Exam 2: Chapter 8 Flashcards
What are the extrinsic factors that affect wound healing in acute surgical wounds
- preoperative period
- intraoperative period
- postoperative period
What are things to consider during the preoperative period
The length of hospital stay prior to surgery, preparation of the operative site, and prophylactic antibiotics
What are the different types of surgeries
clean
clean-contaminated
contaminated
dirty or infected
True or false:
The longer you stay in the hospital, the higher risk you have of developing an infection
true
What class of surgery is considered clean
class 1
What class of surgery is considered clean-contaminated
class 2
What class of surgery is considered contaminated
class 3
What class of surgery is considered dirty or infected
class 4
Which type of surgery is defined by nontraumatic injuries, no inflammation or break in sterile field
Clean or class 1
What types of procedures are considered clean or class 1
Exploratory, mastectomy, THR, or vascular surgery
What type of surgery is defined by involving the GI or respiratory tract
Clean-contaminated or class 2
What types of procedures are considered clean-contaminated or class 2
Bronchoscopy or small bowl resection
Which type of surgeries are defined as having a major break in sterile technique and a gross GI spillage
contaminated or class 3
What types of procedures are considered to be contaminated or class 3
appendicitis, cholecystectomy, diverticulitis
What types of surgeries are defined to have acute bacterial inflammation along with pus and devitalized tissue
dirty/infected or class 4
What types of procedures are considered to be dirty/infected or class 4
drainage of abscess, perforated bowel, and peritonitis
Who is in control during the intraoperative period
the surgeon
What are factors during the intraoperative period that will affect wound healing
Duration of the surgery, obesity, incision tension, comorbidities, type of wound closure
What type of wound closure is used on surgical wounds
primary intention with sutures and staples
True or False:
Stress of surgery activates the parasympathetic nervous system
False: It activates the sympathetic nervous system
What are things to consider during the postoperative period that will affect surgical wound healing
vasoconstriction, hypoxia, hypothermia, pain, hypovolemia
What are the intrinsic factors that affect wound healing in acute surgical wounds
age concurrent conditions nutritional status oxygenation perfusion stress and pain
During the assessment and management of an acute surgical wound, what should we be examining
the location, linear measurements, observe tissue for resurfacing, closure, exudate and palpate incision for collagen deposition and health of surrounding tissue
What are the two types of surgical dressings
primary and secondary
Describe primary dressing
the dressing that touches the wound
Describe secondary dressing
goes over the primary dressing
True or False:
Surgical wounds go through the same healing phase as other wounds
true
Surgical wounds are best evaluated using ____ since the surgery
time
Postoperative days __-__ show signs of inflammation, blood exudate that changes to sanguineous, epithelia resurfaces, and exudate decreases
days 1-4
Postoperative days __-__ show signs of healing ridges along entire incision, wound exudate changes to serous, exudate disappears, and suture material begins to be removed
Days 5-9
Postoperative days __-__ involves the removal of remaining external suture material
10-14
Postoperative days __-__ is when collagen realigns and strengthened, color of incision changes from bright pink to fading pink or silvery gray, healing ridge softens, and functional ability of scar
days 15 to 1-2 years
When do I refer-
Significant increase of bloody ____
exudate that changes from serosanguineous to ____
Increased exudate after day ___
____ of healing ridge
Signs of local wound infection after day __
exudate purulent 4 absence 4
When do I refer-
Signs of ____ infection such as high temp, high WBC, and confusion
Frank wound _____
____ formation
systemic
dehiscence
fistula
