Surgical Wounds Flashcards
Q: What are the four phases of wound healing?
A: Hemostasis, Inflammatory, Proliferation, and Maturation.
Q: What happens during the hemostasis phase?
A: Vasoconstriction, platelet aggregation, clot formation, and initiation of the inflammatory response.
Q: What occurs during the inflammatory phase?
A: Neutrophils and macrophages migrate to the wound, causing erythema, swelling, and phagocytosis of bacteria. 0-3 days duration
Q: What are the key processes in the proliferation phase?
A: Granulation tissue formation, angiogenesis, collagen deposition, and wound contraction. 3- 24 days duration
Q: What happens in the maturation phase?
A: Scar formation, remodeling of collagen, and increased wound tensile strength (up to 80% of normal tissue).
Q: What is healing by primary intention?
A: Wound edges are approximated using sutures, staples, or adhesives, resulting in minimal scarring.
Q: What is healing by secondary intention?
A: Wounds heal by granulation tissue formation, contraction, and epithelialization, leading to larger scars.
Q: What is healing by tertiary intention?
A: Wound is initially left open due to infection or swelling and later closed surgically.
What is a Class 1/ Clean wound
- No contact with GI, urinary ect.
- Prophylactic ABX not routinely given.
What is a class 2/ clean-contaminated wound.
Class II/Clean-Contaminated Wounds
A surgical wound in which the respiratory, alimentary, genital, or urinary tracts are entered under controlled conditions and without unusual contamination, no major break in technique occurs.
Examples: chest procedures, ear surgeries, bowel resections.
Prophylactic antibiotics are routinely given.
What is a class 3 - Contaminated wound
Class III/Contaminated Wounds
Includes open traumatic wounds (open fractures, penetrating wounds)
Operative procedures involving spillage from the GI, GU or biliary tracts (major break in sterile technique)
Prophylactic antibiotics are always given, and sometimes continued as therapeutic antibiotics.
Class IV/Dirty or Infected Wounds
Heavily contaminated/infected wound before an operation
Includes: perforated viscera, abscesses, wounds with undetected foreign body/necrotic tissue.
Can be closed by secondary/tertiary intention.
Giving therapeutic antibiotics is part of the management.
Q: What are the pros and cons of sutures?
Pros: Strong, versatile, widely used.
Cons: Requires removal (unless absorbable), risk of infection.
Q: When are staples preferred?
A: Used in non-cosmetic areas (scalp, high-tension wounds), provides quick closure, but requires a special removal tool.
Q: When should tissue adhesives (glue) be used?
A: Small, clean, low-tension wounds; not for deep, contaminated, or high-movement areas.
Q: When are adhesive tapes (Steri-Strips) appropriate?
A: Small, shallow wounds, especially in pediatric patients; easy and painless application.
Q: What type of dressing is best for heavily exudative wounds?
A: Foam dressings – highly absorbent and protective.
Q: Which dressing is best for autolytic debridement?
A: Hydrogel dressings – provide moisture and cooling, useful for burns and ulcers.
Q: What is the function of antimicrobial dressings?
A: Deliver sustained antimicrobial agents, used for infected or slow-healing wounds.
Q: What are general post-op wound care instructions?
A: Keep the wound clean and dry for 48 hours, avoid scratching, and monitor for signs of infection (redness, swelling, pus, fever).
Q: When should non-absorbable sutures be removed?
Face: 3-5 days
Scalp: 5-7 days
Joints (knees/elbows): 10-14 days
Back & abdomen: 7-14 days
when can hydrocolloids be used ?
Clinical applications: for pressure wounds and minimal to moderate exudative wounds.
when can alginates be used
Clinical applications: for moderate to heavy exudative wounds.
when to use anti-microbial dressings
Only used if there is bacterial infection
deliver a sustained release of antimicrobial agents to the wound bed
Suitable for dirty wounds
Useful for wounds that have been stuck in the inflammatory phase of healing
Examples: Inadine, Acticoat, Silvercel, Urgotulle
