Wound Management Flashcards
Types of wounds (9)
- abrasion
- bruising
- hematoma
- contusion
- puncture wound
- incised wound
- laceration
- complicated wound
- burn
Puncture wounds are
deeper than they are wide
Abscesses must be
lanced
bruisen is a collection of
coagulated blood
Wounds are stitch-able if…
it has been less than 6 hours
the wound is clean
3 phases of healing
inflammatory
granulation
contraction & epithelialization
In the inflammatory process,
clot provides scaffolding for new matrix and migration of cells.
Phagocytic cells will
debride wound (remove dead, contaminated, or adherent tissue and/or foreign material)
granulation cannot proceed until
blood clots, necrotic tissue and infection have been eliminated
Granulation tissue develops for ___________ and continues
3-6 days post injury until epithelialization (wound closure) occurs
Process of contraction and epithelialization
cells migrate centripetally.
Healing epithelium is
fragile and poorly adherent to underlying tissues
granulation tissue:
provides surface for epithelialization
is resistent to infection
is necessary for wound contraction
Factors that affect healing
- location
- infection
- movement
- wound dimensions
- involvement of deep structures
- poor blood or oxygen supply
- foreign bodies
- nutrition
- previous treatment
- age of wound
- economics
What sorts of foreign bodies may be in a wound?
sand, wood, dirt, necrotic tissue, hair
Why do wounds on lower limbs heal more slowly?
decreased vascular supply, bone provinces, no supporting deep musculature, highly mobile joints, higher degree of contamination
Wounds will not heal if they are
DRY
Wound management steps
- hemorrhage control
- initial cleaning
- wound assessment
- prevention of further injury and contamination
- wound debridement
- provision of a moist environment
suture dehiscence is a result of
infection, skin loss, tension in suture line, marked swelling
Initial cleaning procedure:
wash wound with saline or water cover with hydrogel before clipping clean wound with 0.5% Chlorhexidine Flaps of skin should be lifted and flushed underneath Do not wipe wound after flushing
What liquid should be inserted into a puncture wound?
hydrogen peroxide - to kill anaerobic bacteria
Wound assessment requires
sterile gloves
possibly anesthesia
Wound debridement involves
Use of a scalpel to convert an accidental wound into a surgical wound
A wounded horse needs
tetanus vaccination or anti-serum
parenteral antibiotics are used
only initially, unless the wound becomes complicated
prophylaxis
preventative
In choosing antibiotics, it is important to choose
efficacious drug
convenient route and dose
minimal side effects
Wound lavage factors (2)
type of fluid
pressure
Wound lavage purpose
remove dead tissue, bacteria, foreign matter without compromising the physiological status of the new forming tissue
washing a wound with water can cause
cell swelling
povidone-iodine strength used
0.1-1%
Stronger concentrations of povidone-iodine can cause
necrosis
Chlorhexidine concentration
0.1-1%
Which is best?
Chlorhexidine
