LP 5-6 Flashcards
cellulitis
acute infection of skin tissue
drainage of absess
class 4
difference between inflammation vs. infection
pus is present in infection
ruptured appendix
class 4
laceration
cut or tear
craniotomy
class 1
swelling
buildup of fluid
example of class 2
appendectomy cholecystectomy bowel resection
chronic wound
extended period of time ie- diabetes
what is incision chosen for?
exposure least trauma wound closure
inguinal hernia
oblique
I & D
class 4
cutting
cutting trocar
cutting needles
skin eyes
muscles of the abdominal wall
transverse abdomis
external/internal oblique
linear alba
rectum abdominis
can a classification change?
yes during the procedure
example of class 1
plastic ortho eye neurological
keloid
raised scar
intentional wound
surgical wound
most common surgery
laparotomy
what suture is used to ligate vessels?
silk
thermal
heat, cold, chemical
cicatrix
normal scar formation
contusion
bruise
closed wound
skin remains intact
first intention phase 1: lag phase
lasts 3-5 days after injury
most commonly used gauge for suturing skin?
3-0 or 4-0
abdominal hysterectomy or C section
pfannenstiel
fistula
draining tunnels form between two organs
example of class 3
colon resection with fecal spillage appendectomy with appendicitis
aneursym
longitudinal midline
influence choice of needle
size of suture tissue type accessibility of area preference customer of hospital
first intention phase 2: healing
3-20 days post op fibroblasts multiply and bridge wound edges
longitudinal midline incision
vertical xiphoid to pubis midline
class 2
infection: 8-11% minor break in sterile technique
laparoscopic gastric bypass
class 2
prolene
monofilament nonabsorbable
eyed needles
must be threaded, dispense 2 at a time
intraluminal EEA
anastomose tubular structures in GI tract
gangrene
death of an organ or tissue
class 1
infection: 1-5% incision made under ideal surgical conditions no entry to GI, respiratory, biliary or GU
open fracture
class 3
tensile strength
ability to resist rupture
surgiclip
occlude small structure, vessel
should you use silk moist?
no
fibrinogen
combines with thrombin to form fibrin during clotting
contracture
interference with the circulation from pressure
chemical
acid
complicated wound
tissue lost or destroyed
what color is prolene?
blue
surgical gut
rapid absorption in infection
appendectomy
McBurney RLQ
external factors influencing wound healing
drug therapy fluid balance
endogenous
in body
what do injured tissue release?
histamines
delayed full thickness injury
burns or scalding injuries
esphogaus, thoracic cavity
thoracoabdominal incision
restoration of appearance to tissue
minimal scarring
rocky davis muscle splitting incision
appendectomy transverse alternate to mcburney
first intention
minimal post op swelling minimal scar
traumatic wound
accidental wound
fascitis
inflammation of connective tissue
GIA linear stapler
inserts 2 straight, parallel rows of staples into tissue
can a wound be incisional and excisional?
yes
spring or french eye needles
suture forced through the springs
surgical entrance
skin incision incise subq control bleeding put skin knife aside incise fascia separate muscle peritoneum incised lengthen incision control bleeding abdomen is open
second intention
process of granulation wound isn’t sutured
healing first intention
21 days
what is a wound?
any tissue that has been demaged
non cutting
taper blunt
factors influencing third wound healing
any contamination of the wound could lead to an infection
spinal needle
prevent trauma and loss of fluid
restoration of continuity
wound closed and tissue approximated
radiation increases blood supply
FALSE
lateral position, kidney
thoracoabdominal
restoration of tissue strength
may take a year to regain original tissue strength
what does infection indicate?
pathogenic organisms
joint
class 1
extravasation
discharge of blood from vessel
ligating clips
dead space
wound edges haven’t been closely approximated
heart and redness
increased blood flow
upper quadrant oblique
liver, gallbladder
example of class 4
appendectomy-ruptured appendix wound debridement
phagocytosis
cleaning up the wound
factors influencing first wound healing
age nutritional obesity
body’s natural protective response to injury
inflammation
proud flesh
excessive granulation tissue
excisional wound
removal of tissue, organs
third intention
delayed primary closure deep, wide scar
when is the classification of the wound recorded?
at the end of surgical procedure
paramedian rectus incision
vertical
upper/lower transverse incision
horizontal incision above or blow umbilicus on either side
what is added to chromic suture?
salt solution
suture used for drain stitch
silk or nylon
vessels loops
retract vessels
evisceration
splitting of wound with abd organs protruding
CEEA
rectum into colon and staples
hysterectomy
class 2
example of traumatic wound
burn, cut, laceration
2 classifications of a wound
intentional traumatic
clean wound
wound edges approximated and secured
what shouldn’t be used in infection?
silk
contaminated wound
dirty object damages integrity of skin
GIA linear stapler
abrasion
scrape
class 4
infection: 27-40% open traumatic wound >4 hours
trocar needle
tendon ligaments cervix
example of chronic wounds
pressure sores decubitus ulcer
simple wound
skin integrity destroyed
fibrin
responsible for the semisolid character of a blood clot
thrombin
clot formation
class 3
infection: 15-20% open traumatic wound <4 hours major break in sterile technique
TA linear stapler
insert 2 straight staple lines
exogenous
not in body
what happens when nerves are cut?
redness edema heat pain
when do disruptions happen in post op healing?
5-10th day
first intention phase 3: maturation
14 days up to 12 months gains tensile strength
ischemia
insufficient supply of blood to an organ
factors influencing second wound healing
dissection technique direction/length of incision
point
taper,, cutting, trocar
pain
pressure exerted by edema
mastectomy
class 1
dehiscence
splitting open of surgical wound
complications during healing
hemorrhage hematoma infection
skin stapler
approximate skin edges during closure
occlusion banding
closing off of an artery
intraluminal EEA
blunt needle
liver kidney
qualities of a good needle
quality carbon steel strong enough rigid sharp
treatment at bedside for wound disruption
prepare patient to return to OR
inflammatory response
localizes infection eliminates toxins prevents pathogens from spreading repair damaged tissue
intra op wound care
aseptic technique antibiotic therapy
how many days for third intention?
14 days post op
adhesions
abnormal attachment of two surfaces that are normally separate
post op wound care
wound drains dressings packing
TA linear stapler
puncture
penetrating wound
scalpel cuts tissue
vessels are cut cells are damaged
taper
peritoneum muscle fascia
gastrectomy
paramedian rectus LUQ
signs of inflammation
heat redness swelling
incisional wound
intentional cut through intact tissue
chevron incision
below rib cage whole width of the abdomen approx. 24-30 inches
