Chapter 76 Open Wounds Flashcards
What are the phases of open wound healing
Inflammation
Debridement
Repair/Proliferation
Maturation
What are the types of closures
Primary Wound Closure
Delayed Primary Wound Closure
Secondary Wound Closure - third intention healing
Second Intention
What is third intention healing
Secondary wound closure
Describe primary wound closure
First intention healing - appositional healing
What is delayed primary wound closure and when does it occur
Appositional closure within 3-5 days but before granulation tissue
Describe secondary wound closure and when does it occur
Appositional closure of the wound more than 3-5 days after wounding when granulation tissue is present.
Same as third intention healing
What is second intention healing
healing by contraction and epithelialization
What type of dressings should be placed on wounds depending on their moisture content
Dry wound: Exogenous moisture like hydrogel
Mild to moderate exudate: hydrocolloid dressing or polyurethane foam
Heavily exudative: colloidal dressing – calcium alginate + silver
Chlorhexidine MOA and properties?
MOA: Disrupts the cell membrane
Works against
Bacteria
Viruses (more so enveloped viruses less so against nonenveloped)
Fair against fungi
Poor in high temperatures against spores
Moderate rapidity of action
Excellent residual activity
Bactericidal at high []
Bacteriostatic at low []
Define the inhibin number of honey
Amount of dilution to which the honey will retain its antibacterial activity
Measured at dilutions of 25, 20, 15, 10 and 5% (lowest means it’s the strongest)
Honey MOA (3 main mechanisms)
Produces 0.003% H2O2 then oxidized to produce oxygen-derived free radicals that are damaging to microorganisms
Antimicrobial properties are enhanced by phenols and organic acids that are antibacterial and its low pH
Advantages of honey
Enhances autolytic debridement, enhances granulation tissue formation, and epithelialization
Effective against MRSA
What is the mechanism of action for negative pressure wound therapy
Stimulates granulation tissue from stress and strain on the extracellular matrix – altering proliferative response.
Macrodeformations in the tissue due to differing forces at the surface and depths of the wound may change pressure gradients, flow, and hence oxygenation, which may be inductive for release of growth factors, such as vascular endothelial growth factor (VEGF).
Purported beneficial effects of negative pressure wound therapy - name 5
Improves wound perfusion
reduces edema
stimulates granulation tissue formation
decreases bacterial colonization
removes exudate
Recommended negative pressure wound therapy setting for grafts
-65 to -75 mmHg
