
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this class of burn the epidermis and dermis are destroyed, blisters may form and SC tissue may be damaged?
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2nd degree
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these burns are full-thickness burns with SC fat damage. nerve endings have been destroyed.
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3rd degree
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in this type of burn: SC tissue, fat, muscle and bone may be injured?
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4th degree
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what determines burn severity?
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depth and total body surface area
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what are the values according to the rule of 9's?
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arms 9% each
torso: front and back 18% ea head and neck 9% legs 18% each genitalia/peri. 1% |
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what is the tx for first degree burns?
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pain rx: dilaudid, morphine
keep wounds clean and covered |
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what is the tx for 2nd degree burns?
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remove blisters if infected.
appl silvadene antimicrobial cream |
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what are some tx options for burns?
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"CAP"
Cadaveric graft acticoat pig skin |
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what is the tx for 3/4th degree burns?
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perform excision and escharotomy early to avoid compartment syndrome:
split thickness skin graft |
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normal urine output goal?
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.5cc/kg/hr
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what type of fluids should be avoided in burn patient?
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D5W because blood fluid levels are generally elevated secondary to the burns
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