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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?

A

Stage 3

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
Q

In treating pressure ulcers, how do alginate dressings work?

A
  • 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
Q

What are the most common chronic wounds in adults?

A

Venous stasis ulcers

27
Q

Which malleolus is usually affected in venous insufficiency?

A

Medial malleolus

28
Q

Treatment of venous stasis ulcers?

A

Elevation
Compression
+/- Debridement +/- ABX
Vein ligation

29
Q

What are the 5 P’s?

A

Pulselessness, pallor, pain, paresthesias, paralysis

30
Q

What causes arterial insufficiency?

A

Atherosclerosis

31
Q

Where do arterial insufficiency ulcers typically occur?

A

Toes

Anywhere on ankle, leg or foot

32
Q

Tx for claudication?

A

Walking around: revascularization

33
Q

Tx for arterial insufficiency?

A

Walking around
25% heal on own
Amputation

34
Q

What type of scar grows beyond the original boundaries of the wound?

A

Keloid

Seen in darker skin

35
Q

Complications of excising a keloid scar?

A

50-80% recurrence

36
Q

Treatment for a hypertrophic scar?

A
  • Excision if original closure was unusual

- Steroid injections

37
Q

What condition causes Charcot foot?

A

Diabetic neuropathy

38
Q

What does SSI stand for?

A

Surgical site infection

39
Q

Treatment for a superficial abscess after surgery?

A

Reopen wound

+/- oral antibiotics

40
Q

Treatment for surgical infections of organs/ intracavitary spaces?

A

IV antibiotics

Drainage

41
Q

What is a big risk in deep incisional surgical site infections?

A

Fascial necrosis
Dehiscence
Hernia

42
Q

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?

A

Dirty case

43
Q

Which type of case are most surgical infections?

A

Contaminated

44
Q

When should we use ABX for clean wound surgery?

A

If prosthesis involved

45
Q

Which type of surgical wound infections require pre-op ABX?

A

Clean contaminated
Contaminated
Dirty

Surgery Test 1 (7 decks)

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