Wound Management + Flashcards by Frankie Aguinot

Q

goals of wound care

A

. facilitate hemostasis
. decrease tissue loss
. promote wound healing
. minimize scar formation

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Q

wound closed by approximation of wound margins

. healing by first intention
. healing by second intention
. healing by third intention

A

. healing by first intention

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Q

placement of a graft of flap

. healing by first intention
. healing by second intention
. healing by third intention

A

. healing by first intention

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Q

well-vascularized areas

. healing by first intention
. healing by second intention
. healing by third intention

A

. healing by first intention

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Q

recent <24 hours

. healing by first intention
. healing by second intention
. healing by third intention

A

. healing by first intention

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Q

tension free

. healing by first intention
. healing by second intention
. healing by third intention

A

. healing by first intention

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Q

wound left open and allowed to close by epithelialization and contraction

. healing by first intention
. healing by second intention
. healing by third intention

A

. healing by second intention

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Q

contaminated or infected

. healing by first intention
. healing by second intention
. healing by third intention

A

. healing by second intention

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Q

would approximation via reepitheliazation

. healing by first intention
. healing by second intention
. healing by third intention

A

. healing by second intention

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Q

would contraction by myofribroblasts

. healing by first intention
. healing by second intention
. healing by third intention

A

. healing by second intention

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Q

too heavily contaminated for primary closure but appear clean

. healing by first intention
. healing by second intention
. healing by third intention

A

. healing by third intention

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Q

requires debribement

. healing by first intention
. healing by second intention
. healing by third intention

A

. healing by third intention

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Q

time to epithalization with water barrier restored

A

24-48 hours

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Q

mnemonic for factors that affect wound healing

A

DIDN’T HEAL

. Diabetes
. Infection
. Drugs
. Nutrition
. Tissue necrosis
. Hypoxia
. Excessive tension on wound edges
. Another wound
. Low temperature

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Q

How does diabetes affect wound healing

A

diminishing sensation and arterial inflow ++ acute los of diabetic control > diminished CO, poor peripheral perfusion, and impaired leukocyte phagocytosis

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Q

How does infection affect wound healing?

A

potentiate collagen lysis

Q

major points of wound evaluation history

A

. mechanism
. time
. environment
. medical problems

Q

longest duration

cocaine
procaine
tetracaine
lidocaine
licaine with epi
bupivacaine

A

bupivacaine

Q

rapid onset

cocaine
procaine
tetracaine
lidocaine
licaine with epi
bupivacaine

A

cocaine

procaine

Q

onset 5-30 min

cocaine
procaine
tetracaine
lidocaine
licaine with epi
bupivacaine

A

lidocaine

licaine with epi

Q

why do we pair epinephrine with lidocaine

A

. increases duration of action

. promotes hemostasis through vasoconstriction

Q

methods of debridement

A

surgical, enzymatic, mechanical, autolytic, maggots

Q

possible sign of wound with foreign body

A

point tenderness

Q

how to clean wound

A

. high pressure irrigation (normal saline)
. 100-300 ml
. 8 psi
. 30-60 ml syringe and 14 gauge angriocatheter

allowed to granulate . healing by first intention . healing by second intention . healing by third intention

. healing by second intention

why do you keep wound moist 24-48 hours

augments reepithelialization

what nutrition parameters can we optimize in wound care

. glucose . fatty acids . protein . vitamins A, C, and zinc

collagen synthesis vitamin A vitamin C zinc

vitamin A | vitamin C

antioxidant vitamin A vitamin C zinc

vitamin A

fibroblast proliferation vitamin A vitamin C zinc

zinc

indications for systemic antibiotic for traumatic wounds

``` . 6 hours old on extremities . 24 hours old on face and scalp . tendon, joint, bony . cartilage . co-mobidity . puncture . intraoral ```

how do hydrocollouds promote wound debridement

by autolysis

3-5 days . face . arm/anterior trunk . (back, feet and hands, joint, scalp)

. face

7 . face . arm/anterior trunk . (back, feet and hands, joint, scalp)

. arm/anterior trunk

10-14 . face . arm/anterior trunk . (back, feet and hands, joint, scalp)

. (back, feet and hands, joint, scalp)

integra . collagen and condroitin in sulphate . alloderm . apligraftrade

. collagen and condroitin in sulphate

skin substitute containing collagen and seeded cells . collagen and condroitin in sulphate . alloderm . apligraftrade

. apligraftrade

immunologically inert, nonliving, allogenic, acellular dermal matrix . collagen and condroitin in sulphate . alloderm . apligraftrade

. alloderm