Wound Management +

Question 1

goals of wound care

Answer 1

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

Question 2

wound closed by approximation of wound margins

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

Answer 2

. healing by first intention

Question 3

placement of a graft of flap

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

Answer 3

. healing by first intention

Question 4

well-vascularized areas

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

Answer 4

. healing by first intention

Question 5

recent <24 hours

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

Answer 5

. healing by first intention

Question 6

tension free

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

Answer 6

. healing by first intention

Question 7

wound left open and allowed to close by epithelialization and contraction

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

Answer 7

. healing by second intention

Question 8

contaminated or infected

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

Answer 8

. healing by second intention

Question 9

would approximation via reepitheliazation

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

Answer 9

. healing by second intention

Question 10

would contraction by myofribroblasts

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

Answer 10

. healing by second intention

Question 11

too heavily contaminated for primary closure but appear clean

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

Answer 11

. healing by third intention

Question 12

requires debribement

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

Answer 12

. healing by third intention

Question 13

time to epithalization with water barrier restored

Answer 13

24-48 hours

Question 14

mnemonic for factors that affect wound healing

Answer 14

DIDN’T HEAL

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

Question 15

How does diabetes affect wound healing

Answer 15

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

Question 16

How does infection affect wound healing?

Answer 16

potentiate collagen lysis

Question 17

major points of wound evaluation history

Answer 17

. mechanism
. time
. environment
. medical problems

Question 18

longest duration

cocaine
procaine
tetracaine
lidocaine
licaine with epi
bupivacaine

Answer 18

bupivacaine

Question 19

rapid onset

cocaine
procaine
tetracaine
lidocaine
licaine with epi
bupivacaine

Answer 19

cocaine

procaine

Question 20

onset 5-30 min

cocaine
procaine
tetracaine
lidocaine
licaine with epi
bupivacaine

Answer 20

lidocaine

licaine with epi

Question 21

why do we pair epinephrine with lidocaine

Answer 21

. increases duration of action

. promotes hemostasis through vasoconstriction

Question 22

methods of debridement

Answer 22

surgical, enzymatic, mechanical, autolytic, maggots

Question 23

possible sign of wound with foreign body

Answer 23

point tenderness

Question 24

how to clean wound

Answer 24

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

Question 25

allowed to granulate

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

Answer 25

. healing by second intention

Question 26

why do you keep wound moist 24-48 hours

Answer 26

augments reepithelialization

Question 27

what nutrition parameters can we optimize in wound care

Answer 27

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

Question 28

collagen synthesis

vitamin A
vitamin C
zinc

Answer 28

vitamin A

vitamin C

Question 29

antioxidant

vitamin A
vitamin C
zinc

Answer 29

vitamin A

Question 30

fibroblast proliferation

vitamin A
vitamin C
zinc

Answer 30

zinc

Question 31

indications for systemic antibiotic for traumatic wounds

Answer 31

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

Question 32

how do hydrocollouds promote wound debridement

Answer 32

by autolysis

Question 33

3-5 days

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

Answer 33

. face

Question 34

7

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

Answer 34

. arm/anterior trunk

Question 35

10-14

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

Answer 35

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

Question 36

integra

. collagen and condroitin in sulphate
. alloderm
. apligraftrade

Answer 36

. collagen and condroitin in sulphate

Question 37

skin substitute containing collagen and seeded cells

. collagen and condroitin in sulphate
. alloderm
. apligraftrade

Answer 37

. apligraftrade

Question 38

immunologically inert, nonliving, allogenic, acellular dermal matrix

. collagen and condroitin in sulphate
. alloderm
. apligraftrade

Answer 38

. alloderm