Wounds Flashcards
1
Q
Clean wound
A
- Surgical prep
- GI tract not entered
- Primary closure
- No abx
2
Q
Clean- contaminated wound
A
- Surgical prep, enter GI tract
- Primary closure
- Cefazolin abx
3
Q
Contaminated wound
A
- Trauma with foreign material or spillage of GI contents
- Debridement, irrigation
- Secondary closure
- Oflaxaxin abx
4
Q
Dirty and infected wound
A
- Pus at site
- Necrosis
- Debridement, irrigation, secondary closure
- Augmentin
5
Q
First intention healing
A
- Suturing or other closure of wound
- Wound to MD in 12 hrs
- Best aesthetic and fxn outcome
6
Q
Second intention healing
A
- Healing through granulation
- Increased scarring
- Wounds contaminated with debris and bites
7
Q
Tertiary intention healing
A
- Closure after 3-4 days
- Allows close monitoring
- Increased blood flow to wound to encourage healing
- Immunocomp pts
8
Q
Substate phase of healing
A
- Coagulation: fibrin, thromoin and compliment attract inflammation cells
- Platelets attract leukocytes
- Interleukins, histamin, serotonin and bradykinin cause constriction then dilation
9
Q
Proliferative phase
A
- Fibroplasia and matrix deposition
- Collagen and proteoglycans form CT matrix
- Angio genesis in 4 days
- Epitheliazation- keep moist
10
Q
Remodeling phase
A
- Collagen fiber maturation
- Lysis and contraction
- Fibroblasts and leukocytes
11
Q
Infectious agent
A
Bacteria creating toxic metabolites leading to tissues destruction
- Skin aerobes- strep and staph
- Clostridium in dead tissue
- Opportunistic pathogens in immunocompromised
12
Q
Susceptible host
A
- Age- reduced cell fxn
- Immunosuppression- increased susceptibility
- Steroid- suppress inflammation
- Stress, pain
- Smoking- Vasoconstriction
13
Q
Closed, unperfused space
A
- Perfusion and oxygenation very important
- Lack affects natural ability to fight infection
- Hypercapnia and acidosis increase risk
- Narrow outlets- gall bladder, appendix
- Potential spaces
