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Wound Healing 2

Surgery 2

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