Integument

Question 1

Phases of wound healing?

Answer 1

Inflammatory phase Proliferative phase Maturation and remodeling phase

Question 2

What is required for optimum collagen production?

Answer 2

vitamin C

Question 3

scars retain what % of tensile strength of normal skin

Answer 3

70-80%

Question 4

Phases of wound healing

Answer 4

InflammatoryProliferativeMaturation/remodeling

Question 5

Inflammatory phase of wound healing

Answer 5

Last up to 5 days, hemostasis, coagulation, MMPs, serine proteases, leukocyte margination, macrophages start to move in

Question 6

Proliferative phase of wound healing

Answer 6

5-20 days, granulation tissue forms4 processes: neovascularization/angiogenesis, fibroplasia (MMP 1,2,3 facilitate migration of fibroblast which secrete fibronectin forming loose ECM) and collagen deposition (type 3 laid first which is weak baby collagen and slowly replaced with strong type 1 collagen), epithelialization (guided by type 1 collagen), wound contraction (skin peripheral to a full thickness defect advances in a centripedal fashion toward the center of the wound)

Question 7

Maturation/remodeling

Answer 7

type 1 collagen replaces type 3, takes from day 20 to one year

Question 8

Wound contraction rate

Answer 8

0.6-0.75 mm /day

Question 9

Contracture

Answer 9

loss or inhibition of motion or function as a result of excessive scar tissue or muscle atrophy or fibrosis

Question 10

What is required for optimum collagen production

Answer 10

vitamin C

Question 11

When does tensile strength increase rapidly?

Answer 11

after day 4-5 at which fibroplasia and early collagen deposition noted

Question 12

What do fibroblasts make?

Answer 12

collagen

Question 13

What is intussceptive growth?

Answer 13

process of epithelial proliferation and collagen deposition that occurs within the stretched skin to bolster and restore cutaneous areas that are under significant tension

Question 14

How long does wound contraction take?

Answer 14

6 weeks, square and rectangular incisions contract more effectively than circular ones

Question 15

3 weeks after injury, what is tensile strength of scar?

Answer 15

20% of final strength

Question 16

Scars retain what % of tensile strength of normal skin?

Answer 16

70-80%

Question 17

Formation of granulation tissue in cats vs. dogs

Answer 17

cats 19 days, dogs 7.5 days

Question 18

How are wounds classified according to degree of contamination? List and describe.

Answer 18

Clean- atrumatic, surgically created under aseptic conditions

Clean contaminated- minor break in aseptic surgical technique, contamination is minimal and easily removed

Contaminated- recent wound related to trauma with bacterial contamination from street, soil or oral cavity; surgical wound with major break in asepsis

Dirty/infected- older wound with exudate or obvious infection

Question 19

What are the 3 grades of open fractures?

Answer 19

Grade I- small break in skin caused by bone penetrating through

Grade II- soft tissue trauma contiguous with the fracture, often caused by external trauma

Grade III- extensive soft tissue injury, commonly in addition to a higher degree of comminution of the bone

Question 20

which type of lavage solution, compared to the others, was shown to have more mild cytotoxic effects on fibroblasts, hence making it a preferred flushing solution?

Answer 20

LRS

Question 21

what concentration of chlorhexadine is recommended for lavaging wounds?

Answer 21

0.05%

Question 22

Benefits of using sugar in open wound? Drawback?

Answer 22

osmotic action causing bactericidal effect; draws macrophages to wound, accelerates sloughing of devitalized tissue, cheap

Drawback- cuases more effusion, tus requiring more frequent bandage changes

Question 23

Advantages of honey as a wound dressing?

Answer 23

decreases edema, accelerates sloughing of necrotic tissue, provides rich cellular energy source, antibacterial properties b/c of high osmolarity, acidity and H2O2 content

Question 24

list 4 types of wounds that do not typically require the need for antibiotics

Answer 24

Clean wounds

superficial wounds <6 hrs old

contaminated wound that can be converted to clean wound with primary closure

wounds with a healthy granulation bed

Question 25

Describe how to estimate surface area affected by burn wounds

Answer 25

head/neck=9%

each forelimb=9%

each rear limb=18%

dorsal trunk=18%

ventral trunk=18%

Question 26

how do you characterize a 1st degree burn?

Answer 26

superficial; epidermis only

Question 27

characteristics of 2nd degree burn?

Answer 27

epidermis and superficial or deep part of dermis affected

Question 28

characteristics of 3rd degree burn?

Answer 28

full thickness, affecting entire epidermis and dermis

Question 29

characteristics of 4th degree burn?

Answer 29

full thickness with extension to muscle/tendon/bone

Question 30

what percent BSA affected has been shown to have a poor prognosis with burns?

Answer 30

>50%

Question 31

recommended fluid rate during the first 24 hrs in burn patients?

Answer 31

1-4 ml/kg BW x % total body surface area affected

Question 32

At what time point after a burn does the patient’s fluid status often stabilize, making them at higher risk for overload and edema?

Answer 32

48 hrs

Question 33

T/F- in human burn injury, prompt removal of the burn eschar is correlated with improved survival?

Answer 33

true