Wound Management Flashcards
General classification (6)
Aetiology Site Depth of tissue loss Contamination/infection Extent of soft tissue/bony involvement Duration since occurrence
Basic groups classified by cause (10)
Puncture Laceration Incised Abrasion Burn/scald Degloving Crush injury GSW Sinus/fistulae Sx wound dehiscence
Wound contamination at 0-6hrs
Little bacterial multiplication
Contaminated
Wound contamination at 6-12hrs
Bacteria beginning to divide
Early infection
Wound contamination at 12+hrs
Bacterial invasion of tissues
Infection established
What does pre-op management involve
What must be taken into account
Prevention of further contamination from patient and environment
State of wound
Patient condition
Steps of initial wound management (4)
Hair removal
Skin prep
Lavage
Debridment
Reasons for lavage (2)
Remove debris
Dilute bacterial contamination
Sterile saline/lactated ringers lavage:
Type of wound
Properties (2)
Any wound
No tissue damage
No AM action other than dilution
Chlorhexidine lavage:
Type of wound
Properties (3)
Contaminated/infected wounds
Good residual activity
Toxic to fibroblasts
S.aureus often resistant
Povidone-iodine lavage:
Type of wound
Properties (4)
Contaminated/infected
Inactivated by debris/pus/blood
Broad spec.
Poor residual activity
Toxic to host cells
Immediate post-op wound care (4)
Dressing
Observation
Prevent self-mutilation
Pain scoring
What signs should wounds be monitored for (6)
Exudate Erythema Oedema Haematoma Pain Odour
Reasons for wound dressing (4)
Protection from: - further trauma - patient interference - contamination Provision of analgesia
Ideal characteristics of dressings (11)
Non toxic/irritant/allergenic Sterile Absorbent Cost-effective Allows gas exchange Vapour permeable Thermal insulation Maintains moist environment Promotes healing
