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Preeti: SA Surgery > Wounds & Wound Healing > Flashcards

Wounds & Wound Healing Flashcards

1
Q

The most commonly encountered classification of operative wounds

A

Clean wound

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2
Q

A surgically created wound where:

No infection is encountered

Asepsis is maintained

No structure containing bacteria is opened (other than skin)

A

Clean wound

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3
Q

A surgically created wound in which:

Hollow viscus or organ containing bacteria is opened BUT no contents are spilled

A minor break in asepsis has occurred (like a hole in the surgeon’s glove)

A

Clean-contaminated wound

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4
Q

A surgically created wound in which:

A hollow viscus or organ is opened and GROSS SPILLAGE has occurred

A major break in asepsis has occurred

OR:

ANY TRAUMATIC WOUND

A

Contaminated wound

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5
Q

A surgically created wound in which:

The opened structure contains PUS

or

Contents of a perforated hollow viscus

I.E. Peritonitis

A

DIRTY wound

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6
Q

The risk of infection during surgery _______ every hour

A

DOUBLES

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7
Q

A _________ wound implies infection

A

DIRTY

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8
Q

What is the most common source of operative wound infection?

A

The patient’s endogenous flora (skin, GIT)

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9
Q

When are prophylactic antibiotics indicated?

A

When the patient is very old or immunosuppressed

When the surgery is estimated to last over 1 hour

When risk of infection is high/would have catastrophic results

When the surgeon is inexperienced

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10
Q

How long should prophylactic antibiotics be continued perioperatively?

A

Not longer than 24 hours (and longer will mask infection development)

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11
Q

What type of antibiotics are preferred for prophylactic use?

A

SINGLE AGENT (not broad spectrum!)

Ex: Cefazolin or Cefoxitin

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12
Q

Open traumatic wounds should initially be considered

______ at best

A

Contaminated

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13
Q

How does healing of superficial wounds differ in dogs and cats?

A

In cats, SQ tissue plays an important role in healing and immune response.

(If SQ in cats is damaged, wound will take longer to heal)

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14
Q

What is a common organism found in bite wounds in cats?

How is it treated?

A

Pasteurella

Tx with Penicillin Abx

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15
Q

What type of suture material is most appropriate for

a clean-contaminated wound?

A

Short/intermediate lasting ABSORBABLE MONOfilament suture

(because suture can increase risk of infection)

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16
Q

Burn wounds significantly ______ the metabolic state

A

INCREASE

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17
Q

Fluid resuscitation is indicated in burns greater than ________% TBSA

(total body surface area)

A

15%

18
Q

What is the difference between a sinus and fistula draining tract?

A

Sinus tract = communication between MESOTHELIAL surfaces and skin

Fistula tract = communicatoin between 2 EPITHELIAL surfaces

19
Q

A non-healing sinus tract is most commonly caused by _________

A

PLANT material foreign bodies

20
Q

What is the “Golden Period” in relation to wound infection development?

How long is it generally?

A

The time from contamination to when bacteria invade and replicate

to > 105 / gram of tissue

Generally 6 - 8 hours

21
Q

What is an IFP and where are they most likely found?

A

Infection Potentiating Factors

which are negatively charged particles with large surface ares that

inhibit phagocytosis and bacterial killing by the host

Most commonly found in soils and clays (grass awns)

22
Q

What is the best way to lavage a traumatic wound without causing

iatrogenic tissue damage?

A

Using Chlorhexidine (0.05%) under moderate pressure (7 - 8 psi)

and a syringe and needle (18 - 20G)

BEWARE using Chlorhexidine in CATS (hypersensitivity rxns)

23
Q

What are the disadvantages of using Providone-Iodine for wound lavage?

A

The residual activity is TOO SHORT (4 - 6 hours)

Forms inactive complexes with organic matter

Can be systemically absorbed –> TOXICITY and METABOLIC ACIDOSIS

24
Q

What is the most commonly used method of surgical debridement?

A

LAYERED debridement

(start at surface and work your way down until ok to have closure)

25
Q

What kind of wound dressing is used for Autolytic wound debridement?

A

Moisture retentive dressing

26
Q

Which method of wound debridment helps mobilize questionable tissue (either white or black eschar)?

A

Enzymatic wound debridment (uses Granulex)

27
Q

What type of wound dressing is used for mechanical wound debridement?

A

ADHERENT primary dressing

28
Q

When is mechanical wound debridement primarily indicated?

A

Wounds in the LAG phase with

heavy contamination or

thick viscous exudate

29
Q
A
30
Q

Negative wound pressure therapy (VAC) for open wound management

works best when used on wounds in the __________ phase or

__________ phase of wound healing

A

LATE LAG (Debridement) Phase

or

EARLY PROLIFERATIVE Phase

of wound healing

31
Q

What is the major benefit of VAC (Negative wound pressure therapy)?

A

Accelerated granulation tissue formation

(48 hours instead of 4 - 5 days)

32
Q

Which of the following does NOT promote granulation tissue formation?

Calcium Alginate

Honey

Sugar

Maltodextrin

A

Calcium Alginate (C-Salt)

33
Q

What are the indications for WET-to-DRY adherent dressings?

A

Necrotic tissue

Foreign bodies

High viscosity exudate

34
Q

What are the indications for DRY-to-DRY adherent dressings?

A

Wounds with high fluid production which need debridement

(Degloving, bite wounds, lacerations, deep cavity wounds)

35
Q

These dressings are better than adherent dressing for wounds in

LATE debridement/proliferative phase of wound healing

A

Non- adherent moisture retentive dressings (autolytic wound debridement)

36
Q

What is the most commonly used type of PASSIVE drain?

A

Penrose drains

37
Q

What is the most commonly used type of ACTIVE drain?

A

Jackson-Pratt drain

38
Q

What are the 4 classifications of wound closure?

A

Primary

Delayed Primary

Secondary

Second Intention (Contraction and Epithelialization)

39
Q

What classification of wound closure is described by the following?

Immediate closure of a wound after a procedure

A

Primary closure

40
Q

What classification of wound closure is described by the following?

A wound closed BEFORE formation of granulation tissue

that is left open for 2 - 5 days

A

Delayed Primary Closure

41
Q

What classification of wound closure is described by the following?

Wound closure AFTER granulation tissue is formed and covers the wound

A

Secondary CLOSURE

42
Q

What classification of wound closure is described by the following?

Healing by union by adhesion of granulating surfaces,

when the edges of the wound are far apart

and cannot be brought together.

AKA: Contraction and epithelialization

A

SECOND INTENTION healing

Preeti: SA Surgery (10 decks)

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