Wound Classification and Management

Question 1

What is the definition of a laceration?

Answer 1

Skin is cut or torn open in an inrregular pattern

Question 2

What is the definition of a burn?

Answer 2

Skin damage, superficial to full thickness

Question 3

What is the definition of an abrasion?

Answer 3

superficial skin removed, being dragged across a road

Question 4

What is the definition of puncturing?

Answer 4

caused by a sharp object

Question 5

What are pressure sores?

Answer 5

Prolonged pressure to one area over time

Question 6

What is a crush?

Answer 6

Closed wound caused by extreme force over a period of time

Question 7

What is a contusion?

Answer 7

blunt force trauma, doesnt break skin but causes underlying damage

Question 8

What is the first step of basic wound management?

Answer 8

Clip away fur, fill defects and cover exposed tissue with a sterile lubricant

Question 9

What is the second step of basic wound management?

Answer 9

Lavage or irrigation (with sterile solution)
* removes gross contamination and microscopic debris
* reduces infection risk

Question 10

What is the third step of basic wound management?

Answer 10

Exploration
* Exposure of vital structures
* Explore/ Probe any deep tracts
* Foreign body/ foreign material
* Entered abdomen/ thorax

Question 11

What is the fourth step of basic wound management?

Answer 11

• Surgical debridement
• removal of unviable tissue, and gross foreign material
• reduces bacterial contamination

Question 12

What is the fifth step of wound management?

Answer 12

Antibiotics
* use in contaminated wounds (give IV)
* based on likely contaminants from type of wound

Question 13

What is the difference between infection and contamination?

Answer 13

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

Question 14

What is surgical debridement?

Answer 14

Procedure that removes nonviable tissue, bacteria and foreign material from a wound using sharp surgical instruments

Question 15

What is primary closure?

Answer 15

Closing in less than 6 hours (Golden Period)
* Minimal contamination
* Following lavage and debridement
* No dead space and tension

Question 16

What is delayed primary closure?

2-5 days- before granulation tissue

Answer 16

• Minimal to moderate contamination
• Autolytic debridement until primary closure

Question 17

What is secondary closure?

5-7 days- after granulation

Answer 17

• Severe contamination, tissue loss, trauma
• large wounds are unlikely to fully close
• Incise between granulation and skin margins and then close the primary wound

Question 18

How does a wound heal by granulation?

Answer 18

• Closure by granulation
• Disfigurement, incomplete healing and fragile scars can occur with large defects
• Not suitable for some areas
• Aided by moist wound management

Question 19

What is the classification of a clean wound?

Answer 19

• non-traumatic, non-infected, not inflamed
• no break in aspesis
• no drains used

Question 20

What is the classification of a clean-contaminated wound?

Answer 20

Clean procedure where a drain is placed
minor break in asepsis

Question 21

What is the classification of a contaminated wound?

Answer 21

• Non-Purulent traumatic wound
• Major break in asepsis
• Spillage of contents of GIT or urinary bladder

Question 22

What is the classification of a dirty wound?

Answer 22

• Traumatic wound with purulent discharge, necrotic discharge, or foreign bodies
• Perforated viscous, faecal contamination

Question 23

What are intrasite hydrogels used for?

Answer 23

Minimally exudative wounds
applies moisture to dry wounds
covered by a semi-occlusive dressing

Question 24

What is the function of vapour permeable adhesive films?

Answer 24

Maintains a moist envoronment

Question 25

What is the function of polyurethane foam?

Answer 25

Mild to moderately exudative wounds

Question 26

What are hydrocolloids used for?

Answer 26

• Moderately exudative wounds
• Enhance autolytic debridement
• Promote granulation

Question 27

What are alginate dressings used for?

Answer 27

• Heavily exudative wounds
• Potent hydrophillic
• Derived from seaweed

Question 28

What do you use for moderate to high exudate?

Answer 28

Foams or alginates

Question 29

What do you use for moderate to low exudate?

Answer 29

Hydrocolloids

Question 30

What do you use for dry wounds?

Answer 30

Hydrogels to rehydrate

Question 31

What do you use for manuka honey?

Answer 31

• Autolytic debridement
• Antibacterial
• Small amount of hydrogen peroxide
• Heavily contaminated/ infected and exudative wounds
• Not appropriate for dry wounds

Question 32

What is vacuum assisted closure?

Answer 32

• Increases wound perfusion
• Decreases oedema
• Increases granulation tissue
• Decreases bacteria
• Removes exudate constantly via negative pressure

Question 33

What is the purpose of granulation tissue?

Answer 33

• 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

Question 34

What are the top tips for wound management?

Answer 34

• 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