Wound Management.1

Question 1

Define open wounds.

Answer 1

injury causing a break of skin surface, weeks/ months to heal

Question 2

Define closed wounds.

Answer 2

injury does not cause break in body- damage to underlying tissues- bleeding

Question 3

What are the types of open wounds?

Answer 3

incised- surgical
avulsed- degloving
lacerated- tear
punctured- bite
abraision- scratch

Question 4

What are the 2 types of closed wounds?

Answer 4

haematoma, contusion

Question 5

What is a clean wound?

Answer 5

surgical wound- no sterility break

Question 6

What is a clean-contaminated wound?

Answer 6

surgical wounds of resp, urogential/ GI- complete sterility not acheived
fresh wounds- lavaged/ debrided

Question 7

What is a contaminated wound?

Answer 7

contaminated- fresh enough for bacterial multiplication not a problem YET
surgical wounds- major break sterility occurred- leakage of intestinal contents

Question 8

What is a dirty wound?

Answer 8

active infection present- 6+ hours
necrosis- foreign material present

Question 9

Define first intention healing…

Answer 9

clean surgical sounds- sutured, 14 days
blood clots seal wound, epithelium regeneration
macrophages remove dead tissue

Question 10

Define second intention healing…

Answer 10

unable to be sutured, edges too far apart 30% tissue left- heals from bottom up, longer process

Question 11

What are the stages of normal wound healing?

Answer 11

Inflammatory response
Prolifterative phase
Remodeling phase

Question 12

What happens in the Inflammatory Phase?

Answer 12

activation of platelets and fibrin- blood clots
neutrophils attracted to damage- clears bacteria/ necrotic tissue
release inflammatory mediators- attracting macrophages into tissue

Question 13

What happens in the Proliferative Phase?

Answer 13

bright/red- easily damaged
new cells produced, slides over wound granulation- oxygen
re-epthilisation of stem cells- replace damaged tissue
still weak

Question 14

What happens in the Remodeling Phase?

Answer 14

3-2weeks-2 years (severity)
new collagen forms, increasing tensile strength- 80% strength of original tissue
stimulates new blood vessles
scar size reduces- secondary

Question 15

Where do fibroblasts lay down?

Answer 15

collagen bed

Question 16

What 2 stages are important in the Proliferative Phase?

Answer 16

Contraction
Epithelialisation

Question 17

Contraction-

Answer 17

wound edges pull together, 30% wound closed

Question 18

Epithelialisation-

Answer 18

epithelial cells proliferate/ migrate- reattach to granulation tissue