Question | Answer |
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 |