Wounds/Infections/Grafts/Burns Flashcards
what is normal tissue pressure?
8-10 mmHg
What is critical tissue pressure (such as in compartment syndrome)?
30-45 mmHg
what are the 3 types of skin flaps?
- local flaps
- pedicle flaps
- free tissue transfer
what are 3 types of pedicle flaps?
thenar flap
cross-finger flap
groin flap
all 3 flaps require dividing at a second stage
what does a macrophage do?
perform phagocytosis of bacteria, dead cells, foreign bodoes, and damaged tissue. essential regulatory cells in the repair process and they release growth factors essential for tissue repair
what is a pedicle flap?
differs from the so-called free skin graft in two ways: first, it consists of all of the layers of the skin, with a significant amount of attached fat and subcutaneous tissue; and second, it carries its own blood supply from one or more segments of its periphery.
what types of muscles are appropriate for use in a free-flap?
muscle flaps are categorized by the vacular anatomy of the muscle. Categories that are amenable to free tissue transfer are those in which a single pedicle may support the entire muscle. Other muscles cannot be transferred b/c they have a segmental blood supply, in which one pedicle alone will not supply the entire muscle.
what solutions are appropriate for cleaning a wound?
a healthy red wound can be cleaned as early as 24 hours post-surgery and can be cleaned with:
lactated ringer’s solution
saline
mild soap and water
what solutions are NOT appropriate for cleaning a wound?
Hibiclens and Betadine may be used on intact skin before surgery, but they are cytotoxic and invite infection by destroying macrophages
what is the MOST common cause of skin graft failure?
hematoma
what are causes of skin graft failure?
excessive pressure on fresh graft, infection, hematoma, and movement of the grafted area
which level of organism is indicative of sepsis?
wound sepsis is determined by bacterial contamination exceeding 105 organisms per gram of tissue.
this level can be determined only by tissue biopsy
what are the benefits of Hyperbaric Oxygen therapy (HBO)?
HBO can be used to treat limb crush injuries and/or compartment syndrome. It is theorized to maintain tissue oxygen tensions at a viable level despite low tissue perfusion. It also assists with edema reduction and increases tissue oxygenation to foster wound healing by supporting white blood cell bacterial destruction
what is paronychia?
often known as a “runaround” infection and it occurs in the soft tissue fold around the fingernail
what is a felon?
deep infection of the finger pad tha tinvoles small, discrete compartments. Usually a hx of puncture wound or other penetrating injury. Pus formed in a closed space under pressure causes intense pain, throbbing, marked tenderness, redness, and swelling over the fingertip pad
