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Soft Tissue Surgery > 6: wound healing > Flashcards

6: wound healing Flashcards

1
Q

3 layers of the skin

A

Epidermis
hypodermis
dermis

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2
Q

Series of thin muscles under the skin in dogs and cats

A

panniculus

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3
Q

Why is the panniculus so important during surgery

A

failure to preserve will cause loss of blood supply and wound dehiscence

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4
Q

provide blood supply to skin

run parallel to skin

A

Cutaneous arteries

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5
Q

Major blood supply to the skin

A

subdermal plexus

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6
Q

Why is the subdermal plexus important

A

must be preserved to maintain blood supply

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7
Q

Coagulation times

A

<5 min

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8
Q

Inflammatory stage time

A

0-24 hours

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9
Q

debridement stage time

A

2-5 days

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10
Q

Repair stage

A

4-21 days

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11
Q

Maturation stage times

A

21 days - 2 years

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12
Q

3 stages of primary coagulation

A
  1. damaged endothelium exposes collagen fibers to blood elements
  2. Biding of subendothelial collagen with von Willebrand factor
  3. Platelets form platelet plug
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13
Q

Secondary coagulation

A

series of factors react resulting in formation of fibrin meshwork around wound

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14
Q

Intrinsic path numbers

A

12, 11, 9, 8

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15
Q

Extrinsic pathway numbers

A

3, 7

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16
Q

Common path numbers

A

10, 5, 2, 1

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17
Q

Which is necessary for wound healing, macrophages or neutrophils

A

macrophages

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18
Q

First leukocyte to enter wound
numbers increase from 24-48 hours
degrade and clear bacteria

A

Neutrophils

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19
Q

Required for healing of wounds
predominate 2-5 days after injury
phagocytize necrotic tissue

A

Macrophages

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20
Q

Removal of necrotic tissue and debris by macrophages

Most important thing we can do to help heal a wound

A

debridement

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21
Q

End of debridement stages is characterized by influx of

A

fibroblasts into the wound

22
Q

what marks the proliferative stage

A

influx of fibroblasts

rapid accumulation of collagen

23
Q

when epithelial cells proliferate and move across a wound until they contact each other

A

contact inhibition

24
Q

Cells that contain actin and myosin fibers that exert tensile forces on the ECM resulting in closure of the defect

A

Myofibroblasts

25
Q

How does collagen remodel

A

according to tensile forces

26
Q

How is tensile strength changed during maturation phase

A

minimally

27
Q

How does the source of wound strength change over time

A

as the suture starts to absorb, the tissue strength should increase

28
Q

Intrinsic wound factors (7)

A 
hypoproteninemia
anemia
malnutrition
uremia
diabetes mellitus
hyperadrenocroticisim
infection
29
Q

Extrinsic wound factors (4)

A

mechanism (shear, crush)
foreign material
irradiation
antiseptics

30
Q

How are wounds classified

A

based on time and contamination

31
Q

Class 1 wound

A

0-6 hours

minimal contamination

32
Q

Class 2 wound

A

6-12 hours

moderate contamination

33
Q

Class 3 wound

A

> 12 hours
gross contamination
never close

34
Q

Clean wound

A

surgical procedure

not entering GI or respiratory tract

35
Q

Clean-contaminated surgery

A

GI or respiratory tract entered

minor break in asepesis

36
Q

Contaminated surgery

A

Gi with gross contamination,
inflammation
major break in sepsis

37
Q

Dirty surgery

A

devitalized or necrotic tissue
gross debris
Pus

38
Q

When should you use antimicrobials

A 
class 2-3 wound
Clean-contaminated to dirty surgeries
39
Q

What should you always do with bite wounds

A

open them

40
Q

First step in addressing an open wound

A

clip the fur and put sterile lube on it

41
Q

First and most important aspect of contaminated wound treatment

A

removal of trash via mechanical lavage using saline

42
Q

after removal of trash you should

A

debride the wound

43
Q

Wet bandages

A
  1. layer of saline soaked gauze
  2. dry laparotomy sponges on top
  3. vet wrap over all of it
44
Q

active drain

A

preferred
just for support
make vacuum in wound to remove fluid

45
Q

Passive drain

A

gravity

2-5 days at most

46
Q

Wound closure stages

A

Primary
Delayed primary
late secondary
second intention

47
Q

Primary would closure

A

immediate closure of wound

<6 hours

48
Q

Delayed primary wound closure

A

after 6 hours

before granulation >2 days

49
Q

Late secondary wound closure

A

after appearance of granulation tissue >2 days

50
Q

Second intention wound closure

A

no surgical closure

dependent on wound healing

Soft Tissue Surgery (14 decks)

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