Use LEFT and RIGHT arrow keys to navigate between flashcards;
Use UP and DOWN arrow keys to flip the card;
H to show hint;
A reads text to speech;
19 Cards in this Set
- Front
- Back
|
How should a surgical wound heal? |
-Primary intention -The dermis will knit back together & a thin line of new epithelial cells will grow |
|
|
What are the phases of wound healing? |
-Inflammatory -Proliferative -Maturation |
|
|
What happens in the inflammatory phase of wound healing? |
-Immediate; haemorrhage, vasoconstriction & coagulation -Wound surface, clot dries, seals wound & allows a healing environment, eventually slough -After 5 -10 mins the injury causes vasodilation, increased vascular permeability & an influx of neutrophils & macrophages -Debridement " phase inflammatory cells remove bacteria & remove necrotic tissue -Platelets & macrophages release growth factors which stimulate other cells involved in the healing process |
|
|
What happens in the proliferative phase of wound healing? |
-3 -7 days post injury -Fibroblasts proliferate & collagen is produced -Forms granulation tissue -Epithelial cells proliferate & migrate, flowing over each other & reattaching to the granulation tissue underneath. Fastest when moist wound -Incised & sutured wound sealed by epithelial migration in 6 - 8 hours -Once epithelialisation complete; angiogenesis & fibroplasia are inhibited -Wound contraction occurs, with myofibrobasts in wound pulling edges closer together by up to 30% |
|
|
What happens in the maturation phase of wound healing? |
-5 - 7 days post injury -Lysis & reformation of collagen occur continuously, would will always tend to be weaker than the surrounding tissue. -Strength of the healing area of the wound depends upon the collagen laid down -Good blood supply is essential -Infection will release tonic metabolites which delay healing |
|
|
What are open wound examples? |
-Abrasion -Degloving / shear -Avulsion -Laceration -Incisional -Puncture -Burn -Pressure sore |
|
|
What are closed wound examples? |
-Contusion ; bruising -Haematoma |
|
|
What can wounds be classified into? |
-Open wounds -Closed wounds |
|
|
What is lavage? |
-May need GA -Fill wound with a water soluble gel to prevent hair becoming embedded in the tissues -Clip & surgically clean skin -Flush the wound with copious amounts of fluid; most effective way of dislodging & removing bacteria & debris -Hartmans is the ideal fluid to use; isotonic sterile |
|
|
What is debridement? |
-Many wounds will need surgical debridement -Aim is remove damage tissue & foreign material -"Wet to dry" dressing used; though these may be considered outdated |
|
|
What are the properties of bite wounds? |
-Puncture wounds -Look very superficial initially but underlying tissue will often have been badly bruised -Large area of skin may undergo necrosis over the following 3 - 5 days -Large areas of sub - cutaneous tissue may undergo necrosis leading to swelling, seroma or abscess formation, pyrexia, gangrene |
|
|
What are the classifications for contamination? |
-Clean
-Clean contaminated - Contaminated -Dirty |
|
|
What is the contamination classification of clean? |
-A surgical wound -No break in sterility |
|
|
What is the contamination classification of clean - contaminated? |
-Surgical wounds of the respiratory, urogenital or GI systems where complete sterility cannot be achieved -Also fresh wounds which have been carefully lavaged & debrided |
|
|
What is the contamination classification of contaminated? |
-Wounds which have been contaminated but where they are fresh enough for bacterial multiplication not to be a problem yet -Surgical wounds where a major break in sterility has occurred such as the leakage of intestinal contents |
|
|
What is the contamination classification of dirty? |
-Active infection present -Contaminated wound more than 6 hours old -Wounds where tissue is undergoing necrosis -Wounds where foreign material is still present |
|
|
What can be the causes of delayed healing? |
-Seroma formation -Tension on wound edges -Presence of necrotic tissue -Infection -Suture reaction |
|
|
What is a sinus? |
-A connection between a cavity & an epithelial surface. Most commonly due to a reaction to a FB. Removal of the foreign material will allow healing |
|
|
What is fistula? |
-A connection between 2 epithelial surfaces e.g oronasal fistula following canine tooth removal. Must be surgically repaired |
