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Vet Class > Wound Management > Flashcards

Wound Management Flashcards

1
Q

4 stages of the Inflammatory phase

A

Hemorrhage and vasoconstriction
Vasodilation
Fibrin clot
Scab

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2
Q

5 stages of the Debridement phase

A

Platelets- FIRST to arrive
Neutrophils- white blood cells that eat bacteria
Monocytes- become macrophages
Lymphocytes- immune response
Exude pus- wound fluid

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3
Q

Repair phase includes

A

Granulation tissue: fibroblasts make Scar tissue out of collagen. Capillaries bring blood for repair. Macrophages ward off infection. Results in a scab. No nerve in granulation tissue. Then wound contraction and epithelialization

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4
Q

What occurs during the Maturation phase

A

Type 3 collagen to type 1 collagen. Regains 80 to 85 percent of original strength.

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5
Q

Factors affecting wound healing

A

Specific infectious agents
Immunodeficiency
Concurrent disease
Chemotherapeutic agent, radiation therapy
Neoplasm
Malnutrition
Foreign body, necrotic tissue, dead space
Age

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6
Q

Healing of a wound requires three things

A

Proper treatment
Cooperation
Budget

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7
Q

4 types of Wound classification

A

Clean
Clean contaminated
Contaminated
Dirt and infected

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8
Q

Fundamentals of wound management

A

Cover the wound
Assess and stabilize
Culture
Clip and aseptically prepare the area around the wound
Debride dead tissue and remove foreign debris
Lavage
Drainage
Stabilize and protect
Appropriate wound closure

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9
Q

What is an important aspect of lavaging the wound

A

Flush to clean
35cc syringe and 18g needle- enough to clean without pushing bacteria in further.

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10
Q

What should you keep in mind about proper surgical debridement

A

Copious lavage
Closure of dead space
Gentle tissue handling
Proper suture selection
Adequate and judicious hemostasis

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11
Q

What are the 2 types of adherent dressings

A

Wet to dry
Dry to dry

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12
Q

Describe a wet to dry bandage

A

Soak first layer of bandage then wrap. When it dries, it sucks up the pus attached to the tissue. Changing it may be painful. Dead necrotic tissue comes up with the bandage.

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13
Q

When to use sugar bandage

A

Thermal burns with skin sloughing
Deep tissue infections
Contaminated wounds after mechanical debridement
Degloving injuries
Wound bed preparation for skin grafting
Wounds with questionable viability

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14
Q

Advantage of sugar bandage

A

Enhance epithelialiation and granulation tissue formation which accelerates wound healing. Reduces edema. Reduces inflammation, available and inexpensive. Nutrients for cells. Deodorizing. Antibacterial action.

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15
Q

T or F: for a honey bandage you can use any kind

A

F: Manuka honey only

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16
Q

Name 2 types of nonadherent dressings

A

Semiocclusive
Occlusive

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17
Q

Semiocclusive dressings

A

Protect the wound, prevent infection. Primary layer

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18
Q

Role of the bandage

A

Protect wound
Absorb drainage
Reduce dead space
Increase epitheliation and wound contraction
Control hemorrhage
Increase local temp
Protect from self mutilation
Modulate pain
Immobilize stabilize and support underlying structures

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19
Q

Describe the three layers of a bandage

A

Contact/Primary- in direct contact with the wound
Intermediate/Secondary- hold primary in place
Outer/Tertiary- hold entire bandage and establish the sub-bandage pressure

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20
Q

Describe the primary bandage layer

A

Establishes wound environment that supports healing
Keeps wound bed moist and periwound skin dry
Should be STERILE

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21
Q

Describe the secondary layer of bandaging

A

Holds primary dressing in place
Often has inner absorbent layer and an outer stabilizing layer.
Absorbs the excess exudate

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22
Q

Describe the Tertiary layer of bandaging

A

Establishes appropriate pressure
Controls hemorrhage
Limits edema, dead space, and the spread of microflora
Supports underlying tissue and holds other bandages in place

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23
Q

4 things in granulation tissue

A
  1. Fibroblasts proliferation
  2. Capillaries proliferation
  3. Collagen
  4. Macrophages
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24
Q

How does sugar help a wound

A

Sugar causes migration of water and lymph out of the tissue. You need 1 cm.

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25
Q

Closure of a wound 4 types

A

Primary closure-close
Delay primary closure- clean with wet to dry then close
Secondary closure- wet to dry, sugar bandage, remove granulation tissue, close
Second intention healing

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26
Q

Basic surgical technique of Halstead

A

Gentle tissue handling
Hemostasis
Preserve blood supply
Adequate deplbridement
Aseptic technique
Wound drainage
Closure without tension

27
Q

How to decide where to suture

A

Follow tension lines

28
Q

Diff between human and animal vascularizarion

A

Animals have panniculus muscle.

29
Q

When is a Plasty used

A

For wounds with too much tension to close. Cut skin to release tension then close

30
Q

Describe the Axial pattern flap

A

Leave artery intact, cut under to be able to lift skin and move.

31
Q

Purpose of a drain

A

Prevents fluid filling empty space

32
Q

Define Skin graft

A

Take skin from elsewhere on the body and put over wound. No drain. Mesh the graft. Fluid comes out of mesh.

33
Q

Second intention healing

A

Granulation tissue
Epithelialization
Contraction
Treat the wound until it closes by itself

34
Q

Factors affecting contraction

A

Dead space
Bandage
Corticosteroids
Movement
Exposed bone
Infection

35
Q

Vac system

A

Vacuum assisted closure. Cut sponge size of wound. Absorbs fluid and necrotic tissue. Sealing over the top with a drain. Machine continuously, gently sucks fluid. Debrides. Pulls the skin over.

36
Q

T or F: wounds heal from the edges to the center

A

True

37
Q

Why would you make a circle wound into a square shape

A

Wounds close from edges to the center. A square shape will close faster and more neatly

38
Q

Omentum has these qualities

A

Fibrinolysis

39
Q

What are the four stages of wound management

A
  1. Inflammatory phase
  2. Debridement phase
  3. Repair phase
  4. Maturation phase
40
Q

T or F: To retain proper environment, sugar must be present in the wound at all times

A

True

41
Q

Describe a thermal burn

A

Extreme temperature that causes cellular damage

42
Q

Describe a chemical burn

A

Exposure to chemicals that cause tissue necrosis

43
Q

Describe an electrical burn

A

Electrical current causing cellular necrosis along its path

44
Q

Describe a radiation burn

A

Exposure to ionizing radiation at levels that cause acute
cell death

45
Q

Differentiate between the 1st and 2nd degree of burns

A

First degree- only epidermis is affected
Second degree- Full-thickness epidermal necrosis that extends into the underlying dermis

46
Q

Differentiate between the 3rd and 4th degree of burns

A

Third degree- Extend completely through the dermis to the underlying SQ tissue
Fourth degree- Extend to underlying muscle or fascia

47
Q

Describe a fifth degree burn

A

Extension to the bone

48
Q

What is the difference between a partial and a full thickness burn

A

Partial involves the epidermis only. Full thickness involves the epidermis and the underlying dermis.

49
Q

True or False: Epidermal necrosis occurs if the skin temperature reaches 60C (140F) for 1 sec

A

True

50
Q

What temperature does the skin have to reach for a full thickness burn to occur and for how long

A

Full-thickness burn in less than 1 sec if temperature reaches 70C (158F)

51
Q

How to treat a thermal burn

A

Aggressive fluid resuscitation
Early/intensive management of inhalation injury
Early/complete removal of the burn eschar, with sepsis prevention
Improved analgesia
Nutritional support and metabolic intervention

52
Q

Initial first aid for a thermal burn

A

Cool to cold running water to burn area (no ice)
Cover with a sterile, occlusive, nonadherent dressing reduces pain and protects it from
contamination and further trauma.

53
Q

What is one of the most important things to do when treating a thermal burn

A

Fluid resuscitation- vital amounts of fluid are lost from the body when a burn occurs

54
Q

What is the primary goal of fluid resuscitation

A

Restoration of volume and perfusion

55
Q

Treatment of an inhalation injury

A

Bronchial hygiene therapy
Oxygen therapy
Pharmacologic interventions

56
Q

Steps of bronchial hygiene therapy for thermal burns

A

Remove accumulated secretions
Remove necrotic material
Remove foreign debris
Remove bacteria from the airways

57
Q

Define physiotherapy (coupage)

A

hitting either side of the chest to induce coughing

58
Q

What is oxygen therapy and what is its effect on the body

A

Removal of carbon monoxide from the blood
Decreases the respiratory effort which decreases stress

59
Q

What is the benefit of applying talapia skin to a thermal burn

A

Adheres to the wound
Avoids retention of exudates and loss of fluids, rich in collagen type I
Promotes a barrier to bacterial invasion, accelerates healing
Provides pain relief
Peels away easily at bandage change, does not need frequent changes

60
Q

What are the effects of frostbite

A

Extremities are most often affected (pinnae and digits)
Tissue freezing, hypoxia, and release of inflammatory mediators.

61
Q

Treatment of frostbite

A

Gentle rewarming in lukewarm water
Wait until the extend of necrosis is known
Pain management, NSAID, wound management

62
Q

First aid of a chemical burn

A

Dilute. Continue until the chemical is either neutralized or is washed off

63
Q

What are some qualities of an electrical burn

A

Heat generated from the resistance of the tissues to the electrical current flow. Often deeper tissues vs skin

64
Q

In general, how should you treat a wound/burn

A

Prevention of further wound contamination
Good debridement
Practice aseptic technique
Adequate drainage and obliteration of dead space
Promotion of a viable vascular bed
Radiographs
Culture and sensitivity
Biopsy
Selection of appropriate wound closure

Vet Class (22 decks)

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