complex wounds and complication of wound healing Flashcards
Describe the features of this wound
Necrosis of skin - black due to lost blood supply (will need debriding)
Well demarcated
What can you see in this image?
Granulation tissue
Bone (mandible)
Periosteum gone so bone will not support granulation tissue on top of it
What is the issue with the healing of this wound
Chronic granulation tissue preventing epithelialisation
What is faraging used for?
Making holes in the exposed bone to reach the bone marrow to reach a rich supply of blood vessels to promote vascularisation and granulation
Why is this wound likely to get infected?
It is near the mouth
What ways could this wound be closed?
Pinch/punch graft
Free skin graft
Skin flap
Why would secondary intention healing be unlikely to successfully heal this wound?
Large site where infection is likely
Why would a free skin graft be unlikely to work on this site?
Lots of movement on jaw so unlikely to maintain tension and contact with granulation tissue so unlikely to take
What is the goal with this method?
Dressings to promote granulation tissue (e.g., honey, antimicrobial dressings)
Where is this wound located?
lateral aspect of hock
What structures could be underneath this wound?
Hock joint
Splint bones (2nd and 4th metatarsal)
Describe the features of the healing progress of this wound
Ring of healthy epithelial tissue but cannot make progress as no healthy granulation bed to grow over
Infection of granulation bed - not smooth
What may be stopping this wound from healing?
Foreign body (e.g., a bit of bone)
Lots of movement
Pressure sores due to bandaging
What has happened here?
Dehiscence (wound separation) due to tension
