Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

CLINICAL SKILLS II > LECTURE 1&2 (Wound, Tapes and Staples) > Flashcards

LECTURE 1&2 (Wound, Tapes and Staples) Flashcards

1
Q

What can wounds be generally classified as?

A

Acute or Chronic wounds

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

What is an Acute wound?

A

Any surgical wound that heals by primary intention or any traumatic or surgical wound that heals by secondary intention

[expected to progress through the phases of normal healing, resulting in closure of the wound]

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

What is a Chronic wound?

A

A wound that fails to progress healing or respond to treatment over the normal expected healing time frame (4 weeks) and becomes stuck in the inflammatory phase

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

What is the pathologic inflammation in a chronic wound caused by?

A

Postponed, incomplete or uncoordinated healing process

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

What is wound healing delayed by?

A
  • Medications
  • Poor nutrition
  • Co-morbidities
  • Inappropriate dressing selection
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

What are the different types of healing?

A
  • Primary intention
  • Delayed primary intention
  • Secondary intention
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

Describe Primary Intention

A
  • Wound edges are held together by sutures, staples, tapes or tissue glue
  • Minimal tissue loss and wounds heal with minimal scarring
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

What are most clean surgical wounds and recent traumatic injuries managed by?

A

Primary Closure

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

Describe Delayed Primary Intention

A

When the wound is infected or requires more thorough intensive cleaning/debridement prior to primary closure 3-7 days later

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

What is used for traumatic wounds or contaminated surgical wounds?

A

Delayed Primary Intention

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

What is Secondary Intention?

A

Spontaneous wound healing that occurs through a process of granulation, contraction and epithelisation and results in scar formation

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

What method is used fir pressure injuries, ulcers and dehisced wounds?

A

Secondary Intention

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

What are the two phases of Wound healing?

A

1) Haemostasis
2) Tissue Repair & Regeneration

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

What is Haemostasis?

A

The rapid response to physical injury and is necessary to control bleeding which involves
1) Vasoconstriction
2) Platelet response
3) Biochemical response

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

Describe the three phases of Tissue Repair & Regeneration

A

1) INFLAMMATION PHASE (0-4 days) = activates vasodilation leading to increased blood flow causing heat, redness, pain, swelling and loss of function
2) RECONSTRUCTION PHASE (2-24 days) = body makes new vessels covering the surface of wound -> reconstruction & epithelisation -> wound becomes smaller as it heals
3) MATURATION PHASE (24 days-1 year) = scar tissue is formed

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

Which stages in Tissue repair & regeneration are proliferative and regenerative?

A

RECONSTRUCTION PHASE = PROLIFERATIVE

MATURATION PHASE = REGENERATIVE

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

What should be checked in wound assessment?

A
  • Type of wound (acute/chronic)
  • Aetiology (surgical, laceration, ulcer, burn, traumatic, pressure injury)
  • Location & Surrounding skin
  • Tissue Loss
  • Clinical appearance of the wound bed and stage of healing
  • Wound edge
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

What can the degree of tissue loss be classified into?

A
  • Superficial wound (dermis)
  • Partial wound (dermis & epidermis)
  • Full thickness wound (epidermis, dermis, subcutaneous tissue and possibly muscle, bones and tendons)
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

What are the different Wound bed clinical appearances?

A
  • Granulating
  • Epithelising
  • Sloughy
  • Necrotic
  • Hypergranulating
20
Q

Describe a “Granulating” wound bed?

A
  • Healthy red tissue is observed and deposited during the repair process
  • Presents as pinkish/red coloured tissues
  • Comprises of newly formed collagen, elastin and capillary networks
  • Tissue is well vascularised and bleeds easily
21
Q

Describe a “Epithelising” wound bed

A
  • Wound surface is covered by new epithelium (begins when wound has filled with granulation tissue)
  • Tissue is pink (almost white) and occurs only on top of healthy granulation tissue
22
Q

Describe a “Sloughy” wound bed

A

Presence of devitalised yellowish tissue and formed by accumulation of dead cells

23
Q

Describe a “Necrotic” wound bed

A
  • Wound containing dead tissue
  • Wound appears hard, dry and black
  • Dead connective tissue appears grey
  • Presence of dead tissue in a wound prevents healing
24
Q

Describe a “Hypergranulating” wound bed

A
  • Granulation tissue grows above the wound margin
  • Occurs when the proliferative phase of healing is prolonged as a result of bacterial imbalance or irritant forces
25
Q

What are the edges of the wound assessed for?

A
  • Colour
  • Evidence of contraction
  • Changes in sensation
26
Q

How is colour assessed in the wound edges?

A
  • Pink edges indicate growth of new tissue
  • Dusky edges indicate hypoxia
  • Erythema indicates physiological inflammatory response/cellulitis
27
Q

How is Evidence of contraction assessed in the wound edges?

A
  • Wound edges coming together indicate healing process
  • Raised or rolled edges raised indicate hyper granulation tissue
  • Rolled edges can inhibit healing
28
Q

What is wound infection?

A

The presence of bacteria or other organisms which multiply and lead to the overcoming of host resistance. Infection can disrupt healing and damage tissues or produce spreading infection or systemic illness.

29
Q

What are the indications of infection?

A
  • Redness (erythema/cellulitis)
  • Exudate
  • Malodour
  • Localised pain
  • Localised heat
  • Oedema
30
Q

What is the goal of wound cleansing?

A
  • Remove visible debris and devitalised tissue
  • Remove dressing residue
  • Remove excessive or dry crusting exudates
  • Reduce contamination
31
Q

What are the complications of healing?

A
  • Infection
  • Necrosis
  • Periwound dermatitis (form of skin damage)
  • Edema and periwound edema
  • Hematomas (collection of blood outside of blood cells)
  • Dehiscence (splitting or bursting open of a wound)
  • Maceration
32
Q

How does oedema increase the likelihood of a pressure ulcer/injury

A

Oedema causes compression of small vessels -> decreases blood flow -> increases likelihood of a pressure ulcer or injury

33
Q

How does a Macerated wound occur?

A

A macerated wound occurs when skin is in contact with moisture for too long -> slows healing and makes skin more vulnerable to infection

34
Q

What are the common techniques for wound closure?

A
  • Tape
  • Adhesive tissue glue
  • Metal staples
  • Sutures
35
Q

What must happen to wounds before wound closure?

A
  • Cleaned
  • Debrided
36
Q

What are the advantages of Surgical tape strips?

A
  • Ease of application
  • Reduced need for local anaesthesia
  • Evenly distributed wound tension
  • Minimal skin reaction
  • No suture removal
  • Greater resistance to wound infection
37
Q

What are the areas suited for tape closure?

A
  • Forehead
  • Chin
  • Malar eminence
  • Thorax
  • Non-joint-related areas of extremities
38
Q

What are the disadvantages of Surgical tape strips?

A
  • Doesn’t work well on wounds under significant tension or wounds that are ireggular, on concave surfaces or in areas of marked tissue laxity
  • Doesn’t work on deep wounds
  • Doesn’t stick well to naturally moist areas (e.g palms of hands, soles of feet)
  • Doesn’t adhere to wounds that have secretions and persistent bleeding
  • Useless on the scalp
  • Young children might remove them
39
Q

What are the complications of Surgical tape strips?

A
  • Premature tape separation
  • Skin blistering
  • Wound hematoma
40
Q

What makes wound staples better than suturing?

A

Speed of closure since its faster

41
Q

What are the indications of Wound staples?

A
  • Linear lacerations with straight, sharp edges located on an extremity, the trunk or scalp
  • Superficial scalp lacerations in an agitated or intoxicated patient
42
Q

What are the contraindications of Wound staples?

A
  • Deep scalp lacerations
  • CT head scans -> staples can produce scan artefacts
  • MRI -> powerful magnetic fields might remove staples from surface of skin
  • Should not be used on face, neck, hands or feet
43
Q

What is a simple wound?

A

A break on the continuity of the skin limited in depth at the sub-cutaneous fatty tissue that does not affect the underlying structures and without significant loss of tissue

44
Q

What are the primary goals of a simple wound suture?

A
  • Gentle handling of the tissues
  • Closing dead space
  • Supporting and strengthening wounds until healing
  • Approximating wound edges for structural, functional and aesthetically pleasing result
  • Minimising the risks of bleeding and infection
45
Q

What will influence the choice of suture technique?

A
  • Type and anatomic location of wound
  • Thickness of tissue
  • Degree of tension
  • Desired cosmetic result in the case of skin
46
Q

When should sutures be removed?

A

Within 1-2 weeks of their placement

CLINICAL SKILLS II (3 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions