Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

Integumentary > 5] Surgical Wounds > Flashcards

5] Surgical Wounds Flashcards

1
Q

Sutures are for

A

Small incisions

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

Steristrips for?

A

Reinforcing subcutaneous skin closures

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

Staples for

A

Large incisions

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

Tissue adhesives for

A

Used in linear incisions or lacerations

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

Suture removal in the face

A

3-5 days

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

Suture removal in trunk, arms, legs, scalp

A

7 days

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

Suture removal in hands, feet, over joints, back

A

10-14 days

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

What do u document with sutures ?

A

Document # of sutures/staples removed andpatient tolerance to procedure

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

Sutures should be removed before

A

epidermis
has migrated into
the deeper parts ofthe dermis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

Removal of necrotic tissue from a wound to improve or facilitate the healing process

A

Debridement

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

Necrotic tissue is typically the result of

A

Poor blood supply
Prolonged inflammation
Bacterial damage

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

Dead/necrotic tissue serves as a

A

inflammatory stimulus and a medium for bacterial growth

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

Debridement should start when

A

Within 3 day of Dx

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

If a patient has a systemic infection, debridement should start

A

Within 12 hours

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

Systemic infection signs (5)

A 
Increased temperature
Leukocytosis
Confusion
Agitation
Symptoms have no other identified cause
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

Benefits of debridement (4)

A

Removal of bacteria
 Stimulation of growth factors
 Removes senescent cells
 Removes hyperprolifeative, nonmigratory tissue

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

May be yellow, green, gray or black

May be loose and stringy or thick and leathery

A

Necrotic tissue appearance

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

2 main types of debridement

A

Selective and nonselective

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

3 types of SELECTIVE debridement

A

Sharp/surgical
Enzymatic
Autolytic

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

3 types of NONselective debridement

A

Mechanical
Wound irrigation
Hydrotherapy

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

Use of scalpel, forceps, scissors, (by trainedPT, RN or PA) to remove dead tissue

A

Sharp/surgical debride

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
22
Q

Quickest method

A

Sharp debride

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
23
Q

Sharp/surgical debride always used when ?

A

signs of advancing cellulitis or sepsis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
24
Q

Where can sharp/surgical debride be performed

A

Bedside or OR

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
25
Q

Precautions of sharp debride (3)

A

Caution with sharp debridement if pt has
prolonged bleeding time (check PT, PTT,
INR)
 Avoid aggressive debridement if wound does not have adequate blood supply to heal
 Only physicians are licensed to cut healthy
tissue – do not attempt to deroof a tunnel or
sinus tract

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
26
Q

Topical enzyme agents degrade necrotic tissue

A

Enzymatic debride

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
27
Q

Enzymatic debride is a great option for

A

non-surgical candidates, pts in LTC, homecare

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
28
Q

is often performed

prior to application to increase surface area for contact

A

Cross-hatching/scoring eschar

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
29
Q

Do not use enzymatic debride in conjunction with

A

Silver dressings

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
30
Q

Examples: santyl, medihoney

A

Enzymatic Debridement

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
31
Q

Uses the body’s own enzymes to break down necrotic tissue

A

Autolytic Debridement

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
32
Q

Apply a moisture-retentive dressing; fluid

accumulates which aids in the lysis/softening of necrotic tissue

A

Autolytic Debridement

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
33
Q

What softens the tissues in autolytic debride?

A

Phagocytic cells and preotelytic enzymes; digested by macrophages

34
Q

Slowest method of debride

A

Autolytic

35
Q

Autolytic debride CANNOT be used with?

A

Infected wounds

36
Q

Selectively debride
necrotic tissue
Secrete enzymes that breakdown proteins and digest
bacteria

A

Maggots

37
Q

Maggots are applied when?

A

Every 2-3 days

38
Q

Maggots are contra-indicated for

A

limb-threatening wounds,
psychological distress,
bleeding abnormalities,
deep-tracking wounds

39
Q

Uses an external force to remove necrotictissue

A

Mechanical debride

40
Q

What does non-selective mean?

A

Does not discriminate between viable and nonviable tissue

41
Q

Mechanical debride may cause ? So you might have to do what for the pt?

A

May cause pain;

Consider premedicating patient

42
Q

Examples: wet to dry, water jet

A

Mechanical debride

43
Q

Moving water dislodges loose debris; used for large wounds that need aggressive
cleaning/softening of necrotic tissue

A

Whirlpool

44
Q

Whirlpool is contraindicated in

A

Granulating wounds b/c it might macerate the wound bed

45
Q

Disadvantages of?

Periwound maceration
Trauma to wound bed
Waterborne infections
Cross-contamination
Dependent position may increase edema
Potential for burns
A

Whirlpool

46
Q

Specialized equipment that provides pulsating irrigation, followed by suction; operates with the same principle as a carpet shampooer

A

Pulses lavage with suction

47
Q

Disadvantages for Pulsed Lavage with Suction

A 
risk of inhalation of 
aerosolized particles (requires gown plus 
eye/face protection); risk of driving organisms deeper into wound; may cause pain
48
Q

Who can oNLY do sharp debride?

A

PTs

49
Q

When do you NOT debride?

A

-Stable heel wounds with firmly adherent eschar
-Do not debride necrotic arterial wounds
-Do not debride in patients who are at risk for
bleeding (check PT, PTT, INR)
-Systemic infection
- Unidentified structures in wound bed
 Dry gangrene
 Debridement may be delayed in patients whoare critically ill, unstable or severely neutropenic, as long as it is not infected

50
Q

Why not debride stable eschar onheels?

A

Less blood flow
 Small amount of subcutaneous tissue over calcaneus
 Highly susceptible to infection
 Takes longer time to heal

51
Q

 Selective versus nonselective
 Location, type and amount of necrosis present
 Type and amount of necrotic tissue removed
 Instruments used and settings used if
applicable

A

Documentation for debride

52
Q

Most amputations are performed for

A

Ischemic disease of LE

53
Q

Pathophys of amputations

A 
PVD
Trauma
Tumor
Infection
Congenital limb deficiency
54
Q

removes toe and corresponding metatarsal bone

A

Ray amputation

55
Q

removes forefoot

A

Transmetatarsal amputation

56
Q

cuts

through ankle joint

A

Symes amputation

57
Q

Complications with amputations (4)

A

Infection
Dehiscence
Excessive wear of prosthesis causing breakdown
Phantom limb pain

58
Q

Post recovery ambulation rate for hip disarticulation

A

0-10%

59
Q

Post Recovery Ambulation Rate for AKA

A

38-50%

60
Q

Post Recovery Ambulation Rate for knee disarticulation

A

31%

61
Q

Post Recovery Ambulation Rate for BKA

A

80%

62
Q 
Causes:
Violating lifting 
precautions or excess
Wound infection
Tight sutures which cut off blood flow to 
wound edges leading tonecrosis
Decreased skin 
integrity
A

Dehiscence

63
Q

What is dehiscence

A

Surgical complication where the wound ruptures along the incision

64
Q

Sutures break, stretch or cutthrough tissue, knots slip,
suture too thin, insufficient
number of sutures

A

Dehiscence due to technical factors

65
Q

Age >65, emergency operation,cancer, hemodynamic
instability, intra-abdominal
sepsis, wound infection,
hypoalbuminemia, obesity, use of steroids, heavy coughing,
ascites

A

Dehiscence due to patient Factors

66
Q

Lacerations how do you fix it?

A

Irrigate/debride to remove debris

67
Q

Abnormal opening between 2 epithelial surfaces

A

Fistula

68
Q

External fistulas empty into?

A

The environment like skin

69
Q

Internal fistulas empty into?

A

Other organs

70
Q

Esophageal fistula

A

Clear or white output

71
Q

Gastric fistula

A

Green output

72
Q

Small bowel fistula

A

Light brown or tan output

73
Q

Internal organ protrudes from the wound

A

Evisceration

74
Q

If evisceration occurs, what do you do?

A 
1- stay calm
2- keep it moist 
3- keep pt NPO for immediate surgery 
4- lower head of bed less than 20 deg 
5- monitor vitals and assess for Signs/Sx of shock
75
Q

Beta-hemolytic Streptococcus

pyrogenes Develops following a breach in the mucous membranebarrier

A

Necrotizing fasciitis

76
Q

Early signs of necrotizing fasciitis includes

A

Early signs include reddened,

swollen, extremely painful area of cellulitis; fever

77
Q

With progression of necrotizing fasciitis, dark red

induration of epidermis and bullae filled with ? And then?

A

Blue/purple fluid and then As progression continues, skin becomes blue, maroon, or black

78
Q

How does necfasc happen?

A

Bacteria make protein that destroys tissue directly
 Toxins released
 Immune system destroys healthy tissue in fight against bacteria

79
Q

Diagnosed via tissue culture, ESR, WBC,ultrasound, CT scan

A

Nec fasc

80
Q

Treatment for nec fasc

A

Treatment includes early, aggressive surgical
debridement and broad-spectrum IV antibiotics.
Wound is packed and kept moist; often requires daily debridement

81
Q

This skin graft Includes the epidermis and part of the
dermis; more fragile; more
contraction; smoother/shinier; abnormally pigmented

A

Split thickness skin graft

82
Q

This skin graft includes the epidermis and the entire

dermis; better cosmesis; less contraction

A

Full thickness skin graft

Integumentary (15 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions