Wound management Flashcards
3 classes of wound classification based on duration
1) 0-6 hrs / minimal contamination
2) 6-12 hours / significant contamination
3) over 12 hrs / gross contamination
7 steps of wound management
1) prevent further contamination
2) preparation and clipping
3) debridement
4) remove contaminants
5) establish drainage
6) promote viable vascular bed
7) wound closure
How do you debride?
1) sharp scalped
2) adherent dressing
3) lavage
4) preserve tendons / ligaments / N and BV
How can you promote a good vascular bed?
remove necrotic tissue
drainage
bandages
forage (drill holes) into underlying bone
When should a wound be closed?
clean wound no skin tension not a crush wound not infected granulating wont heal by 2nd intention
Whens hould a wound be left open?
puncture wound
cant debride
infected
tension
4 ways to get wound closure
primary closure
delayed primary
secondary
second intention
What is primary closure?
restores normal function, clean wound
What is delayed primary closure?
apposition of skin edges 2-5 days after wound
if contaminated or not viable
What is secondary closure?
5-10 d post wound - either appose granulation tissue or excise granulation tissue and close primarily
infected wounds
What is second intention healing?
coontraction and epithelialisation
not enough lose skin
What is the primary layer of a bandage?
A dressing - in contact with the wound
What is the function of the primary layer of a bandage?
absorb exudate debridement analgesia promote healing prevent adherence to second layer prevent infection
What are the main groups of primary layers?
passive / active
adherent / non-adherent
What is the function of the second layer of a bandage? e.g cotton wool
absorption protection immobilisation pressure hold dressing in place
What is the function of the tertiary layer of a bandage? e.g. vet rap
Holds other layers
immobilise
protect from environment
What would you do and how would you bandage a necrotic wound?
debride
wet - to - dry
What would you do and how would you bandage a slough / discharge wound?
remove debris and discharge
hydrogel(active dressing)
What would you do and how would you bandage a granulating wound?
protect
hydrogel , paraffin gauze, foam
What would you do and how would you bandage an epithelialization wound?
promote healing and contraction
perforated film, paraffin gauze, foam
What would you do and how would you bandage a surgical wound closed primarily?
absorb exudate and prevent inf
perforated film
What is an example of a passive adherent dressing?
swabs
What is an example of a passive non-adherent dressing?
perforated polyurethane
paraffin gauze
What is an example of an active dressing?
hydrocolloids
hydrogels
alginates
collagens
