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vn03 > Wound healing and management > Flashcards

Wound healing and management Flashcards

1
Q

what are some characteristics of a laceration wound?

A
  • wound caused by tearing of tissue
  • uneven edges
  • lower levels of bleeding than incisional
  • extensive involvement of surrounding tissue
  • debridement
  • primary closure, delayed primary closure or secondary intention
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1
Q

what are some characteristics of a surgical (incisional) wound?

A
  • clean cut, caused by sharp object
  • freely bleeding
  • closed by primary intention
  • less prone to infection
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2
Q

what are some characteristics of a abrasion wound?

A
  • caused by friction, removing variable amounts of epidermis, dermis, or hypodermis
  • superficial
  • little to no bleeding
  • can be embedded with dirt and foreign bodies
  • highly contaminated
  • usually require cleaning and management than closure
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3
Q

what are some characteristics of a de-gloving injury?

A
  • caused by skin being torn from underlying tissue
  • can be mechanical or physiological
  • shearing of skin can cause damage to local blood supply and cause ischemia
  • often lead to necrosis
  • secondary bacterial contaminated is common
  • require bandage care
  • often skin graft or amputation
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4
Q

what are some characteristics of a shearing wound?

A
  • combination of degloving and abrasion injuries
  • usually deeper than abrasions and may involve joints
  • likely to be highly contaminated
  • tendency to be extensive and deep
  • amputation or arthrodesis
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5
Q

what are some characteristics of a puncture wound?

A
  • caused by penetration of an object into the tissue
  • usually a small skin opening with deep tissue damage
  • can be a foreign object or bite wounds
  • surface injury may hide true extent of the injury
  • antibiotics often required
  • management of secondary wounds
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6
Q

what are some characteristics of a crush injury?

A
  • caused by prolonged compression
  • may cause swelling or trauma
  • crush syndrome = Rhabdmyolysis
  • surface injury may hide true extent of the injury
  • antibiotics often required
  • management of secondary wounds
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7
Q

what is rhabdmyolysis?

A

damaged tissue releases proteins and electrolytes into circulatory system
- may damage heart, kidneys or cause permanent disability

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8
Q

what are some characteristics of a gunshot injury?

A
  • small entry wound but larger exit
  • extensive damage can occur along the trajectory
  • velocity of the bullet will effect damage caused
  • may require surgery to see full effect
  • often contaminated from bullet
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9
Q

what are some characteristics of a burn and scalding injury?

A
  • can be chemical, radiation or electrical
  • can be superficial or deeper
  • often extensive with large skin deficits
  • secondary contamination is common
  • may need skin flap or debridement
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10
Q

what is a fistulae?

A
  • fistulas are abnormal connection between two body parts which could be the result of injury, surgery, infection or inflammation
  • perianal fistulae
  • oronasal fistulae
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11
Q

what is a sinus (wound)?

A
  • a tract/channel that originated or ends in. one opening
  • can be caused by grass seeds
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12
Q

what can you manage inflammation with?

A

NSAIDs and/or steriods

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13
Q

what is the optimal time for treatment of an open contaminated wound known as?

A

the Golden Period

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14
Q

what is primary closure?

A

performed immediately after presentation

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15
Q

what is delayed primary closure?

A

closed 3-5 days after the wound has occured

16
Q

what is secondary closure?

A

performed following at least 5 days of open wound management

17
Q

what is second intention healing?

A

wound is allowed to heal by granulation

18
Q

how does haemostasis work?

A
  • aggregation of platelets on damaged blood vessels
  • platelets release serotonin, prostogladins and clotting factors
  • fibrinogen is converted into fibrin
  • fibrin threads form a meshwork for the basis of a blood clot
19
Q

what is fibrinogen?

A

blood protein

20
Q

how does inflammation work?

A
  • response is triggered by activation of the platelets and fibrin
  • characterised by the presence of heat and reddening of the tissue
  • histamine is released
  • white blood cells migrate into the wound
  • neutrophils arrive first followed by monocytes, lymphocytes and fibroblasts
  • phagocytosis
21
Q

when does inflammation of a wound happen?

A

24-48 hours

22
Q

how does proliferation happen?

A
  • fibroblasts invade thee wound and synthesise collagen
  • endothelial cells adjacent to the wound edges begin to multiply and migrate towards each other
  • capillary blood cells are stimulated to enter the area
  • granulation tissue is formed
23
Q

what does epithelisation mean?

A

where epithelial cells migrate over the top of the wound to reconstitute the dermis

24
Q

what happens in the remodelling phase?

A
  • the scar tissue strengthens with the reformation of collagen fibres
  • the random appearance of the cells and collagen become organised and follow tension lines
  • may take months to years
25
Q

how strong is a wound after 1 week, 3 weeks and 3 months?

A

1 week - 3%
3 weeks - 20%
3 months - 80%

26
Q

what is debridement?

A
  • removal of damaged tissues and debris from the wound
  • cut or scraped until haemorrhages
27
Q

what is an optimal wound healing environment?

A
  • moist environment
  • no infection/necrosis
  • ph of 6
  • undisturbed
  • optimal temp 35-37 degrees
28
Q

what does colonisation mean?

A

the presence of bacteria that are multiplying and causing a reaction

29
Q

what are some bandage complications?

A
  • decubitius ulcers
  • comprimised circulation
  • slipped
  • patient interferance
30
Q

what are some factors affecting wound healing?

A
  • health status
  • age
  • presence of infection
  • patient interferance
31
Q

how does multidrug resistance arise?

A

inappropriate use of antibiotics

32
Q

what is the definition of granulation?

A

a process by which a wound heals when there has been tissue loss

33
Q

what is the definition of resolution?

A

return of tissue to its original state prior to inflammation having occurred

34
Q

what is the definition of re-epithelialisation?

A

the regrowth of epidermis

vn03 (19 decks)

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