Soft Tissue Injuries and Healing Flashcards

1
Q

What does the term soft tissues refer to

A

those parts which are not bone or cartilage

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2
Q

What type of cells remove dead tissue and clots

A

phagocytes

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3
Q

What is granulation tissue

Is it vascular

A

new tissue that is formed following a wound

It is highly vascular

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4
Q

When is primary closure usually carried out

A

in the first 6 hours after injury provided all foreign material and dead tissue is removed

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5
Q

What is secondary closure

A

The wound is closed after it has been allowed to granulate having overcome any sepsis

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6
Q

What is often necessary for secondary closure

A

skin graft

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7
Q

What is the easiest and most reliable technique for skin grafting

A

Partial thickness or split- skin grafting

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8
Q

What does partial thickness or split-skin grafting involve

A

Split skin (only part of the thickness of the epidermis) taken from a convenient donor site

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9
Q

What are full thickness detached grafts

A

If the dermis is included in its entirety from a donor site

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10
Q

What are attached skin flaps

A

More conventional types of full thickness grafts
Taken from one limb to another
They leave a defect at the donor site which then has to closed by split skin

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11
Q

What is a foreign skin graft

A

Taken either from animal or human

Used as a temporary dressing for large areas of loss e.g. after burns

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12
Q

What causes an abrasion

A

usually friction in trauma

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13
Q

What is the treatment for an abrasion

A

a simple protective dressing

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14
Q

What causes a laceration

A

blunt trauma

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15
Q

What is the treatment for a laceration

A

all dead and foreign material should be excised and the wound closed
X ray if there is a possibility of a foreign body

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16
Q

What does loss of sensation in a burn suggest

A

Full-thickness loss (rather than partial thickness)

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17
Q

What is the treatment for a partial thickness burn

A

They usually heal rapidly and completely

18
Q

What is the treatment for a full thickness burn

A

The damaged tissue will slough and eventually separate or may need to be excised
Resulting wound is then closed by suture or more often skin grafting

19
Q

What is the treatment for a deep wound such as a stab wound to chest or abdomen

A

Laparotomy or thoracotomy may be necessary to achieve an adequate exploration

20
Q

What is a haematoma

A

collection of blood i the tissues

21
Q

What is the treatment of a large haematoma

A

decompression or evacuation to prevent necrosis of overlying tissues

22
Q

What is a contusion

A

the same as a bruise and consists of tissue damaged by a blow or crush

23
Q

Describe the typical appearance of a low velocity gunshot wound

A

well circumscribed

small amount of damage

24
Q

What is the treatment for a low-velocity gunshot wound

A

excising foreign necrotic and contaminated material

25
What is the treatment for a high velocity gunshot wound
``` Open widely Extensive debridement and decompression removal of foreign and non-viable tissue leave wound open insect surrounding tissues ```
26
How do injuries to organs arise
blunt trauma such as RTA
27
What is the treatment for a sprain or partial tear of a ligament
``` They usually heal with minimal treatment Immobilisation ice or cold water compress mobilise joint as pain subsides Physio ```
28
What is the treatment for a complete ligament rupture
apposition of the divided ends followed by a period of protection Immobilisation for 3 weeks protection
29
What is the risk of surgery on no-man's land of the hand
Tendons run within the flexor tendon sheaths and there is a tendency for adhesions to form in the sheath
30
How can we assess injuries to blood vessels
Angiography
31
What is compartment syndrome
venous outflow from a fascial compartment may may become obstructed by swelling causing the pressure to rise gradually within the compartment
32
What happens to the nerves in compartment syndrome
When the pressure reaches a critical level, any nerves passing through he compartment cease to function initially causing paraesthesiae followed by the loss of sensation in the area supplied by the nerve
33
What might happen if the pressure in compartment syndrome is not relieved urgently
the necrotic muscle may lead to the need of limb amputation
34
When might Compartment syndrome arise
following a closed fracture of the tibia and fibula
35
When does compartment syndrome arise
24-48 hours after the injury but occasionally later
36
What makes the pain worse in compartment syndrome
stretching the affected muscles which are also tender
37
What is the treatment for compartment syndrome
Splitting the deep fascia over the length of the compartment skin is left open all necrotic tissue must be removed
38
How can we judge when to decompress
use a manometric device to measure the intra-compartmental pressure
39
How do pressure sores arise
from continued pressure usually over a bony prominence
40
Where are the most vulnerable sites for pressure sores
sacrum and heels
41
What is the treatment for pressure sores
avoid in the first place small sores - simple dressings after removal of sloughs Large sores - wide surgical excision and skin grafting
42
How might we have to treat a patient that self inflicts injuries to their wrists
Often the person stops when they are discovered | Some time in a plaster-cast allows healing