E3: Skin/Soft Tissue Disorders Flashcards
What are the risk factors for impaired wound healing?
- Infection
- Smoking
- Malnutrition
- immobilization
- DM
- Vascular disease
- immunosuppressive therapy
What is the most common pathogen responsible for infection from animal bites?
Pasteurella
What are the 3 pathogens that cause infection from human bites?
- Eikenella Corrodens (gram neg anaerobes)
- Group A strep
- Staph
How can you tell if a human bite is from an adult or child?
-if the maxillary inter canine distance is >2.5cm, it is adult
When should you get a surgical consult for a wound?
- 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
What is the most common cause of a plantar puncture?
Stepping on a nail
What are the indications for closure of a laceration?
- Extension into SubQ
- Decrease healing time
- reduce likelihood of infection
- decrease scar formation
- repair loss of structure or function
- improve cosmesis
What are the contraindications for wound closure?
- Contaminated wounds
- wound is older than 12 hours
- presence of FB
- Wounds involving tendons, nerves, or arteries
What does it mean if a wound is closed by primary intention?
- All layers are closed, has best chance for minimal scarring
- clean or clean-contaminated wounds
What does it mean if a wound is closed by secondary intention?
- Deep layers are closed
- superficial layers left to granulate, can leave a wide scar
- requires frequent wound care
What does it mean if a wound is closed by delayed primary intention?
-Deep layers are closed primarily, and superficial laters are closed 4-5 days later after infection is not a concern
Is Vicryl Absorable?
Yes
Is PDS absorbable?
Yes
Is prolene absorbable?
No
Is Nylon absorbable?
No
Is chromic gut absorbable?
Yes
What are the risk factors for a laceration infection?
- 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
What is cellulitis?
A non-necrotizing inflammation of the skin and SubQ tissue, usually related to acute infection that does not involved the fascia or muscles
What are the most common pathogens responsible for cellulitis in immunocompetent patients?
Strep and staph aureus
What are the most common pathogens responsible for cellulitis in immunocompromised patients?
Pseudomonas, proteus, Serratia, enterobacter, and Citrobacter
What are the 4 cardinal signs of infection?
Erythema, pain, swelling, and warmth
What are the signs of a deep soft tissue infection?
- Violaceous Bullae
- Cutaneous hemorrhage
- skin sloughing
- Skin anesthesia
- rapid progression
- gas in tissue
What is the mainstay treatment of cellulitis?
Beta lactams
What medication should b used when strep or MRSA is suspected?
Cephalexin
