Surgery Practical 2. Wound management Flashcards
Classification of wounds by cause
Classification of wounds by contamination
Clean wound?
Surgical sterile wound
Clean-contaminated wound — ?
Contaminated wound — ?
Dirty wound — ?
Classification of wounds by time factor
Grade 1: mild contamination in a traumatic wound not older than 6 hours (‘Golden period’)
Grade 2: moderate contamination 6 to 12 hours
Grade 3: severe contamination, older that 12 hours
Do timorous wounds heal?
No !
Types of wound healing
- primary wound healing - no scar, nor functional loss
- secondary (or second intention) wound healing — nit the perfect healing. Scar formation. Some extend of functional loss
Biology of wound healing
Wound —> bleeding —> vasoconstriction and clot formation —> inflammation —> pus and exudate —> (this stage is very susceptible to secondary infection)
—> angioneogenesis, new tissue formation (granulational/proliferational tissue) —> (here antimicrobial treatment is not needed already)
—> maturation of tissue, looking the vessels
Description of stages
Factors affecting wound healing
If presence of multiresistent microbe is presumed…
Wound management step by step
Lavage
Close or not to close the wound? How to decide?
Primary closure has NO granulational tissue
What cases should NOT be closed?
- from bite (drainage!)
- penetrating wound
- wound is severely confused
- there is a suspect for a retained foreign body
