Chapter 11 Terms

Question 1

Define Traumatic injury

Answer 1

physical injuries of sudden onset and severity that require immediate medical attention. Traumatic injuries are the result of a variety of blunt, penetrating, and burn injuries.

Question 2

define closed wound

Answer 2

The skin remains intact, but underlying tissues suffer damage.

Question 3

define open wound

Answer 3

The integrity of the skin is damaged.

Question 4

define simple wound

Answer 4

The integrity of the skin is compromised. There is no loss or destruction of tissue and there is no foreign body in the wound.

Question 5

define complicated wound

Answer 5

Tissue is lost or destroyed, or a foreign body remains in the wound.

Question 6

define clean wound

Answer 6

Wound edges can be approximated and secured. A clean wound is expected to heal by first intention.

Question 7

define contaminated wound

Answer 7

Contamination occurs when a dirty object damages the integrity of the skin. A contaminated wound can become infected within a short period.
Debridement of infected and/or necrosed tissue may be necessary, followed by thorough irrigation of the wound to further clean and wash out the contaminants, a procedure commonly referred to as irrigation and debridement (I and D).

Question 8

define chronic wound

Answer 8

wounds that persist for an extended period of time (bed sores and ulcers)

Question 9

what are the signs of inflammation?

Answer 9

Pain, Heat, Redness, Swelling, Loss of function.

Question 10

why does inflammation happen?

Answer 10

When injured tissues release histamine from the damaged cells. The histamine causes the small blood vessels in the area to dilate, increasing the blood flow to the area, and resulting in heat, redness, and swelling.

Question 11

what are the types of wound healing?

Answer 11

first intention (primary union), second intention (granulation), and third intention (delayed primary closure).

Question 12

what happens during the second intention of wound healing?

Answer 12

Healing occurs when a wound fails to heal by primary union or the wound is left open and allowed to heal from the inside to the outside by filling with granulation tissue

Question 13

what happens during the third intention of wound healing?

Answer 13

Healing occurs when two granulated surfaces are approximated; also referred to as delayed primary closure. (used in wounds that are contaminated or contain devitalized tissue)

Question 14

what happens during the first intention of wound healing?

Answer 14

First-intention healing occurs with a primary union that is typical of an incision opened under ideal conditions.

Question 15

define incidental/ chronic wounds

Answer 15

Incidental wounds, or iatrogenic wounds, are wounds that can happen as a result of therapy or treatment.

Question 16

define intentional wounds

Answer 16

chemical wounds, occlusion banding, and surgical site incision or excision. Surgical site incisions can be incisional or excisional.

Question 17

define wound

Answer 17

wound is described as any tissue that has been damaged by surgical or traumatic means.

Question 18

what are the phases of primary union?

Answer 18

Phase 1: LAG/ inflammatory response
(day 3-5) no tensile strength
Phase 2: proliferation
(day 3-20) 25-30% tensile strength
Phase 3: Maturation/ differentiation
(day 14-12 months) continued collagen fiber weave, slow and sustained increase in tensile strength

Question 19

what factors influence wound healing

Answer 19

Physical condition: age, obesity, smoking, etc.
External factors: drug therapy, hematology
Suture techniques: surgical site infections, etc.

Question 20

What are the CDC surgical wound classification categories?

Answer 20

Class I: Clean
Class II: Clean contaminated
Class III: Contaminated
Class IV: Dirty
(classified according to the degree of microbial contamination)

Question 21

Class I: Clean

Answer 21

• primary closure
• no inflammation
• ideal surgical conditions
• no entry into aerodigestive or genitourinary tract

Question 22

Class II: Clean Contaminated

Answer 22

• primary closure
• open/mechanical drain (Penrose)
• minor break in sterile technique
• entered into aerodigestive or genitourinary tract

Question 23

Class III: Contaminated

Answer 23

• Acute inflammation
• major break in sterile technique
• entry into aerodigestive or genitourinary tract with spillage

Question 24

Class IV: Dirty/ Infected

Answer 24

• perforated organ
• microbial contamination before the procedure
• open traumatic wound