Wound Closure Flashcards
Q: What are wounds?
A: Wounds are breaks in tissue continuity caused by trauma (physical, chemical, or biological). They vary in type (acute and chronic), shape, size, and methods of healing.
Q: Why is rapid closure and repair of wounds important?
A: Rapid closure assists and enhances the wound healing process, reduces morbidity and complications, and can even reduce mortality, especially in extensive wounds or multiply injured patients.
Q: What are the five methods of wound closure?
A:
1. Direct closure (Primary and delayed)
2. Direct closure assisted by undermining of margins
3. Healing by secondary intention
4. Skin grafts
5. Skin flaps
Q: What is direct closure?
A: Direct closure means approximating the wound edges together using stitches, staples, clips, or adhesive tapes. It leads to healing by primary intention, resulting in a linear scar.
Q: What is the difference between primary closure and delayed primary closure?
A:
- Primary closure occurs immediately in clean traumatic or surgical wounds.
- Delayed primary closure is performed after several days once the wound is clean, commonly in contaminated traumatic wounds.
Q: What is direct closure assisted by undermining of margins?
A: When wound edges are too far apart to be approximated without tension, undermining the adjacent skin at an avascular plane helps in stretching the skin for direct closure.
Q: What is a graft?
A: A graft is a piece of tissue transferred from a donor site to a recipient site, completely separated from its original circulation, and relies on the recipient site to develop new circulation.
Q: What are the three types of grafts based on donor and recipient sites?
A:
1. Autograft: Graft transplanted from one site to another in the same individual.
2. Allograft: Graft transplanted between two individuals of the same species.
3. Heterograft (Xenograft): Graft transplanted between individuals of different species.
Q: What is a skin graft, and when is it used?
A: Skin grafts are used to close large wounds (greater than 1 inch in width) or when direct closure would cause deformity.
Q: What is a split-thickness skin graft (STSG)?
A: STSG is composed of the epidermis and part of the dermis, harvested using a dermatome. It is commonly used for extensive wounds like full-thickness burns or traumatic injuries.
Q: What is a full-thickness skin graft (FTSG)?
A: FTSG is composed of both the epidermis and the entire dermis, harvested by scalpel. It is used for wound closure on the face or hand and requires direct closure or STSG at the donor site.
Q: What is the process of skin graft “take”?
A: Skin graft “take” is the process of vascularization at the recipient site, which occurs within 72 hours. The graft initially relies on nutrient diffusion from the recipient site.
Q: What are the three main requirements for successful skin graft “take”?
A:
1. Good circulation at the recipient site.
2. Clean wounds, free from infection.
3. Good contact between the graft and recipient site without fluid accumulation or excessive tension.
Q : What is a flap?
A: A flap is a piece of tissue transferred from one site to another while maintaining its circulation through a base or pedicle.
Q: What are the three types of flaps based on the type of base?
A:
1. Peninsular flap: Attached at one side to the donor site.
2. Island flap: Circulation is preserved through an isolated vascular bundle or subcutaneous tissue.
3. Free flap: Fully separated from the donor site, requiring surgical anastomosis at the recipient site.
