Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

Medicine II: Surgery > Wound Healing and Management > Flashcards

Wound Healing and Management Flashcards

1
Q

What are the types of wounds?

A 
incision
abrasion
puncture
avulsion
laceration
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

What is the definition of an incision?

A

cut or wound intentionally produced by cutting w/ a sharp instrument
CLEAN

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

What is convenient about an incision wound?

A

has wound healing in mind, straight line

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

What is the definition of an avulsion?

A

wound where skin is torn partially or fully away, tends to bleed

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

What do you do with a partial avulsion?

A

debride and suture in place if viable

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

What do you do with a total avulsion?

A

generally not replaceable, can use as a skin graft if you remove fat

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

What is an additional negative about an avulsion?

A

cannot get back together; requires skin flap

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

What is the definition of a puncture?

A

wound or hole in the skin and deeper tissue layers cause by a sharp object

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

What do you not do with a puncture wound?

A

close it

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

How do you treat a puncture?

A

assessing damage to underlying vital structures, and examining for foreign body

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

What are examples of puncture wounds?

A

dog or cat bites, nails, or sharp metal

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

What is the definition of an abrasion?

A

superficial loss of the epithelial layer

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

What is required with an abrasion?

A

cleaning the wound, prevents traumatic tatooing

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

What may be required for cleaning of an abrasion?

A

pain medication or anesthesia

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

How do you treat an abrasion?

A

after cleaning give abx ointment, remaining cells will regenerate and migrate to close the wound

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

What is the definition of a laceration?

A

wound caused by a sharp object producing edges that may be jagged, dirty or bleeding

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

What can be effected by a laceration?

A

most often the skin, but any tissue can be affected (sub cut fat, tendon, muscle, bone)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

What is the definition of a crush wound?

A

a body part that is subject to a high degree of pressure or force, usually after being squeezed between two heavy or immobile objects

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

What injuries are associated with crush wounds?

A

lacerations, fractures, compartment syndrome, bruising

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

What is a contusion?

A

area of soft tissue swelling and hemorrhage with out violation of the skin

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

How do you treat a contusion?

A

application of cold compress to minimize swelling, followed by application of warm, moist compress for absorption of blood

may need to evacuate the hematoma w/aspiration

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
22
Q

What is a fact about the quantity of pressure ulcer in a patient?

A

if you have one you have more

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
23
Q

What is a stage 1 pressure ulcer?

A

intact skin with non-blanchable redness of a localized area usually over a bony prominence, darkly pigmented skin may not have visable blanching; its color may differ from the surrounding area

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
24
Q

What is a stage 2 pressure ulcer?

A

partial thickness loss of dermis presenting as a shallow open ulcer with a red pink wound bed, with out slough; may also present as an intact open/ruptured serum filled blister

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
25
Q

What is a stage 3 pressure ulcer?

A

a full thickness tissue loss; subcutaneous fat may be visable but bone, tendon and muscle are not exposed
slough may be present but does not obscure the depth of tissue loss
may include underminning or tunneling

26
Q

How do you treat a stage 3 pressure ulcer?

A

clean very well and serial debride

27
Q

What is a stage 4 pressure ulcer?

A

full thickness tissue loss with exposed bone, tendon or muscle
slough or eschar may be present on some parts of the wound bed
often includes tunneling or undermionning

28
Q

What is an unstageable pressure ulcer?

A

full thickness tissue loss in which the base of the ulcer is covered by slough(yellow, tan, green, gray or brown) and/or eschar (tan, black, brown) in wound bed

29
Q

What are the phases of healing?

A

substrate
proliferation
maturation

30
Q

What is the substrate phase?

A

aka inflammatory, lag or exudative phase
PMNs quickly appear and remain approx 48 hrs and may be the origin of inflammatory mediators such as compliment and kallikrein

Monocytes enter the wound 24 hr after PMNs and evolve to macrophages

31
Q

What are involved in the subsrate phase?

A

PMNs and macrophages

32
Q

What are the main cells involved in wound debridement?

A

Macrophages

33
Q

What do macrophages produce?

A

growth factors such as TGF-B (stimulates fibroblasts) , interleukin-1 (induces fever, promotes hemostasis, enhances fibroblast, and active T-cells)

34
Q

What is the proliferative phase?

A

Characterized by the production of collagen; wound scar may be hard, red, raised

35
Q

How is the wound inbetween the substrate phase and the proliferative?

A

edematous (tumor) and erythmatous (rubor); difficult to distinguish early signs of infection

36
Q

What is the primary cell of the proliferative phase? What does it do?

A

fibroblast, produces collagen

37
Q

What is the maturation phase?

A

remodeling phase, characterized by the maturation of collagen

wound scar gradually flattens and becomes less prominent, more pale and supple

38
Q

What happens to the skin after a wound?

A

it will never reach the same strength (70%)

39
Q

What are factors that affect healing?

A 
amount of tissue trauma (laceration vs crush)
hematoma
bacterial contamination
steroids
nutritional status
40
Q

What is the biggest reason why wounds breakdown?

A

poor nutrition

41
Q

What are types of wound closures?

A

primary
secondary
tertiary or delayed primary

42
Q

How do you do primary closure?

A

close by direct approximation of the wound edges. Includes primary suturing, stapling, gluing, pedicled flaps, and skingrafts

43
Q

What does the wound like in primary closure?

A

wound is pink and tissue is fragile

44
Q

What is the goal of primary closure?

A

to protect and promote new growth by maintaining a moist environment

45
Q

What type of dressing do you use for a primary closure?

A

a low or adherent dressing, fragile skin

46
Q

What do you use to irrigate all the wound closures?

A

0.9% sodium chloride

47
Q

How do you do a secondary closure?

A

aka spontaneous closure

wound is left open and allowed to heal by process of wound contraction and epithelialization at a rate of 1 mm/day

48
Q

When is secondary closure used?

A

wounds that have been infected or packed up

49
Q

What is an example of a time where you would do a secondary closure?

A

ileostomy takedown

50
Q

What is a bad sign in a secondary closure (or any closure really)?

A

if the wound is pale

51
Q

What is going on in the wound in a secondary closure?

A

the inflammatory phase is continuing, producing granulation tissue “pound flesh” which consists of inflammatory cells and a proliferation of capillaries

52
Q

What does the wound look like in a secondary closure?

A

granular in appearance, glossy red and bleeds easily; beefy and irritated

53
Q

What is slough?

A

the formation of viscous, yellowish layer of tissue

54
Q

What do you put over the wound in a secondary closure?

A

wet to dry dressing changes, VAC dressings or hyrocolloid

55
Q

What can you add to the closure with the dressing?

A

collagenase(accuzyme)

56
Q

What is VAC? What is it used for?

A

vacuum assisted closure
used for healing acute wounds and chronic wounds
uses continuous negative pressure distributed over wound surface

57
Q

What are the last steps in secondary closure?

A

excise all granulation tissue and preform a delayed primary tertiary closure allowing the wound to heal by secondary intention. Then close with a skin graft

58
Q

What is healing by tertiary closure?

A

delayed primary closure
wound is left open and later closed with suture
suturing interrupts secondary healing

59
Q

When do you used tertiary closure?

A

grossly contaminated wounds

60
Q

What are the steps in wound care?

A 
sterile preparation and drapping
admin of local anesthetic
irrigation and debridement
hemostasis
closure in layers
dressings and bandages
61
Q

What are the steps of wound debridement and irrigation?

A

use sharp debridement to remove clot, debris, and necrotic tissue
irrigate w/ copious NS
evacuate hematomas
hemostasis achieved w/cauterization, absorbable ligature or pressure

62
Q

What is a contraindication to cauterization? Why?

A

Venous bleeding, its controlled by pressure

Medicine II: Surgery (14 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions