wound healing Flashcards
what 3 factors determine which method of wound healing takes place?
- how the wound was created
- amt of tissue loss
- degree of contamination
5 steps to wound healing
- hemostasis (stop blood)
- clean pathogens/debris
- seal wound against infection
- regenerate epidermis
- repair deeper tissue injury
tensile strength
- ability of wound to withstand normal activity stresses
- nothing to do w/ time but type of tissue (stronger tissues like skin/fascia take longer to regain strength as compared to weak intestine)
preop factors/general systemic that affect wound healing
-nutrition, physical condition, meds, age, preop skin prep, preop stress, existing infection
intraop factors that affect wound healing
sx length, wound location, complications, foreign bodies in wound (implants), elimination of dead space, unplanned hypothermia
protein and wound healing
- collagen
- reduce evisceration risk
carbs/fats in wound healing
bc preferred fuel, will reduce oxidation of essential a.a.
vit A in wound healing
inc. tensile strength and infection resistance
vit B in wound healing
carb metabolism
vit C in wound healing
collagen and capillary formation
zinc in wound healing
collagen
how many days before sx do you stop ASA/coumadin
7 days
how many days before sx do you stop heparin
2-7 days
how many days before sx do you stop NSAIDs (ibuprofen, rofecoxib)
2 days
what 2 things can you irrigate wound with
water and saline
what 3 things do you NEVER clean opened wounds with
CHG, iodine, ETOH
dead space
when tissue layers aren’t closed properly in wound closures
fibrin sealants
flowables
- combo of passive and active hemostatic topical agents
- need direct contact w/ blood bc literally stop blood flow by converting fibrinogen to fibrin but do not contain either
- Floseal, Surgiflo
active hemostatic topical agents
-contain thrombin from bovine, human, or recombinant sources
passive/mechanical hemostatic topical agents
- physical barrier to blood flow
- collagen, cellulose, gelatins, polysaccharides spheres
