Soft Tissue Injuries Flashcards
Skin is unbroken
Contusion
Superficial layers are lost
Abrasion
Tissues torn by a blunt instrument.
Laceration
Tissue torn by sharp instrument.
Incised wound
Sharp, slender object
Penetrating wound
Missing tissue
Avulsion
People with mandibular fractures have this injury 10% of the time.
Spinal cord
Avoid giving this kind of drug to patients with possible head wounds.
Narcotics/Analgesics bc head injuries can cause depressed breathing, and this would be made worse if they took analgesics.
How to evaluate a soft tissue wound.
1) Achieve hemostasis (by applying pressure).
2) Clear area to allow assessment.
3) Palpate area to assess deeper structures.
4) Assess missing tissues.
How to achieve hemostasis on a soft tissue wound.
Apply pressure
Suturing wounds retains what?
The clot
Purpose of suturing a wound.
1) Get hemostasis
2) Coaptation of wound margins.
3) Clot retention
Hematoma under tissue can cause what?
Tissue to die bc it cuts off the blood supply to the tissue.
What kind of sutures do you use for subcuticular wounds?
Absorbable bc you don’t want to make another cut just to take out the sutures.
Chromic gut is mono or multifilament?
Monofilament
Silk is mono or multifilament?
Multifilament
Cartilage heals quickly or slowly?
Slowly! So use non-resorbable sutures.
Nylon and polyprolene is mono or multifilament?
Monofilament.
Suture made of collagen
Plain gut
Structure of plain gut.
Monofilament
How long does it take for plain gut to resorb?
5-6 days
How long does it take for chromic gut to resorb?
10-15 days
Plain or chromic gut used in the mouth?
Chromic bc it lasts longer.
Suture used for cosmetic repair.
Prolene
Prolene to look Pretty
This suture lasts longer than chromic gut.
Vicryl
Most commonly used suture needed
1/2 circle swaged needle that’s reverse cutting.
Part of the needle that meets the thread.
Eye
Thinnest part of the needle.
Eye
Where to grab the needle.
As close to the swaged end as possible, without touching the swaged end.
Eye is AKA?
Swaged end
Advantage of reverse cutting needles.
Less likely to avulse the tissue.
This shape needle is good for passing between nasal nares.
Straight
Finger used to control the needle driver.
Index finger
How many throws make a knot?
2
How many throws make 1.5 knots?
3 throws This is BAD!
How many throws make two knots?
4 throws
A space formed between tissues that are normally connected.
Dead space
Why do we try to avoid dead spaces in sutures?
Because a clot will form there, constricting blood supply to the tissues.
Type of suture used from going onto the skin (like from the vermillion border to skin).
Prolene to look pretty
Type of suture used if going from vermillion to mucosa.
Chromic or plain gut.
A single stitch is called what?
Interrupted suture
How do you close a wound?
In LAYERS! To prevent hematoma formation.
Suture type for deeper layers.
Resorbable
Suture type for skin closure (supfericial layers)
Non-resorbable.
After how many days do you remove non-resorbable sutures and why?
5-7 days bc you can get increased scar formation since the epithelial cells keep depositing at the wound margins.
A wound in the mouth is closed from the inside or outside first?
Inside bc the mouth has a lot of bacteria.
Must be done to the margins so you get nice healing.
Evert the margins
Stitch used to evert the margins.
Horizontal mattress
How do we close high-tension areas, like at the corner of the mouth?
Tension-free
Resorbable or non-resorbable sutures used in high cosmetic areas?
Resorbable
May necesssitate removal of the affected part of the wound.
End circulation wounds bc they don’t get enough blood supply.
Closure in which no sutures are placed.
Secondary
Closure used when:
1) The extent of the wound is unclear.
2) Avulsion would make primary closure difficult.
3) Avulsion prevents primary closure.
Secondary closure
Secondary closure is AKA what?
Delayed
