Wound classification Flashcards
what are 4 considerations in wound management?
- anatomic location
- mechanism of trauma
- degree of contamination
- duration of injury
Why does anatomic location of a wound affect the wound management?
- head, body, limbs have different abilities to heal
- degree of tissue disruption in area
- supporting structure injury
- joint involvement
What are 11 mechanisms of trauma?
- laceration
- avulsion or degloving
- puncture
- blunt trauma
- thermal burns
- chemical burns
- gunshot
- hit by car
- international harvester
- vascular injury
- septic injury
What are the features of laceration?
- direct antomical disruption
- little collateral injury
- best wounds to try to reconstruct
What are features of avulsion or degloving?
- direct tissue loss
2. collateral damage
What are the features of puncture wounds?
- extent of injury undetermined
- common
- predisposed to infection–bite wounds
- predisposed to foreign body
What are the features of puncture wounds?
- extent of injury undetermined
- common
- predisposed to infection–bite wounds
- predisposed to foreign body
What are the features of blunt trauma?
- massive soft tissue injury
2. severe skeletal damage
What can cause thermal burns?
- fire
2. radiation injury (similar effect)
What can be a consequences of thermal burns?
- protein loss
- fluid loss
- (sepsis in people)
What are the features of chemical burns?
- direct and collateral tissue injury–serum scald, chronic diarrhea
What is an example of a product that causes chemical burns?
- coppertox
How do gun shot injuries differ in their mechanism of causing injury
- low velocity gun shots hit tissues of different density and start to tumble
- high velocity gun shots hit and cause massive acoustic wave and everything in that wave is traumatized–devastating to body cavity
Why should gun shot wounds be considered infected?
because they carry debris, dirt into the wound
What are the features of trauma caused by hit by car?
- high energy injury
- frequent collateral injury–in area hit and away from it
- must evaluate major body systems
What are two causes of vascular injury?
- cast complication–can wear through tip of toe, shift in the cast causes pressure points and skin injuries
- septic injury–hypercoagulable and form clots
What is a cause of septic injury?
clostridial myositis
What is a cause of septic injury?
clostridial myositis (flunixin meglumine injection)
What is a cause of septic injury?
clostridial myositis (flunixin meglumine injection)
What are 5 contributing factors to infection risk?
- aseptic technique
- tissue handling
- suture material
- electrocautery–minimize trauma
- patient imune status–fasting
What are examples of clean contaminated wounds
going into the bladder, upper respiratory tract or lower respiratory tact
What are two examples of contaminated wounds?
- wounds
What are two examples of dirty wounds?
- wounds >4 hours
2. gross contamination of the body cavity
If you add suture material to a contaminated wound, how much do you decrease the number of bacteria required to get the wound infected?
by 100x
What are 4 features of clean wounds
- elective
- aseptic technique
- no viscus violated
- no drain
What is the infection rate of clean wounds?
2.5% in dogs and cats
Should prophylactic antibiotics be used in clean surgeries?
- only for inexperienced surgeons
2. only to target the likely pathogen (coliform and staph in dog; cow; actinobacter, coliforms, horse: strep, coliforms)
What are 3 types of clean-contaminated wounds?
- hollow viscous surgery
- minimal contamination
- clean surgeries with DRAINS
What is the infection rate of clean contaminated wounds?
4.5%
Should prophylactic antibiotics be used in clean-contaminated wounds?
only to target likely pathogens
What are 3 examples of contaminated surgeries?
- GI surgery
- contamination?
- open fresh wounds
What is the infection rate of contaminated surgeries?
5.8% in dogs and cats
Should antibiotic be used for contaminated surgeries?
yes, do for best guess but also culture the wound
What are two examples of dirty wounds?
- old wounds >4 hours
2. GI tract rupture
What is the infection rate of dirty surgery?
dogs and cats: 18.1%
human 27-40
What is the infection rate of clean wounds?
2.5% in dogs and cats
human 1-5
What is the infection rate of clean contaminated wounds?
4.5%
human 3-11
What is the infection rate of contaminated surgeries?
5.8% in dogs and cats
human 10-17
What is the infection rate of dirty surgery?
dogs and cats: 18.1%
human 27-40
Should antibiotics be used in dirty surgeries?
yes, essential
What are three different types of factors that determine whether are not wound will get affected
- surgeon factors
- patient factors
- surgery site factors
What are surgeon factors?
- aseptic–surgical technique
2. patient management techniques
What are patient factors?
- age
- immune status
- metabolic status
