Suturing Flashcards
Classification of wounds by cause?
- Intentional
- Unintentional
Classification of would by status of skin integrity?
- Open
- Closed
How can wounds be classified?
- Cause
- Status of skin integrity
- Severity of injury
- Degrees of contamination
- Depth
- Descriptive qualities
Classification of wound by severity of injury?
- Superficial
- Penetrating
Classification of wound by degrees of contamination?
- Clean
- Clean/contaminated
- Contaminated
- Infected
Classification of wound by depth?
- Partial thickness
- Full thickness
Classification of wounds by descriptive qualities?
- Laceration
- Abrasion
- Contusion
- Incision
- Puncture
What is a primary intention wound characterized by?
- Closed skin edges
- Minimal granulation tissue
- Early suturing
- Minimal scarring
- Minimal tissue loss
- Rapid healing
- Minimal risk of infection
What is a secondary intention wound characterized by?
- Open skin edges
- Extensive granulation tissue
- No suturing
- Extensive scarring
- Extensive tissue loss
- Delayed healing
- Extensive risk of infection
What is a tertiary intention wound characterized by?
- Open skin edges that are sutured later
- Moderate granulation tissue
- Delayed suturing
- Moderate scarring
- Moderate tissue loss
- Delayed healing
- Moderate risk of infection
Phases of normal wound healing
- Defensive/Inflammatory
- Proliferative (3-4 days after)
- Maturation (3 wks to 2 yrs after)
What are the 2 major processes of the defensive/inflammatory phase of wound healing?
- Hemostasis
2. Inflammation
Principles of wound care?
- Minimize bacterial infection
- Remove FBs and devitalized tissue
- Achieve hemostasis
- Handle tissues gently
- Approximate wond edges
Do esters or amides have a shorter half life?
Esters
Which may cause side effects in renal patients - esters or amides?
Esters
Which may cause side effects in liver patients - esters or amides?
Amides
MC local complication of wound anesthesia?
Anxiety to injection
MC cause of systemic complication in local anesthesia?
Inadvertent injection into a vessel
How does epinephrine affect the duration of Lidocaine?
Doubles the duration
What parts of the body should NOT get epi?
- Locations of body with single dependent blood supply
- Fingers, toes, penis, nose (and pinna of ear)
What is an alternative anesthetic to use if patient is allergic to amides and esters?
Diphenhydramine
Define primary closure
- All layers closed
- Minimizes scarring
- Usually performed in clean and clean/contaminated wounds
Define secondary closure
- Deep layers closed
- Superficial left open to granulate from inside out
- Prolonged process
- Leaves a scar
- Requires frequent wound care and irrigation
- Usually performed when there is excess tissue loss or infection
Where are absorbable sutures MC used?
- Mucosal areas (oral cavity and tongue)
- SQ or deep tissues
MC types of non-absorbable sutures
- Nylon
- Polypropylene
- Silk
How are non-absorbable sutures MC used?
Mostly to close skin or suture catheters in place
Which sutures are less tensile and flexible - mono or multifilament sutures?
Monofilament
Which sutures do not pass through tissue easily?
Multifilament sutures
How to treat dog and cat bites?
- Need copious irrigation
- Facial wounds may need sutures
- Otherwise generally do NOT suture
