Pathophysiology of Wound Healing

Question 1

Wound

Answer 1

disruption of anatomic and cellular continuity of tissue

Question 2

Wound healing

Answer 2

biologic process which restores tissue continuity after injury.

Question 3

Traumatic Wound classification

Answer 3

Open (contaminated or infected): Abrasion, laceration, puncture, burn, avulsion (degloving)
Closed: Contusion, crushing

Question 4

Degrees of contamination

Answer 4

Clean, Clean-contaminated, Contaminated, Infected/dirty

Question 5

Clean (no contamination)

Answer 5

surgical wound/incision; no break in aseptic technique.

Spay/neuter, exploratory laparotomy. Sx infection rate = 0-6%

Question 6

Clean- contaminated

Answer 6

Sx w/ non sterile luminal organs but no spillage or infection in viscera.
Enterotomy, cholecystectomy
Placement of drain in clean wound, and minor break in sterility (perforated surgical glove)
Give prophylactic Abx. Sx infection rate = 4.5 - 9%

Question 7

Contaminated

Answer 7

Sx of luminal organs w/ leakage of visceral contents
Bile spillage in cholecystectomy, cystotomy w/ spillage of infected urine, serious break in sterility, and early open traumatic wound
Abx prophylaxis, lavage and debridement. Sx infection rate = 6 - 28%

Question 8

Infected (dirty)

Answer 8

Perforated viscera, abscess, peritonitis, fecal contamination.
Infection present in traumatic wound or traumatic wound > 12hrs post injury
Abx, lavage, debridement, drainage, +/- wet-dry bandages