Wound healing and management Flashcards
what are some characteristics of a laceration wound?
- 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
what are some characteristics of a surgical (incisional) wound?
- clean cut, caused by sharp object
- freely bleeding
- closed by primary intention
- less prone to infection
what are some characteristics of a abrasion wound?
- 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
what are some characteristics of a de-gloving injury?
- 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
what are some characteristics of a shearing wound?
- 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
what are some characteristics of a puncture wound?
- 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
what are some characteristics of a crush injury?
- 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
what is rhabdmyolysis?
damaged tissue releases proteins and electrolytes into circulatory system
- may damage heart, kidneys or cause permanent disability
what are some characteristics of a gunshot injury?
- 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
what are some characteristics of a burn and scalding injury?
- 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
what is a fistulae?
- fistulas are abnormal connection between two body parts which could be the result of injury, surgery, infection or inflammation
- perianal fistulae
- oronasal fistulae
what is a sinus (wound)?
- a tract/channel that originated or ends in. one opening
- can be caused by grass seeds
what can you manage inflammation with?
NSAIDs and/or steriods
what is the optimal time for treatment of an open contaminated wound known as?
the Golden Period
what is primary closure?
performed immediately after presentation
what is delayed primary closure?
closed 3-5 days after the wound has occured
what is secondary closure?
performed following at least 5 days of open wound management
what is second intention healing?
wound is allowed to heal by granulation
how does haemostasis work?
- 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
what is fibrinogen?
blood protein
how does inflammation work?
- 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
when does inflammation of a wound happen?
24-48 hours
how does proliferation happen?
- 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
what does epithelisation mean?
where epithelial cells migrate over the top of the wound to reconstitute the dermis
