Wound healing Flashcards
Abrasions: what? treat?
- superficial layer removal
- clean/scrub; moist dressing with topical antibiotic
Laceration: what? treat?
- cut/torn tissue
- clean, debride, irrigate, realign wound margins, recommend immobilization
Contusion: what? treat?
- outer layer remains intact
- eval for hematoma (evac)
Avulsion: what? treat?
- torn off tissue (partial or total) (major or minor)
- major total = amputation
- partial = well vascularized, viable flap (reattach)
Puncture: what? treat?
- deep pentration, small surface wound
- tetanus
Common chronic wounds (4)
- pressure ulcers
- venous stasis ulcers
- diabetic food ulcers
- arterial ulcers
Venous stasis ulcers??
improper venous valves
usu around ankles
Arterial ulcers: associated with?
atherosclerosis
ABI?
Ankle brachiall index
ankle systolic/arm systolic
measures severity of arterial ulcers?
WH: primary v secondary v tertiary intent
Primary: suture (fibrin seals within 48 hours, short inflamm phase, proliferation –> red raised scar)
Secondary: no suture, wait for contracture/granulation and epithelialziation, prolonged inflamm
Tertiary: clear infection, then suture
Phases of wound healing
- hemostasis- fibrin clot (cytokine/GF reservoir); PDGF main; platelet aggregates
- Inflammation-
- Proliferation- granulation, fibroblast proliferation, myofibroblasts
- Remodeling- scar maturation , collagen crosslinkning
Efferocytosis-
MAC cleans apoptosed cells which indiccates to MAC to become anti-inflammatory
(impaired in diabetic wounds)
Main cell involved in re-epithelialziation?
Keratinocyte
3 wound management strategies?
- Moist wound healings-
- manage exudate- rich in MMP
- Debridement- surgical, chemical (enzymes; eg collagenase), autolytic, biologic (maggot)
