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CVNT2 > Wound Management > Flashcards

Wound Management Flashcards

1
Q

Why is wound classification important?

A

Ensures correct management of the wound and patient

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2
Q

What are the characteristics of a class 1 wound?

A

0-6 hours old
Clean laceration
Minimal contamination

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3
Q

What are the characteristics of a class 2 wound?

A

6-12 hours old

Significant contamination

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4
Q

What are the characteristics of a class 3 wound?

A

> 12hrs old

Gross contamination

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5
Q

What is a clean wound?

A

A wound created under sterile conditions (surgical)

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6
Q

What is a clean contaminated wound?

A

Wound with minimal contamination (easily removed)
Surgical penetration of a tract
Can close after appropriate treatment

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7
Q

What is a contaminated wound?

A

Wound with gross contamination with foreign debris

Can close after appropriate treatment

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8
Q

What is a dirty/infected wound?

A

Wound with infection >10^5 organisms per gram

Never close primarily

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9
Q

What is an incision wound?

A

Created by sharp objects, smooth edges with minimal surrounding trauma

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10
Q

What is an abrasion wound?

A

Created by blunt trauma/shearing force, damage to skin

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11
Q

What is an avulsion wound?

A

Tearing of tissue from attachment, avulsion of limbs, degloving

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12
Q

What is a laceration wound?

A

Irregular wound created by tearing, variable damage to tissues

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13
Q

What is a puncture wound?

A

Penetrating wound by sharp object, minimal superficial damage but substantial deeper damage

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14
Q

What are the 3 stages of wound healing?

A

Inflammatory phase
Proliferative phase
Maturation phase

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15
Q

When is the inflammatory phase of wound healing?

A

Within first 72 hours post-injury

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16
Q

What happens in the inflammatory phase of wound healing?

A

Haemorrhage within minutes of injury, then vasoconstriction

Vasodilation to release clotting elements into wound

WBCs leak from blood vessels into wound, initiating debridement

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17
Q

When does the early proliferative phase of wound healing begin?

A

3-5 days post-injury

18
Q

What happens in the early proliferative stage of wound healing?

A

Granulation tissue fills wound

Fibroblasts lay network of collagen in wound bed for strength

Epithelial cells from wound margins migrate to cover wound

19
Q

What happens in the maturation stage of wound healing?

A

Remodelling phase -

Collagen fibres reorganise, remodel and mature to give wound tensile strength, forming scar tissue

20
Q

When does the maturation stage of wound healing occur?

A

2-4 weeks post-injury

21
Q

What are the broad goals of wound healing?

A

Full epithelialisation without scar formation in as minimal time as possible

Without re-occurrence/risk of breakdown

Cost effective as possible

22
Q

What are the 6 goals of wound management?

A
  1. Prevent further contamination
  2. Remove foreign debris
  3. Debride dead/dying tissue
  4. Promote viable vascular bed
  5. Provide drainage
  6. Select appropriate method for closure
23
Q

How do you assess viability of tissue in wound healing?

A

Colour, warmth, pain sensation, bleeding

24
Q

What is a primary wound closure?

When can sutures be removed?

A

Closure for wounds with minimal tissue contamination/loss/trauma

Explore, lavage and debride wounds before closing

Sutures removed at day 10

25
Q

What is a delayed primary wound closure?

A

For wounds which have gone beyond the ‘golden period’ (0-6 hours)
Explore, lavage and surgically debride thoroughly

26
Q

What is a secondary wound closure?

A

For heavily contaminated/dirty wounds

Managed as open until granulation established, then wound edges are debrided and closed

27
Q

What is secondary intention healing of a wound?

A

Wounds with significant tissue loss/contamination/ infection

Managed as open wound

Allowed to granulate and epithelialise

28
Q

What factors make a wound suitable for closure?

A

Significant tissue to allow reconstruction without dehiscence

No devitalised tissue

No signs of infection/contamination

Adjacent skin is healthy

Functional structures will be affected by delayed closure

29
Q

Why might you choose a non-adherent/passive/absorbent dressing (e.g. Allevyn)?

A

Absorbs fluid - suitable for exudative wounds

Semi-permeable (breathable)

Delivers moist environment

30
Q

When might you choose a non-adherent/passive/MILDLY absorbent dressing?

A

Lightly exuding lesions, sutured wounds, superficial cuts and abrasions, light burns

Allows epithelialisation and light absorption of exudate

31
Q

How often should you change a wet to dry/dry to dry dressing?

A

Daily/twice daily depending on volume of exudate

32
Q

How often should you change a dressing on a granulating wound?

A

Every 2-3 days

33
Q

What are some of the limitations which can be encountered during wound care?

A

Cost (main)
Infection
Patient tolerance of nursing care
Owner patience

34
Q

What are the most important things to consider when triaging a wounded patient?

A

Any life-threatening concerns (pneumothorax, diaphragmatic hernias, ruptured bladder, head injuries)

Hydration status

TPMR

Visual check of wounds/haemorrhage severity

Respiratory effort or concerns

35
Q

What are the main steps in cleaning and prep of a wound?

A
  1. Cover and protect wound (sterile lube or saline-dampened swab)
  2. Clip hair away from around wound
  3. Flush wound with sterile technique
  4. Investigation of wound can now be carried out
36
Q

What equipment is required for flushing a wound?

A 
Warm Hartmanns/saline 
Giving set 
3-way tap 
18/19G needle 
20-30ml syringe 
Incontinence pads (lots)
37
Q

How does nursing of an equine wound differ to cat/dog nursing?

A

Often involves radiographs/ultrasound

More concern over tension on wound

Quills sometimes used to release pressure

Aim for minimal scar tissue

Care with selection of topical ointments

38
Q

Are these drains active or passive?

A

Active

39
Q

Are these drains active or passive?

A

Passive

40
Q

How often should a wound dressing be checked?

A

At least every 4-6 hours

41
Q

When checking a wound dressing, what should you be looking for?

A

Damp/wet, slipping

Patient interference and tolerance of dressing

Tightening (swelling above/below elbow)

Checking toes for moisture/temperature

42
Q

When should wound management patients be discharged and allowed to go home?

A

ASAP - usually when dressing are being changed every 2-3 days and wound has made good progress

CVNT2 (47 decks)

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