Extremity Wound Reconstruction Flashcards
seconary intention healing
“doing nothing”
wound is left open and not sutured closed .dressings until healing occurs on its own.
when would you let something heal by seconary intention
- small wounds
- no exposed vital structures
- delayed presentation
- contaminated
- dead space.
cons of secondary intention healing
- scarring
- more pain
- prolonged healing.
less stable. prominent. more likely for contracture.
what is primary intention?
wound is sutured closed.
pro: faster healing, improved scarring, less pain, exposed vital strucutres covered.
what is delayed primary intension
a compromise between secondary and primary intention. initially leave wound open and then return at a later time to close primarily.
when would you let a wound heal by delayed primary intention
when primary intention not possible (infection, swelling, delayed presentation) but preferable.
three types of skin grafting
- split thickness- epidermis and partial dermis
- full thickness- epidermis and dermis
- composite graft - full thickness graft and underlying cartilage
when do you do a skin graft
when secondary healing is not possible and soft tissue loss too large for primary closure.
what kind of graft
split thickness skin graft with meshed skin graft.
when you have a split thickness skin graft, how does the donor site heal?
by secondary intention. there’s no way to close that, you will get a scar.
would you use a split thickness or full thickness for a large burn?
split thickness for large burn. full thickness skin grafts used for small defects.
How do skin grafts survive?
phase 1; plasmatic ___: diffusion of plasma and nutrition, occurs in the first 48 hours. diffusion of plasma and nutrients.
phase 2; ___ and capillary ingrowth. day 2-5. capillary buds from recipient bed start to contact graft.
phase 3: __. over 6 days. __ drainage starts to occur, and ___ links between graft and wound bed form.
phase 1; plasmatic imbibition: diffusion of plasma and nutrition, occurs in the first 48 hours. diffusion of plasma and nutrients.
phase 2; inosculation and capillary ingrowth. day 2-5. capillary buds from recipient bed start to contact graft.
phase 3: revascularization. over 6 days. lymphatic drainage starts to occur, and collagenous links between graft and wound bed form.
Random pattern flaps involve skin flaps with the blood supply based on the ___-____ plexus o blood vessels.
based on the subdermal plexus of blood vessels.
flaps are cool because it Involves using skin (+/- other tissue) WITH its own blood
supply to close a wound/defect
