wounds Flashcards
What are the 6 stages of wound healing?
Coagulation, inflammation, collagen synthesis, angiogenesis (granulation), epithelialization, contraction
What conditions inhibit collagen synthesis?
Vit C deficiency, protein-calorie malnutrition
For a wound that closes by primary intention, how long does it take for epithelialization to complete?
24-48 hours. At this time, wound dressing can be changed and less bulky dressing applied.
How should wounds be treated that are closing by second intention?
Pack with moist gauze and cover with sterile dressing
What is third (delayed primary) intention wound healing?
Type of healing seen following closure of wounds that are visibly contaminated. Example: ruptured appendix that leaked pus- close peritoneum and fascia and give abx, once infection cleared, stitch up subq and skin.
What qualifies as a “clean” wound (risk of infection 1.5%)?
Wound created in sterile fashion, everyone maintained sterile technique, and was not a respiratory, GI, or GU surgery.
What qualifies as a “clean-contaminated” wound (risk of infection 3%)?
Respiratory, GI, or GU tract entered but no sig spillage of contents or local infection; minor break in aseptic technique
What qualifies as “contaminated” wound (risk of infection 10%)?
Gross spillage of GI tract, or GU/biliary tracts entered in presence of local infection, or wound was from recent trauma, or major break in aseptic technique
What qualifies as a “dirty” wound (risk of infection 30-35%)?
Wound was result of remote trauma and contains devitalized tissue, or there is est infection or perforated viscera prior to the procedure.
Early SSI’s, occurring in the first 24 hrs postop, or most commonly due to what bugs?
Strep or Clostridium
Other than first 24 hrs postop, what are most common bugs for wound infection?
Depends on the flora of the body part
What are the 5 W’s of postop fever?
Wind (atelectasis, PNA) in 24-48 hrs, water (UTI) after POD #3, wound infection after POD #5, walking (DVT) usu POD#7-10, wonder drugs (e.g. anesthesia)
