Wound Healing

Question 1

What are the three types of wounds?

Answer 1

Surgical
Chronic
Traumatic

Question 2

What are surgical wounds?

Answer 2

Incision - cut into or make an opening into tissue

Excision - removal of tissue

Question 3

What is a chronic wound?

Answer 3

Develop last over time due to pathophysiological conditions

Question 4

What is a traumatic wound?

Answer 4

Mechanic, thermal, or chemical destruction

Question 5

What r the phases of wound healing? How long is each phase?

Answer 5

Phase 1 - Inflammation 0-4 days
Phase 2 - proliferation or fibroplastic (2-22 days)
Phase 3 - maturation or remodeling (21 days - 2 years)

Question 6

WhT are the wound healing types?

Answer 6

First intention (primary)
Secondary intention (granulation)
Third intention (tertiary)

Question 7

What is primary wound healing?

Answer 7

Surgical incision
Aseptic technique
Gentle handling of tissue
Minimal tissue damage 
Bring edges together
ASAP after surgery

Question 8

What is granulation healing?

Answer 8

Secondary intention
Healing occurs with proper cleaning and dressing changes of wound
Wound fills in gradually
Extensive scar tissue
Contraction of surrounding tissue

Question 9

What is tertiary or third intention healing?

Answer 9

Wound contaminated to start with
Wound approximation delayed by three or more days after injury
May need debridement
Retention sutures

Question 10

What are the classifications of a surgical wound?

Answer 10

Clean wound class 1
Clean contaminated class 2
Contaminated class 3
Dirty class 4

Question 11

When should the nurse classify the wound on the documentation sheets?

Answer 11

Always at end of surgical procedure

Question 12

What would put a wound in class 1?

Answer 12

Elective surgical procedure with wound made under ideal surgical conditions

Primary closure
No open wound drainage - closed system acceptable
No breaks in stere technique
No inflammation present
Alimentary, respiratory,genitourinary tracts, or oropharyngeal cavity not entered

Eg breast biopsy, herniorrhaphy

Question 13

What would put a wound in class 2?

Answer 13

Primary closure, open wound drainage present
Minor break in technique ctrl occurred
No inflammation or infection present
Alimentary, resp and genitourinary tracts and oropharyngeal cavity entered under controlled conditions without significant spoilage or unusual contamination

Eh tracheostomy, nephrectomy

Question 14

What would put a wound in class 3?

Answer 14

Open, fresh traumatic wound of less than 4 hrs duration.
Major break in technique occurred
Acute non purulent inflammation present
Gross spillage/contamination from gastrointestinal tract
Entrance into genitourinary/biliary tracts with infected urine or bile present

Eg. Bowel resection with spillage, appendectomy for acute appendicitis

Question 15

What would classify a wound as dirty (class 4)?

Answer 15

Old traumatic or more than 4 hours duration from dirty source with retained necrotic tissue, foreign body, or fecal contamination

Question 16

What factors can affect wound healing?

Answer 16

Circulatory status
Age
Nut status
Fluid and electrolyte balance
Hematology
Inflammatory and immune responses
Drug therapy
Radiation therapy

Question 17

What intraoperative factors can affect wounds?

Answer 17

Length of surgery
Location of wound
Complications
Foreign bodies in wound
Elimination of dead space in wound

Question 18

What is a keloid?

Answer 18

Abnormal deposit of collagen in healing skin wound

Causes large dense scar

Question 19

What are adhesions?

Answer 19

Fibrous bands in peritoneal cavity holding two structures together.

Question 20

What sutures have the highest occurrence of complications?

Answer 20

Silk or cotton