Final Flashcards
How is an abscess treated? (1/2/3 intention?)
3rd intention
When would we refer out a patient with a laceration?
When bone/tendon is exposed; when there is evidence of nerve damage- check for distal sensory/motor deficit/ two-point discrimination
How late can we close a wound?
Best before 8 hrs
But can go up to 4-5 days (3rd intention)
What is the difference between a cheloid vs hypertrophic scar?
cheloid: scar expands outside of the original injury
hypertrophic scar: scar grows but is within bounds of the original wound
What scalpel would we use for a shave biopsy?
10
What scalpel might be used to lance a boil?
11
What is the relative strength of a wound after 10 days? after 30 days? after 2 years?
10 days: 5-6%
30 days: 30%
2 yrs: 80%
Epinephrine concentrations for:
laceration:
MI/IV:
Anaphylaxis:
Laceration: 1:100,000
MI/IV: 1:10,000
Anaphylaxis: 1:1,000
What solution is in a punch biopsy jar?
10% Formalin
What are appropriate suture sizes to use on: areas under tension face small/no tension areas extremities trunk
Under tension: 3-0/4-0 Face: 5-0/6-0 small/no tension: 5-0 extremities: 4-0/5-0 trunk: 4-0
Suture Removal Time Frame for: Face Scalp Extremity (low tension) Extremity (high tension) Abdomen Chest/back
Face: 3-5 days Scalp: 5-7 days Extremity (low tension): 6-10 days Extremity (high tension): 10-14 days Abdomen: 6-12 days Chest/back: 6-12 days
What suture is best for closing high tension wounds?
mattress
What suture is best for internal closure?
subq
What is the process for draining an access?
Wait until it comes to a head
Incision and drainage: use more lidocaine than usually necessary, open lesion with #11 scalpel (wear eye protection!). cruciate vs linear incision. Let contents drain, gently express, break up pockets, pack cavity with gauze
What is the time frame for delayed closure?
optimally done at 4-5 days
What are the stages of healing?
Inflammatory (day 1-5): dolor/calor/rubor/tumor
Proliferative (day 5-3 wks): granulation tissue forms, WBCs migrate to area
Maturation (3wks +): collagen deposits
When should a patient stop taking aspirin?
a week before procedure
When should a patient stop taking Tylenol?
3 days before procedure
When should a patient stop taking garlic or fish oil?
3-7 days before procedure
Why might a wound dehisce?
Too much tension placed on newly sutured tissue
Too little tension- wound edges too loosely apposed
inappropriate suture material–> breakage/ tissue reaction
poor tissue quality–> poor healing (nutritional status/immune status, etc)
When would we use superglue as a form of closure?
When primary intention is simple, not a complicated wound
