Wound Management.1 Flashcards
Define open wounds.
injury causing a break of skin surface, weeks/ months to heal
Define closed wounds.
injury does not cause break in body- damage to underlying tissues- bleeding
What are the types of open wounds?
incised- surgical
avulsed- degloving
lacerated- tear
punctured- bite
abraision- scratch
What are the 2 types of closed wounds?
haematoma, contusion
What is a clean wound?
surgical wound- no sterility break
What is a clean-contaminated wound?
surgical wounds of resp, urogential/ GI- complete sterility not acheived
fresh wounds- lavaged/ debrided
What is a contaminated wound?
contaminated- fresh enough for bacterial multiplication not a problem YET
surgical wounds- major break sterility occurred- leakage of intestinal contents
What is a dirty wound?
active infection present- 6+ hours
necrosis- foreign material present
Define first intention healing…
clean surgical sounds- sutured, 14 days
blood clots seal wound, epithelium regeneration
macrophages remove dead tissue
Define second intention healing…
when wound edges unable to be sutured- tissue loss
base/margins filled with granulation tissue- debris removed
re-epithelialisation begins on granulation tissue present- wound contract repeats until healed
What are the stages of normal wound healing?
Inflammatory response- clots/ scabs form (WBC contraction
Prolifterative phase- new cells produced, slides over wound (3-7 days)
Remodeling phase- epidermal growth, new collagen laid forming scar tissue- secondary wound- scar size reduces
What happens in the Inflammatory Phase?
triggered by activation of platelets and fibrin in blood clot
neutrophils attracted to damage- clears bacteria/ necrotic tissue
release inflammatory mediators- attracting macrophages into tissue
What happens in the Proliferative Phase?
granulation
bright/red- easily damaged
IMPORTANT TISSUE
barrier to local infections- excellent BS for healing
Where do fibroblasts lay down?
collagen bed
What 2 stages are important in the Proliferative Phase?
Contraction
Epithelialisation
Contraction-
wound edges pull together, 30% wound closed
Epithelialisation-
epithelial cells proliferate/ migrate- reattach to granulation tissue
What happens in the Remodeling Phase?
scar formation occurs
3-2weeks-2 years (severity)
new collagen forms, increasing tensile strength- 80% strength of original tissue
scar size reduces- secondary
