Wound Classification and Management Flashcards
What is the definition of a laceration?
Skin is cut or torn open in an inrregular pattern
What is the definition of a burn?
Skin damage, superficial to full thickness
What is the definition of an abrasion?
superficial skin removed, being dragged across a road
What is the definition of puncturing?
caused by a sharp object
What are pressure sores?
Prolonged pressure to one area over time
What is a crush?
Closed wound caused by extreme force over a period of time
What is a contusion?
blunt force trauma, doesnt break skin but causes underlying damage
What is the first step of basic wound management?
Clip away fur, fill defects and cover exposed tissue with a sterile lubricant
What is the second step of basic wound management?
Lavage or irrigation (with sterile solution)
* removes gross contamination and microscopic debris
* reduces infection risk
What is the third step of basic wound management?
Exploration
* Exposure of vital structures
* Explore/ Probe any deep tracts
* Foreign body/ foreign material
* Entered abdomen/ thorax
What is the fourth step of basic wound management?
- Surgical debridement
- removal of unviable tissue, and gross foreign material
- reduces bacterial contamination
What is the fifth step of wound management?
Antibiotics
* use in contaminated wounds (give IV)
* based on likely contaminants from type of wound
What is the difference between infection and contamination?
Contamination is the presence of an infectious agent on a body surface
Infection is the ‘invasion and multiplication of microorganisms in body tissues, especially that causing local cellular injury due to competitive metabolism, toxins, intracellular replication, or antigen-antibody response
What is surgical debridement?
Procedure that removes nonviable tissue, bacteria and foreign material from a wound using sharp surgical instruments
What is primary closure?
Closing in less than 6 hours (Golden Period)
* Minimal contamination
* Following lavage and debridement
* No dead space and tension
What is delayed primary closure?
2-5 days- before granulation tissue
- Minimal to moderate contamination
- Autolytic debridement until primary closure
What is secondary closure?
5-7 days- after granulation
- Severe contamination, tissue loss, trauma
- large wounds are unlikely to fully close
- Incise between granulation and skin margins and then close the primary wound
How does a wound heal by granulation?
- Closure by granulation
- Disfigurement, incomplete healing and fragile scars can occur with large defects
- Not suitable for some areas
- Aided by moist wound management
What is the classification of a clean wound?
- non-traumatic, non-infected, not inflamed
- no break in aspesis
- no drains used
What is the classification of a clean-contaminated wound?
Clean procedure where a drain is placed
minor break in asepsis
What is the classification of a contaminated wound?
- Non-Purulent traumatic wound
- Major break in asepsis
- Spillage of contents of GIT or urinary bladder
What is the classification of a dirty wound?
- Traumatic wound with purulent discharge, necrotic discharge, or foreign bodies
- Perforated viscous, faecal contamination
What are intrasite hydrogels used for?
Minimally exudative wounds
applies moisture to dry wounds
covered by a semi-occlusive dressing
What is the function of vapour permeable adhesive films?
Maintains a moist envoronment
What is the function of polyurethane foam?
Mild to moderately exudative wounds
What are hydrocolloids used for?
- Moderately exudative wounds
- Enhance autolytic debridement
- Promote granulation
What are alginate dressings used for?
- Heavily exudative wounds
- Potent hydrophillic
- Derived from seaweed
What do you use for moderate to high exudate?
Foams or alginates
What do you use for moderate to low exudate?
Hydrocolloids
What do you use for dry wounds?
Hydrogels to rehydrate
What do you use for manuka honey?
- Autolytic debridement
- Antibacterial
- Small amount of hydrogen peroxide
- Heavily contaminated/ infected and exudative wounds
- Not appropriate for dry wounds
What is vacuum assisted closure?
- Increases wound perfusion
- Decreases oedema
- Increases granulation tissue
- Decreases bacteria
- Removes exudate constantly via negative pressure
What is the purpose of granulation tissue?
- Protects the wound
- Barrier to infection
- No nerve endings
- will bleed if traumatised then heal again
- can remove all dressings, open to air if possible
What are the top tips for wound management?
- determined by solution
- lavage pressure should remove bacteria
- if unsure whether to close a wound then dont
- cover topical agents
- communication is key to success
