Flashcards
Wound healing
Cards in this deck (33)
- 1refresher-anatomyintegumentary system
3 layers
-epidermis, dermis, hypodermis (subcutaneous layer) - 2types of woundssurgical -caused by excision, incision
traumatic- mechanial, thermal, chemical, destruction
chronic - pressure ulcers
implications to practice- determines wound closure - 3three types of wound closureprimary - first intention
secondary - intention, granulation
tertiatry - intention, delayed primary closure - 4primary intentionhealth edges incised wound
minimal infection - strict aseptic technique
minimal trauma to wound
no tissue loss
no dead space
minimal drainage - 5secondary intentionoccurs when wound edges cannot be joined together
wound left open to heal
from inside to outside
typically for infection
large scar, skin contractions, prolonged healing - 6tertiary intentiondelated primary closure
typically seen - inflamed, contaminated, traumatic, haemodynamically unstable
closure delyaed - 73 phases of wound healhtinginflammatory (reactive), proliferative (regenerative), remodelling (maturation)
- 8inflammatory phaseinflammatory response, migration of exudate, increased blood supply, vascular response, cellular response to fight infection, formation of scab, lasts 1-4 days
- 9proliferative phaseallows new epithelial to cover wound occurs within hours of injury
cells migrate and proliferate to close defect
collagen synthesis, wound contraction occurs
formation of granulation tissue
surgical implications - may need skin graft - 10remodeling phaselate process - begins 2-4 weeks after injury
can last up to 1 year
scar tissue formed during fibroplasia
break down and regeneration of collagen
scare ages, fibre bundles closelyy packed
best tensile strength 80% approx - 11factors influencing wound healingpatient factors - nutrition, oxygenation, age, disease state
Perioperative factors - maintanence of body temp, consequences of hypothermia - 12causes of delayed wound healingpatient factors
age, stress, immunological status, smoking
perioperative factors
SSI, aseptic technique, antibiotic prophylaxis
criteria for SSI
superficial, deep, organ/space - 13Intraoperative tissue handlinglength, direction, dissection technique (blunt/sharp)
amount of tissue handling, retraction technique, achievement of haemstasis, precise tissue approximation, elimination of dead space, secure wound closure - 14wound classificationCDC classification system
class 1 - clean wounds
class 2 - clean contaminated wounds
class 3 - contaminated wounds
class 4 - infected wounds - 15clean - class 1 woundsuninfected wound no inflammation
- 16clean contaminated wounds - class 2operative wounds, nil unusual contamination, controlled conditions
- 17contaminated wounds - class 3open, fresh, accidental wounds, major breaks in sterile techniques, nonpurulent inflammation is encountered
- 18dirty/infected wounds - class 4includes old traumatic wounds, retained tissue, involve existing clinical infection or perforated viscera
- 19complications of wound healthingdehiscence, eviceratoin, haemorrhage, infection, fistula
- 20factors preventing dehiscencelong paramedian incision
adequacy of closure
intraabdominal pressure
deficient wound healing
infection - 21factors preventing infecitondegree of contamination
adequacy of local blood supply
virulence of organism
presence of dead space - 22wound management alternativesdebridement, hyperbaric oxygenation, negative pressure wound therapy, vacuum assisted closure, skin substitutes, growth factors
- 23debridementremoval of patients dead tissue, reveal health tissue
surgery, mechanical means forceful irrigtion - 24hyperbaric oxygenation or HBOdefinition - use of oxygen at a higher level than atmospheric pressure
technique - 100% oxygen, under pressure in chamber, increase oxygen dissolved in plasma (increase oxygen tension) - 25negative pressure or VACdefinition - continous suction in a sealed environment to aid wound healing
principle use for:
acute, traumatic wounds, subacute wounds, dehisced incisions, pressure ulcers, flaps
contraindications: fistulas, necrotic tissue, osteomyelitis, malignancy - 26hydrotherapywater used to perform debridement
pulsative lavage
hazardous - aerosol/droplets - good use of PPE - 27Skin substitutesgroup of substances, that aid in temporary permanent closure of wound for coverage
used on thermal injuries - 28growth factorsnaturally occuring substance capable of stimulating cellular growth, proliferation, cellular differentiation
types - platelet derived growth factors, epidermal growth factors - 29haemostaticschemical, external, thermal
- 30chemicalabsorbed gelatin, collagen, oxytocin, thrombin
- 31externalantiembolic stockings, torniquets, bp cuff, pressure dressings, packing, suction
- 32thermalcold/hot methods, diathermy, electrosurgery, laser
- 33tissue replacement materialsbiologic wound cover, biologic materials
Information
- Description
- User has deleted their subject information Flashcards on Wound healing, created by Deleted user on 12/06/2018.
- Created by
- Deleted user
- Views
- 17
- History
-
- Created by Elizabeth Then · Jun 12, 2018
- Copied by Elizabeth Then · Jun 12, 2018
- Rating