Surgery 2
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| Phases of wound healing | Hemostasis. Inflamation and recruitment. Fibroblast proliferation and granulation (2-21 days). Collagen synthesis (2-21 days). Angiogenesis (2-7 days). Wound remodeling and contraction (2-20 days)
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| inflammatory cells that migrate to the site of a wound | neutrophils and macrophages
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| how soon does migration of inflammatory cells occur after an injury | minutes to 24 hours
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| how soon does reepithelialization occur after an injury | 24-48 hours
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| how soon does collagen deposition occur after an injury | 7-14 days
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| how soon does increased tensile strength occur after an injury | 6 months
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| what is a clean wound | incision through prepped skin without violation of GI, GU or repiratory tracts
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| what is a clean contaminated wound | incision through prepped skin and into GI GU or respiratory tracts that have also been prepped
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| what is a contaminated wound | GI, GU or respiratory tract surgery with active infection somewhere else in the body
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| what is an infected wound | existing infection at the site of operation
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| treatment for abscess | incision and drainage
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| wound closure by primary intention | immediate approximation of skin edges
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| wound closure by delayed primary (tertiary) intention | leaving a contaminated wound open for 2-5 days to allow for reduced bacterial counts, then close primarily
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| wound closure by secondary intention | leaving a wound oopen to allow for healing by reepithelialization and contraction
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| how should wounds at high risk for infection be closed | by secondary intention
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| how long should an operative dressing be left in place | 48 hours
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| traditional dressing for open contaminated wound | wet to dry
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| best dressing for open contaminated wound | wound VAC
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| factors that reduce wound healing | infection, malnutrition, increased age, ischemia, smoking, diabetes, steroids, radiation and chemo
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| Nonblanchable erythema of intact skin, heralding ulceration, +/- warmth/induration = | Decubitus stage I
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| Partial-thickness skin loss involving epidermis, dermis, or both; lesion appears as abrasion = | Decubitus stage II
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| Full-thickness skin loss with damage or necrosis to subcutaneous layer & may extend to (not through) underlying fascia = | Decubitus stage III
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| Full-thickness skin loss with extensive destruction, necrosis, damage to muscle, bone, etc; may involve sinus tract = | Decubitus stage IV
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Created by:
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