wound healing

Question 1

what 3 factors determine which method of wound healing takes place?

Answer 1

• how the wound was created
• amt of tissue loss
• degree of contamination

Question 2

5 steps to wound healing

Answer 2

• hemostasis (stop blood)
• clean pathogens/debris
• seal wound against infection
• regenerate epidermis
• repair deeper tissue injury

Question 3

tensile strength

Answer 3

• 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)

Question 4

preop factors/general systemic that affect wound healing

Answer 4

-nutrition, physical condition, meds, age, preop skin prep, preop stress, existing infection

Question 5

intraop factors that affect wound healing

Answer 5

sx length, wound location, complications, foreign bodies in wound (implants), elimination of dead space, unplanned hypothermia

Question 6

protein and wound healing

Answer 6

• collagen

- reduce evisceration risk

Question 7

carbs/fats in wound healing

Answer 7

bc preferred fuel, will reduce oxidation of essential a.a.

Question 8

vit A in wound healing

Answer 8

inc. tensile strength and infection resistance

Question 9

vit B in wound healing

Answer 9

carb metabolism

Question 10

vit C in wound healing

Answer 10

collagen and capillary formation

Question 11

zinc in wound healing

Answer 11

collagen

Question 12

how many days before sx do you stop ASA/coumadin

Answer 12

7 days

Question 13

how many days before sx do you stop heparin

Answer 13

2-7 days

Question 14

how many days before sx do you stop NSAIDs (ibuprofen, rofecoxib)

Answer 14

2 days

Question 15

what 2 things can you irrigate wound with

Answer 15

water and saline

Question 16

what 3 things do you NEVER clean opened wounds with

Answer 16

CHG, iodine, ETOH

Question 17

dead space

Answer 17

when tissue layers aren’t closed properly in wound closures

Question 18

fibrin sealants

Question 19

flowables

Answer 19

• 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

Question 20

active hemostatic topical agents

Answer 20

-contain thrombin from bovine, human, or recombinant sources

Question 21

passive/mechanical hemostatic topical agents

Answer 21

• physical barrier to blood flow

- collagen, cellulose, gelatins, polysaccharides spheres