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Surgery Test 1 > Wound Healing > Flashcards

Wound Healing Flashcards

1
Q

What is primary wound healing?

A

Healing by primary intention:

-Tissue is anatomically re-approximated

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2
Q

Advantages of primary wound healing?

A
  • Easier care
  • Faster return of function
  • Better cosmetically
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3
Q

Disadvantages of primary wound healing?

A

Increased risk of infection

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4
Q

What is secondary wound healing?

A

By secondary intention:

-Wound left open; granulation tissue forms and wound closes by contraction of tissues

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5
Q

Advantages of secondary wound healing?

A

Infection is nearly impossible

-Good for highly contaminated wounds

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6
Q

Disadvantages of secondary wound healing?

A

Complicated care

Possible poor cosmetic outcome

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7
Q

What is tertiary wound healing?

A

Delayed primary closure:

  • Wound left open for 5 days w/ wound care then surgically closed
  • Abundant granulation tissue-vascular
  • Rarely used
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8
Q

How long is inflammatory phase in primary wound healing?

A

4 days

-Unknown in secondary or tertiary

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9
Q

How long is the maturation and remodeling phase in wound healing?

A

9-12 months

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10
Q

When does the proliferative phase in wound healing occur?

A

After epithelium covers wound

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11
Q

Can a chronic wound be converted to an acute wound?

A

Yes

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12
Q

Do we use systemic ABX for an infected wound?

A

No, only if there is sepsis or cellulitis

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13
Q

What can inhibit wound healing?

A

Edema

Pressure

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14
Q

What vitamin is important for collagen production?

A

Folic acid

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15
Q

What is magnesium important for in wound healing?

A

Protein synthesis

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16
Q

What role does vitamin A play in wound healing?

A

Inflammatory response
Macrophages
Collagen

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17
Q

What role does Zinc play in wound healing?

A

Cofactor in DNA and RNA synthesis

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18
Q

What effect does uncontrolled DM or hyperglycemia have on wound healing?

A

Impaired collagen formation
Impaired healing
Inhibits fibroblast and endothelial cell proliferation

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19
Q

What effects do steroids have on wound healing?

A

Decrease Vitamin A

Alter remodeling and deposition of collagen

20
Q

What effect does smoking have on wound healing?

A

Lowered O2 capacity in hemoglobin

Decreased collagen formation

21
Q

Which stage of pressure ulcer has full thickness skin loss?

22
Q

What characterizes stage 1 pressure ulcers?

A

Unblanchable erythema

23
Q

In treating pressure ulcers, how do hydrocolloid dressings work?

A
  • For an occlusive barrier over ulcer. Maintain moist environment to prevent infection.
  • Prevent shearing
  • Stage 1, 2, 3 and some stage 4 ulcers with no necrotic tissue and minimal exudate
24
Q

In treating pressure ulcers, how do transparent adhesive dressings work?

A
  • Moist environment
  • Promote epithelialization
  • Stage 1, 2, and 3 with no necrotic tissue and minimal exudate
25
In treating pressure ulcers, how do alginate dressings work?
- From brown seaweed - Light to heavily draining stage 2, 3, and 4 ulcers - Infected and non-infected wounds - Not for dry wounds (delay healing)
26
What are the most common chronic wounds in adults?
Venous stasis ulcers
27
Which malleolus is usually affected in venous insufficiency?
Medial malleolus
28
Treatment of venous stasis ulcers?
Elevation Compression +/- Debridement +/- ABX Vein ligation
29
What are the 5 P's?
Pulselessness, pallor, pain, paresthesias, paralysis
30
What causes arterial insufficiency?
Atherosclerosis
31
Where do arterial insufficiency ulcers typically occur?
Toes | Anywhere on ankle, leg or foot
32
Tx for claudication?
Walking around: revascularization
33
Tx for arterial insufficiency?
Walking around 25% heal on own Amputation
34
What type of scar grows beyond the original boundaries of the wound?
Keloid | Seen in darker skin
35
Complications of excising a keloid scar?
50-80% recurrence
36
Treatment for a hypertrophic scar?
- Excision if original closure was unusual | - Steroid injections
37
What condition causes Charcot foot?
Diabetic neuropathy
38
What does SSI stand for?
Surgical site infection
39
Treatment for a superficial abscess after surgery?
Reopen wound | +/- oral antibiotics
40
Treatment for surgical infections of organs/ intracavitary spaces?
IV antibiotics | Drainage
41
What is a big risk in deep incisional surgical site infections?
Fascial necrosis Dehiscence Hernia
42
What kind of surgical infection case is characterized by the following: abscess; preoperative perforation of biliary, respiratory, GI, or GU tract; penetrating wound >4 hours old?
Dirty case
43
Which type of case are most surgical infections?
Contaminated
44
When should we use ABX for clean wound surgery?
If prosthesis involved
45
Which type of surgical wound infections require pre-op ABX?
Clean contaminated Contaminated Dirty

Surgery Test 1 (7 decks)

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