Soft tissue injury

Question 1

Primary intention

Answer 1

• Surgical incisions

- Heal quick, minimal scar

Question 2

Secondary intention

Answer 2

• Scar formation
• Slow healing
• Risk of unification
• Pressure and vasc ulcers

Question 3

Tertiary intention

Answer 3

• Allow wound healing and then close by primary intention

- Abd incisions

Question 4

Wound cleansing

Answer 4

• Irrigation and scrubbing with saline
• No soap or detergent
• Scrub brush or sponge

Question 5

Hemorrhage control

Answer 5

• Direct pressure with sterile dressing
• Close scalp wounds with sutures/ staples
• Temporary tourniquets

Question 6

Wound closure

Answer 6

• Do not close with heavy bacterial load, tissue defects, foreign bodies
• Primary closure preferred if possible

Question 7

Suturing

Answer 7

• Smallest size and least amount of suture possible
• Face = 5-6 suture
• Other area = 3-4
• Suture holes due to tension and time of suture

Question 8

Suture removal

Answer 8

• Face: 3-5 days

- Extremities and trunk: 7-10 days

Question 9

Suture alternatives

Answer 9

• Metallic staples- increased tension
• Tape- max resistance to infxn. Good following sutures, inferior at maintaining alignment
• Tissue adhesives- minor wounds on intact epithelium. Not near eyes

Question 10

Abx prophylaxis

Answer 10

• High risk pts
• Started within 4 hrs
• Low efficacy with topical
• Contact with feces, pus, saliva