Wound healing

Question 1

4 stages of healing

Answer 1

Hemostasis/Coag
Inflammation
Migration, proliferation
Remodeling

Question 2

4 stages of Migration/Proliferation

Answer 2

Angiogenesis
Epithelization
Contraction
Fibroplasia

Question 3

Coagulation

Answer 3

Vessel rupture, constriction
Platelet aggregation, coag
Platelets degranulate
Cytokines released
Fibrin clot formation

Question 4

Inflammation

Answer 4

Attraction, activation of infiltrating cells
Neutrophils phagocytose
Macrophages debride, send signals (most important)

Question 5

Which cells provide angiogenic stimuli?

Answer 5

Keratinocytes and macrophages

Question 6

Epithelization aided by ___ environment.

Answer 6

Moist

Question 7

Fibroplasia

Answer 7

Fibroblasts migrate and replicate
Dominant cell type at wound edge
Deposit matrix

Question 8

Which cells are responsible for remodeling?

Answer 8

Fibroblasts

Question 9

Halsteds Principles

Answer 9

Gentle handling of tissue
Careful hemostasis
Aseptic technique
Avoidance of tension
Sharp dissection
Obliteration of dead space

Question 10

Primary intention

Answer 10

Wound closed w/ stitches or staples

Question 11

Secondary intention

Answer 11

Epidermis and dermis not closed.
Allowed to granulate in
COntamination, infection, peritonitis
Must be packed daily w/ moist gauze

Question 12

VAC therapy

Answer 12

Negative pressure wound therapy.
Decreases edema, enhanced granulation
Lower bacteria counts
Excellent results

Question 13

Most common nosocomial infxn

Answer 13

SSi

Question 14

Most SSI’s are acquired when?

Answer 14

At time of surgery

Question 15

Common bugs for SSI

Answer 15

Staph A

Coag Neg Staph

Question 16

Preferred pre-op Abx

Answer 16

Cefazolin (Ancef) 1-2g IV