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Tech 6 > wound management > Flashcards

wound management Flashcards

1
Q

What is debridement?

A

the removal of necrotic tissue by excision

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2
Q

What is lavage?

A

the flushing of a wound to remove foreign material, wound exudate, and contamination

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3
Q

VTNE ?: Should antimicrobials be added to crystalloids for a wound lavage?

A

no

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4
Q

when lavaging, what is the best type of solution to use?

A

Sterile saline 0.9%

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5
Q

when lavaging, what types of soaps and antiseptic scrubs should be used and why?

A

none because most solutions can be damaging to tissues

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6
Q

what is granulation tissue?

A

new tissue formed in the repair of soft tissue (scab)

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7
Q

how many PHASES are there of wound healing and what are they, in order?

A

5 phases

  • inflammatory
  • debridement
  • lag
  • repair
  • maturation
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8
Q

what phase of wound healing takes place directly after the injury?

A

inflammatory

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9
Q

what takes place that marks the end of the inflammatory phase?

A

when WBCs leak into the wound

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10
Q

what is the role of bleeding within a wound?

A

helps clean out the wound by washing away surface bacteria

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11
Q

what is the role of a bloodclot within a wound?

A

it stabilizes the edges of the wound

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12
Q

what phase of wound healing begins around 6 hours after an injury takes place?

A

debridement phase

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13
Q

what types of WBCs are seen during the debridement phase and what is their purpose?

A

phagocytic cells like neutrophils and monocytes; clean up the wound by removing necrotic tissue, bacteria, and foreign material

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14
Q

when does the lag phase take place?

A

first 3-5 days post injury

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15
Q

what takes place during the lag phase?

A

the body gathers materials to promote healing

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16
Q

what phase begins after the clot has formed and necrotic/foreign material has been removed?

A

repair phase

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17
Q

what has to take place before the repair phase can begin?

A

foreign material (including necrotic material) has to be removed

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18
Q

what produces collagen that will later mature into a scar?

A

fibroblasts

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19
Q

what phase of wound healing is associated with an invasion of fibroblasts?

A

repair phase

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20
Q

at what phase of wound healing does epithelialization occur?

A

repair phase

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21
Q

what is the final phase of wound healing?

A

maturation phase

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22
Q

what is another name for maturation phase?

A

remodeling phase

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23
Q

when does the maturation phase of healing take place?

A

around 3 weeks post injury and can continue for several years

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24
Q

name 3 types of debridement

A

layered, en bloc, enzymatic

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25
Q

what phase is essential to prepare for the repair phase and why?

A

lag phase, this gathers all the cells that are needed to promote healing and tissue repair

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26
Q

which type of debridement is conservative and begins at the superficial layers?

A

layered debridement

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27
Q

which type of debridement completely excises the wound?

A

en bloc debridement

28
Q

what form of debridement uses chemical based products to dissolve necrotic tissues?

A

enzymatic debridement

29
Q

what are the STAGES of wound healing, in order?

A
  • exudative (inflammatory and debridement phases)
  • collagen (lag and repair phases)
  • maturation (maturation)
30
Q

what are the 4 closure methods for a wound?

A
  • primary
  • delayed primary
  • contraction/epithelialization
  • secondary
31
Q

primary closure is also known as what?

A

first intention healing

32
Q

contraction/epithelialization is also known as what?

A

second intention healing

33
Q

secondary closure is also known as what?

A

third intention healing

34
Q

what type of closure is used wound is closed 3-5 days after injury, before granulation tissue develops?

A

third intention healing/ secondary closure

35
Q

what type of closure is used when the wound is allowed to heal without surgical closure?

A

second intention healing/ epithelialization

36
Q

what type of closure is involved when the wound is closed before 3-5 days post injury, before granulation tissue develops?

A

delayed primary closure

37
Q

what is contamination?

A

the introduction of infectious microbes into a wound

38
Q

what type of closure is used when the wound is closed with sutures within the same day as the injury?

A

first intention healing/ primary closure

39
Q

what is a degloving injury?

A

when the skin/tissue is removed by trauma

40
Q

what is the color of poor granulation tissue and why does it have this color?

A

white, due to high amount of fibrous tissue with a low number of capillaries

41
Q

what is infection?

A

the invasion and multiplication of microorganisms in body tissue causing local cellular injury.

42
Q

how can you tell the difference between a contaminated wound and an infected wound?

A

the bacterial count and WBC count is much higher in an infected wound

43
Q

what is dessication?

A

extreme dryness

44
Q

what are some benefits of bandaging a wound?

A

protects from further contamination, prevents wound dessication, minimizes surrounding edema, absorbs wound exudates and debris, promotes wound retention of CO2 and creation of an acidic environment, keeps wound warm

45
Q

what is an abrasion?

A

a partial thickness wound of the epidermis

46
Q

what is a laceration?

A

sharply incised edges with minimal tissue trauma, can be superficial (skin) or deep (muscle or tendon)

47
Q

what is an avulsion laceration?

A

a laceration where the tissue is torn away from surrounding structures

48
Q

what is the purpose of using a drain in wound management?

A

to eliminate dead space, provide wound drainage and prevent further contamination

49
Q

what are the 2 types/categories of drains?

A

active and passive

50
Q

what is the purpose of an open drain?

A

AKA passive drain

allows for wound fluid to drain from the skin and to treat or prevent abscesses from bite wounds and other injuries

51
Q

what is the purpose of a closed drain?

A

AKA active drain

allows for drainage of additional fluids and provides constant negative pressure

52
Q

when is the ideal time to remove an open drain?

A

3-5 days

53
Q

when is the ideal time to remove a closed drain?

A

depends on amount of fluid that is being drained

54
Q

example of open drain

A

Penrose drain

55
Q

example of closed drain

A

Jackson-Pratt (JP) drain

56
Q

2 types of degloving injuries

A

anatomic and physiologic

57
Q

how long can abdominal or chest compression bandages be left on?

A

no longer than 4 hours

58
Q

what are decubitus ulcers?

A

AKA bed sores
ulceration on the skin as a result of compression of tissue between a bony prominence and a hard surface the patient is laying on

59
Q

what are some ways to prevent decubitus ulcers?

A

adequate padding, rotate patient every 2-4 hours throughout the day, examine pressure points daily, give physical and hydrotherapy 3-4 times a day

60
Q

how many degrees of burns are there?

A

4 (1st- superficial, 4th- severe)

61
Q

which burn is superficial and doesn’t blister?

A

first degree burn

62
Q

which burn is burned throughout all layers of the dermis and appears white, black, leathery, firm, and depressed?

A

third degree burn

63
Q

which burn is superficial and blisters with fluid accumulation?

A

second degree burn

64
Q

what is the slowest method of debridement?

A

enzymatic debridement

65
Q

which heals by reepithelialization, abrasions or lacerations?

A

abrasions

66
Q

what is iatrogenic degloving and how does it occur?

A

degloving/sloughing of skin that occurs due to the fault of the technician or doctor. occurs by giving certain drugs perivascularly which will cause necrosis if not given directly IV

67
Q

with which drugs can we see iatrogenic degloving injuries if not administered properly?

A

ketamine (IV only), barbituates (IV only), Vitamin K (SQ but is small amounts in multiple locations)

Tech 6 (3 decks)

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