war wounds: debridement and irrigation Flashcards
In general, extremity wounds should be extended in a ________
longitudinal manner (parallel with the bone)
truncal wounds should be extended along __________
Langer’s lines
how long should closure of blast injuries be avoided after the injury occurs?
48 hours
Assurance of ________ and removal of all nonviable skin, fat, fascia, muscle, and bone are essential to reduce the load of contamination and necrotic tissue prior to dressing application.
hemostasis
All methods of wound irrigation are adjuncts and not substitutes to ________
sharp surgical debridement.
The current recommendations of irrigation volume for small wounds is
1-3 liters
The current recommendations of irrigation volume for moderate wounds is
4-8 liters
The current recommendations of irrigation volume for large wounds or wounds with evidence of heavy contamination is
9 or more liters
T/F Normal saline, sterile water and potable tap water all have comparable efficacy and safety as irrigation solutions
true
T/F The inclusion of irrigation fluid additives such as iodine, bacitracin or antibiotics has proven benefit.
false
what are the risk factors for invasive fungal infections to look for during the first wound debridment
Dismounted blast injury
Above knee immediate amputation
Extensive perineal/genitourinary/rectal injury
Massive transfusion of >20 units in the first 24 hours
T/F all wounds must be closed prior to arrival at a definite care location to prevent further bacterial and fungal introduction
false
T/F Placement of antibiotic impregnated PMMA can be used as an adjunct to D&I to deliver increased local antibiotic concentrations while minimizing the associated side effects of high systemic loads of these antibiotics.
true
An ______ event refers to an iatrogenic event in which a sponge or surgical instrument is deliberately or unintentionally left behind while the wound proceeds to definitive management.
RFO
Explosive munitions injure through ______ major mechanisms.
four
