Wound Healing Flashcards
- Wound involving normal but colonized tissue
- Minor breaks in sterile technique
- Entry of GU,GI,or respiratory tract without significant spillage
Clean-Contaminated wound (Type II)
- Wound containing foreign or infected material
- Traumatic wounds
- Open, fresh, accidental
wounds - Gross spillage from GI tract
- Entry into infected tissue,
bone, urine, or bile
Contaminated wound (Type III)
- Atraumatic, uninfected *Noentry of GU, GI, or respiratory tract
- Primarily closed
- If necessary, drained with closed drainaged
Clean Wound (Type I)
- Old traumatic wounds with retained devitalized tissue and those that involve existing clinical infection or perforated viscera
- Organisms causing postoperative infection were present in the operative field before operation
Dirty Wound (Type I)
Type of Wound
* Operations with major breaks in sterile technique (e.g., open cardiac massage)
Contaminated Wound (Type III)
Type of Wound
* Breast surgery (MRM)
* Thyroid surgery
Clean wound (Type I)
Type of Wound
*Drainage ofabscess
* Debridement of soft tissue
infection
Dirty wound (Type IV)
Type of Wound
* Resection of infarcted bowel
Dirty wound (Type IV)
Type of Wound:
Incisions in which acute,
nonpurulent inflammation is encountered including necrotic tissue without evidence of purulent drainage (e.g., dry gangrene)
Contaminated (Type III)
Type of wound:
Operations involving biliary tract, appendix, vagina, and oropharynx (provided no evidence of infection or major break in technique is encountered)
Clean-Contaminated wound (Type II)
3 Phases of Wound healing
- Hemostasis & Inflammation
- Proliferation
- Maturation & Remodeling
Time course of Phase 1 of Wound healing
7 days
Time course of Phase 2 of Wound healing
5 days to 3 weeks
Time course of Phase 3 of Wound healing
3 weeks to 1 year
Clean wounds (Type I) are closed ______ to allow healing by ______
immediately; Primary intention
Contaminated (Type III) or Dirty wounds (Type IV) heal by
Secondary intention
Type of healing for Clean-Contaminated (type II) wounds that involves surgical toilet of open wound and closure after 48 hours
Tertiary closure (Delayed primary intention)
Type of closure for wounds from traumatic injuries, dog bites, or lacerations from foreign bodies
Tertiary closure (delayed primary intention)
Wounds left to heal by secondary intention are maintained on __________ phase until wound closes spontaneously
Proliferation
Wounds left to heal by tertiary intention are closed after a few days when the wound is clean and __________ is abundant
Granulation tissue
Pro-inflammatory interleukin that activates PMNs and induces chemotaxis
IL-1
Pro-inflammatory interleukin that activates fibroblast proliferation and induces collagen and proteoglycan synthesis
IL-4, IL-8
Active molecule in wound healing that activates macrophages but inhibits fibroblast proliferation
IFN-a
(Interferon interferes with fibroblast proliferation)