Soft Tissue Injuries Flashcards
What’s abrasion ?
caused by the force of an object rubbing on the surface of the skin
What’s Contusions ?
are bruises caused by rupture of blood vessels subcutaneously or deeper within tissue
What’s Lacerations ?
are splits in the skin and underlying tissues caused by blunt impact that crushes the tissues over a site of bony prominence
What’s Incised wounds ?
These wounds are ‘clean’ incisions through the skin and deeper tissues that are caused by a sharp instrument or object such as a knife or broken glass
What’s avulsion ?
In an avulsion injury, tissue at the wound site may be displaced from the underlying tissue layers yet still be partially attached
What’s bite wound ?
wounds caused by rapturing skin and underlying tissue with teeth of an animal or human
What’s High-velocity missile injuries ?
Injuries caused by a high-velocity object, such as a bullet or shrapnel (which may include biological – human – body parts)
What’s hematoma ?
A haematoma is a collection of blood within the soft tissues
What’s the key questions must be answered ?
How and where did it happen? When did it happen? What is relevant in the medical history? Tetanus status?
What’s the contraindications in wound exploration and where we should inspect ?
■ Do not explore a gaping penetrating wound of the neck (deep to the platysma) outside the operating theatre environment
■ Blood vessels – Identify bleeding vessels and those in spasm
Why you should Always check for other anatomical structures damage and foreign body in the wound area ?
Cause avulsion and skin flap can hide fractured skull and foreign bodies like tooth fragments and schrapnels of metal.
In why cleansing serve ?
the most important stage in reducing the risk of infection and in preventing possible ‘tattooing’ of the tissues by debris
What are cleansing solutions available ?
■ Normal saline. ■ Chlorhexidine 0.5% (aqueous). ■ Chlorhexidine 0.5% (alcohol based). ■ Iodine (povidone iodine) 1% (aqueous). ■ Iodine (povidone iodine) 1% (alcohol based).
What’s Wound closure materials of ?
■ Adhesive paper strips (Steri-Strips, Suture Strips). ■ Tissue glue (Dermabond, Tisseel, and Histoacryl). ■ Sutures – Resorbable. ■ Sutures – Nonresorbable. ■ Staples – These are rarely if ever used on the face.
What’s breakage and cutting out ?
■ Breakage – the tensile strength of the suture material is too low or the suture is too small.
■ Cutting out – too fine a suture material is used or the suture is placed in friable tissue.
What’s knot slippage and extruded suture ?
Knot slippage – knot tying is inadequate. Every material other than silk benefits from an extra throw on the conventional surgeon’s knot.
■ Extruded suture – this occurs in combination with infection
Resorption that is too rapid – nonabsorbable or more slowly absorbable suture should have been used. ■ Removal too early – suture is removed before sufficient healing.
What’s Undermining of the skin ?
When tissue loss is not extensive and mainly involves skin, a small border of skin on either side of the wound may be carefully separated from the underlying fat.
This allows advancement of the released elastic skin across the wound
What’s drains ?
Deep or extensive wounds may require the insertion of a drain, which lies along the length of the depth of the wound. The purpose of a drain is to remove excessive inflammatory exudate and ‘oozed’ blood from the wound to prevent it from collecting as a focus of infection
When we do skin grafting ?
when large areas of skin have been lost.
What’s the difference between local and distant flap ?
The donor area
Which Factors affecting wound healing ?
1. Site of the wound (e.g. tissue, blood perfusion, movement). 2. Timing of treatment. 3. Nature of treatment (correct or incorrect technique). 4. Infection. 5. Systemic factors (e.g. age, health, nutrition, steroids).
What’s preoperative wound infection etiology ?
Preoperatively ■ Wound contamination with organisms at the time of trauma. ■ Delay in treatment.
Postoperative wound infection etiology ?
Postoperatively ■ Contamination at the time of injury. ■ Poor cleansing/wound débridement or poor aseptic operative technique. ■ Poor closure of the wound. ■ Failure to administer appropriate prophylactic antibiotics. ■ Host susceptibility.
How to mimize scarring ?
Good wound care, early suture removal, moisturization and massage all help to reduce scarring.
Nonsurgical techniques to improve scars include silicone-based gels for self-application,
silicon pressure dressings, intralesional steroids and steroid-impregnated tape.
Scarring operation in how much time done ?
18 months after wound closure
