Exam 1 Flashcards
What are the four stages of wound healing?
Inflammatory stage, debridement stage, proliferative/repair stage, maturation stage.
What is the role of macrophages in wound healing?
Produce cytokines and growth factors that modulate the wound healing process, phagocytize necrotic tissue and debris, attract mesenchymal cells into the wound and influence their differentiation into fibroblasts.
What is the function of neutrophils in wound healing?
phagocytizing bacteria
What are the 3 processes that occur in the repair stage?
Fibroplasia, capillary infiltration, epithelial proliferation and migration.
What are the features of a clean wound?
Surgically created
No infection encountered
Aseptic technique maintained
No structure normally containing bacteria opened.
What are the feature of a clean - contaminated wound?
Surgically created
Hollow viscus organ normally containing bacteria is opened, but no contents are spilled.
Minor break in technique occurs (e.g. hole in glove detected).
What are the features of a contaminated wound?
Surgical wound with gross spillage of hollow viscus organ or major break in technique.
Traumatic wounds
What are the features of a dirty wound?
Contains pus
Contains contens of perforated hollow viscus organ
What impact does hypothermia have on surgical patients with regard to wound care?
hypothermia is positively correlated with risk of infection
What is the most common source of operative wound infections?
Patients endogenous flora (skin and gi)
Under what circumstances would prophylactic antibiotics be warranted for surgical patient?
When the risk of infection is high or when infection would have catastrophic results.
When are prophylactic antibiotics started and stopped?
Administer 30-60 minutes prior to skin incision. Only maintained for 24 hours post-op (max)
When would cefazolin be a good choice as a prophylactic antibiotic choice?
To prevent infection from skin flora. (no contact with GIT)
When would Cefaxitin be a good choice as a prophylactic antibiotic choice?
If the GIT is encountered - it’s a broad spectrum, second generation cephalosporin.
Four quadrant antibiotic therapy.
Choose ab antibiotic that covers gram negative, gram positive, anaerobic and aerobic organisms.
What is meant by physiologic degloving injury?
Skin is devitalized but still in place
What is meant by anatomic degloving injury?
Skin is avulsed from the underlying tissue
At what point should necrosed skin from a physiologic degloving injury be removed?
Once it no longer formed a barrier (when there’s a break and it separates)