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31 Cards in this Set

  • Front
  • Back

Secondary Complications

•Local / systemic infections-abx
•Hypoproteinemia-protein for healing
•Sequelae related to tissue necrosis

Wound Healing

•Hemostasis and Inflammation
•Cell migration and Proliferation

Types of Wounds-know difference

•Puncture Wound

Contusion def


Rupture of sq vessels and extravasation of erythrocytes

Contusion signs

•No break in skin

Hematoma def

big bruise

Rupture of a deeper and larger vein or artery
•Fluid fluctuance / doughy mass

usually benign depending on location

Crush Injury

•Composite injury involving 2 or more tissue types

usually involves bones

•Assess ___ in crush injuries

neuro/circulation status and function

------ can develop in crush injuries

Compartment syndrome

hours later


•Superficial or deep
•Partial / full thickness

benign-leave open unless deep


•Stretching or tearing away of the soft tissues, creating a full thickness loss

flapping of skin


Shearing forces
•May appear viable on admission

•48-96 hours later will declare themselves


avulsion to extreme-torn completely away

underlying tissue too


•Trauma w/ sharp object
•Halo of erythema
•Will gap if muscle is involved
•Superficial – dermis and epidermis
•Deep-more concerned when in muscle or getting close to bone


what to do

*Heightened risk of infection-wood more than bullet/glass
•Do not close-dont enclose infection
•Do not remove Impaled objects



•Crush injury
•Grossly contaminated-RATS-rabies, abx, tetanus, soap


•Distal foot

Reimplantation factors

Sharp, guillotine like > crush/avulsion
•Upper > lower extemity
•Children > adults
•Physical condition

Determinants of Wound Healing

•Oxygen-acidation dec healing
•Infection Smoking / Temp
•Electrolyte / Acid-Base Balance
•Preexisting Health Conditions

Wound Assessment

•Exam-tunneling? cavetation? circulation bilaterally?
Resuscitation, critical care, rehabilitation

Wound Management

•Systemic support
•Perfusion and oxygenation
•Infection control / antibiotics
•Progressive physical activity
•Wound closure and debridement


•Primary closure-stitches or dermabond
•Partial thickness-wet to dry dressing
•Deep partial thickness / full thickness-wound vac-inc granulation

Alterations in Healing

•Keloids / excess scarring
•Scar contracture
•Pressure ulcer

Fingertip Injuries

•Crush – distal phalanx
•Subungual hematoma
•High pressure pain / grease gun


•Unpredictable path
•Appearance not always reflection of injury

Compartment Syndrome when


•6-8 hours – 48-96 hours

Compartment Syndrome


•pain not relieved by narcotics
•Pain w/ flexion, decreased mobility of digits
•Tense skin
•High index of suspicion for comatose patient

4-6hrs to intervene before loose extremity

Compartment syndrome

pressure _______ require fasciotomy

Pressures > 30-60 require fasciotomy

Strain def

•Overstretching at point of attachment to tendon
•3rd-may need surgery

Sprain def

•Joint exceeds normal limit and damages ligaments
•1st minor pain
•2nd week to heal more edema bruising
•3rd lots edema no walking on it, may need surgery

compartment syndrome

_______intervene before loose extremity after signs show up

4-6hrs to intervene before loose extremity