wounds Flashcards
types of wounds and how many do we have
- vulnus scissum
- vulnus contusum
- v. laceratum
- v lacero-contusum
- vulnus morusum
- v sclopetarium
- v punctum
what is the classifcation of wounds according to contmaination - essay 28
- clean
- clean contaminated wounds
- contaminated
- infected wounds
5 principels of wound treatment
- hemostasis
- disinfecting
- analgesia
- skin closure
- dressing and follnw up
bite wounds grading
grade 1 - superficial, skin lesion torn skin
grade 2 - deeper, subcutaneous, muscles or muscle
grade 3- necrosis or tissue loss
phases of wound healing
depends on the type of wound in general
- inflammatory phase - signs,
- proliferative stage - fibroblast (collagen) come in, granulation tissue is forming, wound edges are beginning to contract
- maturation stage - depends on factor like morbidities, infection - wound is strengthened and scar tissue formed
phases of wound healing
depends on the type of wound in general
- inflammatory phase - signs,
- proliferative stage - fibroblast (collagen) come in, granulation tissue is forming, wound edges are beginning to contract
- maturation stage - depends on factor like morbidities, infection - wound is strengthened and scar tissue formed
characteristics of surgical woundsvs other wounds
1) clean
2) small scar
3) rapid restoration of tissue strength
4) minimal infection/complication
5) involves re-epiltheliazation only to heal the wound
healing by secondary intention features
edges of wound cannot be approximated as there is a lot of dead space in between
- you have excessive loss of tissue
granulation forms to fill in the gap snd slowly the wound will contract appearing smaller due to the collagen fibers
zones of burns
- zone of coagulation - dead
- zone of stasis- can either surive or die as diminished blood supplu
- zone of hyperemia - healing begins from here
whats the complication you want to avoid in burns
hypovelmia
limb ishcemia - due to compression
how do we classify the burns in terms of whats affeted
epidemris
epidermis + dermis divided further into superficial partial thickness and deep partial thickness
epridermins and dermis
skin and sc tissue
1st degree burn
just the dermis its described as a dry surface and treatment is nn surgical all you will have is redness and pain but no bisters
second degree
you can have a blister in both categories but it’s more associated with the superficial one
which burn is blister absent
3rd degree and 1st degree and usuallly 2nd degree(deep) and 4th degree
which burns has svere pain
1st degree
2nd degree superficial
which burns have no pain
3rd degree and 4th
which burns have no pain
3rd degree and 4th
which burns is capillary refil present
1st degree and second
- very quickly
- slowly
managment of burns
elevate - reduces pain and swelling
topical silver sulfadiazine (deep burns to reduce infection)
eschartomy- performed for circumferential full thickness burns to the chest that will limit the expansion of the chest. patient may need a fascitomy to quicly relive the pressure
skin graft
9 % rule
the chest - 9%
each hand - 9%
genitals- 1%
upper back 9
full leg - 18
lower back 9
things to be mindful off when you have a burn patient
- AIRWAY IS SECURE
- LOOSING FLUIDS
- PAIN MANAGMENT
why would you be worried about the airway in burns
due to smoke inhalation it can cause edema of the airways leading to upper airway obstruction so patients should be intubated promptly
why would you be worried about the airway in burns
due to smoke inhalation it can cause edema of the airways leading to upper airway obstruction so patients should be intubated promptly
how do you calculate how much fluid to give in burns
parkland formula
- % of burn
- patients weight
partial thickness burn vs full
Partial-thickness burns involve the epidermis and portions of the dermis. Full-thickness burns extend through and destroy all layers of the dermis.
what’s the difference in appearance between superficial dermal and deep dermal
superficial: blister, blanches and refils, pinkish , more painful sensate
deep : (blister sometimes) - does not blanch , blotchy red , insensate
signs of inhaltional Dinosaur confusion due to carbon monoxide inhalation and finding it difficult to breathe strider or hoarseness of voice or signs of an impending area destruction and require immediate information
singed nasal hair
burns to the face
blisters on upper palate
sooty sputum
Dinosaur confusion due to carbon monoxide inhalation and finding it difficult to breathe strider or hoarseness of voice or signs of an impending area destruction and require immediate information
full thickness
white or charred,leathery , insensate, no blanch
management of cellulitis
- bloods
- skin swab
- oral/IV ab’s depending on severity
- demarcate the border so you can see if it grows rapidly or not
- elevate if possible
management of cellulitis
- bloods
- skin swab
- oral/IV ab’s depending on severity
- demarcate the border so you can see if it grows rapidly or not
- elevate if possible
signs of cellulits
5 signs of inflammation
poor demarcation
systemic symptoms, feverr, malaise , lyphadenopathy
