Oral Surgery, Bitches COPY Flashcards
SOAP - expand and define:
Subjective: med Hx, CC
Objective: vitals, radiographs, etc. (obtain/organize)
Assessment: analyze and diagnose
Plan: and/or procedure
Surgical Wound Classification, Class I
Class II
Class III
Class IV
Clean, uninfected
Clean-contaminated (resp, alimentary, genital, urinary entered)
Contaminated - open, fresh, accidental
Dirty-infected - old, traumatic, infected
When making incisions, the blade is _______ to the surface
Perpendicular
3 potential complications of a Flap:
Necrosis
Dehiscence (opens up)
Tearing
In a Flap, the _____ should be wider than the ______
Base wider than Tip
T/F
It is almost impossible to make an incision too long
True
*avoid tears and nerve damage/pain
Important: Incisions heal in what direction?
In width (across)
*independent of length, does NOT heal end to end
**longer incision better
Make releasing incisions how many teeth away from the extraction site?
1 - 1.5 teeth away
Irrigate tissue with _______ instead of _______
Saline solution
Distilled water
If an instrument is used to place tissue in _______ , don’t use it again
Formalin
*denatures tissues
T/F
Don’t crush, overheat, or dry out tissue
True
Poorly controlled _______ will lead to increase tension on the wound, decrease vascularity, and provide a culture/medium for infection
Hemostasis
Dead space (like a socket) will remain empty after closure and will fill up with blood, with leads to what?
High potential for infection
Eliminate dead spaces by suturing from the bottom or a ______ dressing
Pressure
4 methods to promote wound Hemostasis:
Assist natural (direct pressure)
Thermal coagulation (electrocautery)
Suture ligation
Vasoconstrictors
4 methods to eliminate Dead Space:
Suture
Pressure dressing
Packing
Drains (suction/nonsuction)
In the 1st couple days use _______ to decrease inflammation
After use ______
Ice
Heat
Decrease infection risk by _________ during surgery
Remove necrotic and foreign ischemic material - known as ________
Irrigation
Debridement
4 ways to Control Edema during surgery:
Careful
Elevation
Systemic steroids
Ice
Mucosal edges heal until they meet, known as…
Epithelialization
When will epithelial healing stop?
Once it touches other free edge of epithelium
3 stages of wound healing:
Inflammatory
Fibroplastic
Remodeling
Anything tending to hold wound edges apart:
Tension
Primary intention:
Secondary intention:
Tertiary intention:
Sutured lacerations/incisions
Gap (extraction sockets)
Grafts
Primary intention of bone has edges less than _____mm apart
Secondary intention of bone healing has edges more than _____ mm apart
1 mm
1 mm
Healing in extraction socket - Whitish yellowish stuff:
Greenish:
Socket looks empty:
Fibrin clot (or fluid if soft, bone/tooth/peanut if hard)
Food
If symptoms, dry - if no pain, not dry
Extraction sockets heal by _______ intention
Secondary
If the nerve is Contused, you normally get _______ recovery
Spontaneous
When there is opening into sinus lining, how to wounds heal?
Proliferate along wound into tract
*creates opening (epithelialized tract between oral cavity and sinus)
Inflammatory Stage Phase I:
Phase II:
Vascular (vasoconstriction)
Cellular (Complement cascade)
What holds wounds together during the inflammtory stage?
Fibrin
*not strong
4 signs of Inflammation:
Rubor (redness)
Calor (heat)
Dolor (pain)
Tumor (swelling)
In the Fibroplastic Stage, _______ strands form the latticework in which _______ lay down ground substance and ________
Fibrin
Fibroblasts
Tropocollagen
After Tropocollagen is layed down by the Fibroblasts, capillary ingrowth occurs and wounds rapidly gain strength - this phase lasts how long?
These wounds are ______ due to excess/haphazard collagen arrangement
These wounds are _______ b/c lots of vascularization
These wounds are ___% as strong as uninjured tissue
2-3 weeks
Stiff
Erythmatous
70-80%
T/F
You can’t wear hand jewelry in surgery
True
What stage of wound healing is 70-80% as strong as uninjured tissue?
What stage is 80-85% as strong?
Fibroplastic
Remodeling
Wound Maturation, aka…
Remodeling Stage of wound healing
In the Remodeling Stage, _____ is removed and the wound softens
Collagen
T/F
Every incision results in a scar
True
4 factors that impair wound healing:
Foreign material
Necrotic tissue
Ischemia
Wound tension
Foreign material (impairing wound healing) can be bacteria, dirt, or _______
Suture material
Flushing a wound with a sterile solution, aka…
Debridement
What can prevent the growth of reparative cells?
Necrotic tissue
2 factors that impair Wound Healing
Ischemia (leads to further necrosis and decreased nutrients)
Tension (anything tending to hold wound edges apart)
What heals better b/c there is less re-epithelialization, collagen deposition, contraction, and remodeling?
Primary Intention Wounds
What type of wound contains a Gap between epithelial edges and takes longer to heal?
What is an example?
Secondary Intention
extraction sockets
Wound treated by coverage with tissue grafts:
Tertiary Intention
Bone Healing has the same 3 stages as Soft Tissue: Inflammation, fibroplasia, and remodeling
In addition, what 2 factors are involved?
Osteoclasts
Osteoblasts
Bone
Less than 1 mm apart:
More than 1 mm apart:
Primary Intention
Secondary Intention
In Bone healing of Secondary Intention, a ______ formation extends beyond the free edges of the bone and is followed by ossification
Callus
Extraction Socket Healing:
Bleeding, Clot, Platelets adhere to surrounding tissued , then _____ transformed into ______ (thin, whitish)
Fibrinogen
Fibrin