Chapter 14: Wounds Flashcards
Primary wound closure
Suture wound closed immediately (a.k.a. “first intention”)
Secondary wound closure
- Wound is left open and heals over time without sutures (a.k.a. “secondary intention”)
- it heals by granulation, contraction, and epithelialization over weeks (leaves a larger scar)
Delayed primary closure (DPC)
Suture wound closed 3 to 5 days AFTER incision (classically 5 days)
How long a sutured wound epithelializes?
24 to 48 hours
After a primary closure, when should the dressing be removed?
POD #2
When can a patient take a shower after a primary closure?
Anytime after POD #2 (after wound epithelializes)
What is a wet-to-dry dressing?
Damp (not wet) gauze dressing placed over a granulating wound and then allowed to dry to the wound; removal al_lows for “microdébridement” of the woun_d
What inhibits wound healing?
- Infection
- ischemia
- diabetes mellitus
- malnutrition
- anemia
- steroids
- cancer
- radiation
- smoking
What reverses the deleterious effects of steroids on wound healing?
Vitamin A
What is an abdominal wound dehiscence?
- Opening of the fascial closure (not skin)
- treat by returning to the O.R. for immediate fascial reclosure
What is Dakin solution?
Dilute sodium hypochlorite (bleach) used on contaminated wounds
What is negative-pressure wound therapy (a.k.a. “wound vac”)?
Occlusive dressing with sponge and negative pressure system used to accelerate wound healing in acute and chronic wounds
What are the components of an negative pressure wound therapy (NPWT) system?
- Negative pressure unit
- Occlusive dressing
- Foam sponge
What are the potential advantages of negative-pressure woundtherapy?
- Draws wound edges together
- removes exudates and infectious materials
- reduces edema
- promotes perfusion
- facilitates formation of granulationtissue
