wounds Flashcards
factors affecting wound healing
nutrition
age
obesity
immunocompromised (disease or steroids)
chronic disease - DM, artificial valve
smoking
meds - steroids, NSAIDs, chemotherapy
stress
infection
phases of wound healing
not linear!!!
hemostatic/inflammatory (2-5 d) - neutrophils/macrophages
proliferative (5 d- 3 week)
- granulation tissue & fibroblasts
remodeling/maturation (3 week-2 year)
primary intention
initial union of edges with complete healing; minimal granulation tissue
clean, uninfected, clean margins, suture, neat scar, complications rare
secondary intention
leaving wound open, GRANULATION tissue fills between edges leaving a scar
unclean, infected, irregular margins, no sutures, irregular wound, complications common
delayed primary closure
healing which granulation tissue fills the gap between edges, usually a contaminated wound
closure after risk of infection has passed, usually 4 days
Dupuytren’s contracture
excessive contraction
Marjolin’s ulcer
squamous cell carcinoma appearing years after wound
wound pain
nociceptive or neuropathic
when would you use an alginate dressing?
exudative wounds
when would you use a hydrogel dressing?
pressure ulcers, surgical wounds, burns, radiation dermatitis
when would you use a hydrocolloid dressing?
severe exudative wound
when would you use a foam dressing?
infected would
when would you use a film dressing?
epithelializing wound, superficial wound with limited exudate
cat bite mgmt
polymicrobial, high infection risk
Pasteurella species
high risk bites mgmt
irrigate!!!
abx prophylaxis for high risk bites
augmenting 500 mg TID 5-7 days
was the animal vaccinated against rabies?
