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Surgical skills > Wound classification > Flashcards

Wound classification Flashcards

1
Q

what are 4 considerations in wound management?

A
  1. anatomic location
  2. mechanism of trauma
  3. degree of contamination
  4. duration of injury
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2
Q

Why does anatomic location of a wound affect the wound management?

A
  1. head, body, limbs have different abilities to heal
  2. degree of tissue disruption in area
  3. supporting structure injury
  4. joint involvement
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3
Q

What are 11 mechanisms of trauma?

A
  1. laceration
  2. avulsion or degloving
  3. puncture
  4. blunt trauma
  5. thermal burns
  6. chemical burns
  7. gunshot
  8. hit by car
  9. international harvester
  10. vascular injury
  11. septic injury
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4
Q

What are the features of laceration?

A
  1. direct antomical disruption
  2. little collateral injury
  3. best wounds to try to reconstruct
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5
Q

What are features of avulsion or degloving?

A
  1. direct tissue loss

2. collateral damage

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6
Q

What are the features of puncture wounds?

A
  1. extent of injury undetermined
  2. common
  3. predisposed to infection–bite wounds
  4. predisposed to foreign body
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7
Q

What are the features of puncture wounds?

A
  1. extent of injury undetermined
  2. common
  3. predisposed to infection–bite wounds
  4. predisposed to foreign body
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8
Q

What are the features of blunt trauma?

A
  1. massive soft tissue injury

2. severe skeletal damage

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9
Q

What can cause thermal burns?

A
  1. fire

2. radiation injury (similar effect)

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10
Q

What can be a consequences of thermal burns?

A
  1. protein loss
  2. fluid loss
  3. (sepsis in people)
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11
Q

What are the features of chemical burns?

A
  1. direct and collateral tissue injury–serum scald, chronic diarrhea
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12
Q

What is an example of a product that causes chemical burns?

A
  1. coppertox
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13
Q

How do gun shot injuries differ in their mechanism of causing injury

A
  1. low velocity gun shots hit tissues of different density and start to tumble
  2. high velocity gun shots hit and cause massive acoustic wave and everything in that wave is traumatized–devastating to body cavity
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14
Q

Why should gun shot wounds be considered infected?

A

because they carry debris, dirt into the wound

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15
Q

What are the features of trauma caused by hit by car?

A
  1. high energy injury
  2. frequent collateral injury–in area hit and away from it
  3. must evaluate major body systems
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16
Q

What are two causes of vascular injury?

A
  1. cast complication–can wear through tip of toe, shift in the cast causes pressure points and skin injuries
  2. septic injury–hypercoagulable and form clots
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17
Q

What is a cause of septic injury?

A

clostridial myositis

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18
Q

What is a cause of septic injury?

A

clostridial myositis (flunixin meglumine injection)

19
Q

What is a cause of septic injury?

A

clostridial myositis (flunixin meglumine injection)

20
Q

What are 5 contributing factors to infection risk?

A
  1. aseptic technique
  2. tissue handling
  3. suture material
  4. electrocautery–minimize trauma
  5. patient imune status–fasting
21
Q

What are examples of clean contaminated wounds

A

going into the bladder, upper respiratory tract or lower respiratory tact

22
Q

What are two examples of contaminated wounds?

A
  1. wounds
23
Q

What are two examples of dirty wounds?

A
  1. wounds >4 hours

2. gross contamination of the body cavity

24
Q

If you add suture material to a contaminated wound, how much do you decrease the number of bacteria required to get the wound infected?

A

by 100x

25
Q

What are 4 features of clean wounds

A
  1. elective
  2. aseptic technique
  3. no viscus violated
  4. no drain
26
Q

What is the infection rate of clean wounds?

A

2.5% in dogs and cats

27
Q

Should prophylactic antibiotics be used in clean surgeries?

A
  1. only for inexperienced surgeons

2. only to target the likely pathogen (coliform and staph in dog; cow; actinobacter, coliforms, horse: strep, coliforms)

28
Q

What are 3 types of clean-contaminated wounds?

A
  1. hollow viscous surgery
  2. minimal contamination
  3. clean surgeries with DRAINS
29
Q

What is the infection rate of clean contaminated wounds?

A

4.5%

30
Q

Should prophylactic antibiotics be used in clean-contaminated wounds?

A

only to target likely pathogens

31
Q

What are 3 examples of contaminated surgeries?

A
  1. GI surgery
  2. contamination?
  3. open fresh wounds
32
Q

What is the infection rate of contaminated surgeries?

A

5.8% in dogs and cats

33
Q

Should antibiotic be used for contaminated surgeries?

A

yes, do for best guess but also culture the wound

34
Q

What are two examples of dirty wounds?

A
  1. old wounds >4 hours

2. GI tract rupture

35
Q

What is the infection rate of dirty surgery?

A

dogs and cats: 18.1%

human 27-40

36
Q

What is the infection rate of clean wounds?

A

2.5% in dogs and cats

human 1-5

37
Q

What is the infection rate of clean contaminated wounds?

A

4.5%

human 3-11

38
Q

What is the infection rate of contaminated surgeries?

A

5.8% in dogs and cats

human 10-17

39
Q

What is the infection rate of dirty surgery?

A

dogs and cats: 18.1%

human 27-40

40
Q

Should antibiotics be used in dirty surgeries?

A

yes, essential

41
Q

What are three different types of factors that determine whether are not wound will get affected

A
  1. surgeon factors
  2. patient factors
  3. surgery site factors
42
Q

What are surgeon factors?

A
  1. aseptic–surgical technique

2. patient management techniques

43
Q

What are patient factors?

A
  1. age
  2. immune status
  3. metabolic status

Surgical skills (23 decks)

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