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Emergency/surg > E3: Skin/Soft Tissue Disorders > Flashcards

E3: Skin/Soft Tissue Disorders Flashcards

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1
Q

What are the risk factors for impaired wound healing?

A
  • Infection
  • Smoking
  • Malnutrition
  • immobilization
  • DM
  • Vascular disease
  • immunosuppressive therapy
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2
Q

What is the most common pathogen responsible for infection from animal bites?

A

Pasteurella

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3
Q

What are the 3 pathogens that cause infection from human bites?

A
  • Eikenella Corrodens (gram neg anaerobes)
  • Group A strep
  • Staph
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4
Q

How can you tell if a human bite is from an adult or child?

A

-if the maxillary inter canine distance is >2.5cm, it is adult

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5
Q

When should you get a surgical consult for a wound?

A
  • If it is a deep penetrating wound to the bone, tendon, joints, or other major structures
  • complex facial lacs
  • wounds associated with neurovascular compromise
  • wounds with complex infections
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6
Q

What is the most common cause of a plantar puncture?

A

Stepping on a nail

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7
Q

What are the indications for closure of a laceration?

A
  • Extension into SubQ
  • Decrease healing time
  • reduce likelihood of infection
  • decrease scar formation
  • repair loss of structure or function
  • improve cosmesis
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8
Q

What are the contraindications for wound closure?

A
  • Contaminated wounds
  • wound is older than 12 hours
  • presence of FB
  • Wounds involving tendons, nerves, or arteries
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9
Q

What does it mean if a wound is closed by primary intention?

A
  • All layers are closed, has best chance for minimal scarring
  • clean or clean-contaminated wounds
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10
Q

What does it mean if a wound is closed by secondary intention?

A
  • Deep layers are closed
  • superficial layers left to granulate, can leave a wide scar
  • requires frequent wound care
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11
Q

What does it mean if a wound is closed by delayed primary intention?

A

-Deep layers are closed primarily, and superficial laters are closed 4-5 days later after infection is not a concern

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12
Q

Is Vicryl Absorable?

A

Yes

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13
Q

Is PDS absorbable?

A

Yes

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14
Q

Is prolene absorbable?

A

No

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15
Q

Is Nylon absorbable?

A

No

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16
Q

Is chromic gut absorbable?

A

Yes

17
Q

What are the risk factors for a laceration infection?

A
  • Wound older than 12 hours
  • bites
  • crush wounds
  • contaminated wounds
  • avascular areas
  • wounds involving joint spaces, tendons, or bones
  • history of valvular heart disease
  • immunocompromised patients
18
Q

What is cellulitis?

A

A non-necrotizing inflammation of the skin and SubQ tissue, usually related to acute infection that does not involved the fascia or muscles

19
Q

What are the most common pathogens responsible for cellulitis in immunocompetent patients?

A

Strep and staph aureus

20
Q

What are the most common pathogens responsible for cellulitis in immunocompromised patients?

A

Pseudomonas, proteus, Serratia, enterobacter, and Citrobacter

21
Q

What are the 4 cardinal signs of infection?

A

Erythema, pain, swelling, and warmth

22
Q

What are the signs of a deep soft tissue infection?

A
  • Violaceous Bullae
  • Cutaneous hemorrhage
  • skin sloughing
  • Skin anesthesia
  • rapid progression
  • gas in tissue
23
Q

What is the mainstay treatment of cellulitis?

A

Beta lactams

24
Q

What medication should b used when strep or MRSA is suspected?

A

Cephalexin

25
Q

What Abx should be used for cellulitis in a patient with a PCN allergy?

A

Macrolides

26
Q

What medications should be used for a mild cellulitis?

A

Penicillin, cephalosporin, Dicloxicillin, or Clindamycin

27
Q

What medications should be used for a moderate cellulitis?

A

Penicillin, ceftriaxone, Cefazolin, or Clindamycin

28
Q

What is the treatment for recurrent cellulitis?

A

Penicillin or erythromycin BID for 4-52 weeks

29
Q

What are the 3 risk factors for abscess formation?

A
  • Staph aureus carrier
  • break in skin
  • Immunocompromised
30
Q

How should you treat cellulitis secondary to a burn injury?

A

IV cefazolin or Clindamycin or Vanc if suspected MRSA

31
Q

What is necrotizing fasciitis?

A

-Infection of the deep soft tissues that results in progressive destruction of the muscle fascia or overlying Sub Q fat

32
Q

What are the common pathogens that cause fourniers gangrene?

A
  • E coli, Klebsiella, enterococci

- Anaerobes: Bacteroides, fusobacterium, clostridium

33
Q

What is Fourniers Gangrene?

A

-Infection of the perineum often involving the scrotum, characterized by sever pain starting in the anterior abdominal wall and migrates to the gluteal muscles, scrotum, and penis

34
Q

What is the treatment of Fourniers Gangrene?

A

Aggressive surgical debridement and broad spectrum Abx

Emergency/surg (9 decks)

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