Wound healing

Question 1

Primary closure

Answer 1

occurring within 24 hours from injury (see wound, close it)

o There is minimal contamination/ tissue damage & adequate healthy tissue available

Question 2

Delayed primary closure

Answer 2

occurring 3-5 days (closing before granulation tissue formed)
o Mild to moderate tissue damage (contamination), the delay allows for drainage & improved tissue resistance to infection

Question 3

Tertiary:

Answer 3

> 5 days

Contains extensive damage (infection), here close after granulation bed formed!

Question 4

What wound closure involves the body healing on its own?

Answer 4

Second intension healing

Question 5

What are the three phases of wound healing?

Answer 5

• Inflammation
• Repair/ Proliferative
• Maturation

Question 6

What is the key player in the inflammation phase?

Answer 6

Macrophages, they signal angiogenesis and fibroplasia.

Question 7

What is a contracture?

Answer 7

pathologic term for wound healed over area of mobility, but mobility is lost because too tight/joint cant move)

Question 8

Abrasion Wounds

Answer 8

Friction force
o	Size: varies
o	Depth: superficial/ partial thickness
o	Contamination: minimal 
o	Damage: minimal 
o	Treat: clean & bandage (heal by 2nd intension)

Question 9

Incision/ Laceration

Answer 9

Shear force
o	Size: larger (mobile skin); varies
o	Depth: must explore (varies) 
o	Contamination: minimal 
o	Damage: minimal 
o	Treat: primary wound healing- clean, debride & close (except tendons, body wall penetration, deep puncture bite wounds or hemorrhage)

Question 10

Deglove/ Avulsion wound

Answer 10

Tension force (skin separated from subdermal/ blood supply)
o Size: can be large
o Depth: usually large pockets/ not deep
o Contamination: a lot + debris
o Damage: possible
o Treat: open wound management ( delayed primary or second intension healing)

Question 11

Shear wound

Answer 11

Tension force
- Size: variable
o Depth: involves deep tissues (tendon, bone)
o Contamination: Highly + debris
o Damage: Possible surrounding tissue
o Treat: open wound management (2 intention & grafts) & treat orthopedic injury

Question 12

Puncture wounds

Answer 12

penetrating wounds with compression force
o Size: small
o Depth: usually deep
o Contamination: high
o Damage: tissue injury
o Treat: primary closure or surgical explore w/ delayed primary closure.

Question 13

Should you explore if there are abdominal wounds?

Answer 13

Yes, because if there is a perforation, this could lead to other issues!

Question 14

Bite wounds:

Answer 14

shear+ compression+ tension forces
o Size: small, but is tip of iceberg (injury below skin worse)
o Depth: possible penetration of body cavity
o Contamination: Highly
o Damage: likely to surrounding tissues

Question 15

Wound bed in the three phases of wound repair?

Answer 15

1. Inflammatory phase- provisional matrix
2. proliferative phase: granulation tissue
3. Maturation phase: scar

Question 16

Why should you scrub around the wound and not in the wound with open wound management?

Answer 16

if concentrated antiseptic enters wound is toxic to fibroblast)

Question 17

What is the point of debridement?

Answer 17

minimize infection to promote healing!

Question 18

Open wound management Points (5)

Answer 18

1. Prevent further contamination
2. Remove foreign contamination
3. Lavage
4. Debridement
5. promote vascular bed