Wound Closure and Bx Flashcards
What should you have before stepping into OR?
hat
mask
shoes
Why is important to close the wound?
hemostasis prevent infxn preserve fxn restore appearance min pt disocomfrot
What is phase 1 of wound healing? How long?
initial lag phase
days 0-5days
What is phase 2 of wound healing? How long?
fibroplasia phase -rapid increase in wound strength
days 5-14days
What is phase 3 of wound healing? How long?
final maturation phase - further connective tissue remodeling (80% of normal skin strength)
day 14- complete healing
What sutures should be used during phases 1 and 2?
non absorbable skin stuure or stpales
What if pt passes the time allotted for primary intention?
gauze + cephalexin x5days
return on day 3 and close w/non asorbable sutures
What suture should be used for face? When to remove?
simple interrupted: 5 -6
subcuticular: 4-5
remove: 3-5days
What suture should be used for scalp? When to remove?
simple interrupted: 4
10 days
When to remove sutures for: upper body and hand? Lower body? Over joint?
upper body: 7-10days
lower body: 10-14days
over joint; 14-21days
When can tapes and strips be used?
reinforcement to sutres
does not provide skin-edge eversion
When can tissue adhesives be used?
facial, scalp that are les sthan 8cm and 0.5cm deep
What is good about tissue adhesives?
fast
painless
no suture
low cost
What is bad about tissue adhesives?
takes 7 days for sterngth
early dehiscence
expensive
When is bx contraindicated?
infxn
inflammation
injury
coagulpathy
When can excision be used?
malignant lesion
benign growth causing irritation
removal of subcutaneous growth - sebaceous cysts, lipoas
When can punch bx be used?
malignant lesion
subcutaneous growths -sebaceous cysts, lipomas
When can shave bx be used?
malignant
subcutaneous growths - sebacous cysts, lipoas
bening appearing lesions and comsetic is important
What is the procedure sequence for bx?
PARQ signed mark site workspace prep alcohol prep anesthetic \+/-sutures prep (betadine) procedure dress wound
What should you avoid when chosing a bx site?
cosmetic area
old lesions
ulcerated lesion
poor circualtion
