SUR-100 Chapter 11 Wound Healing
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70 terms
Terms | Definitions |
|---|---|
 cut through intact tissue to expose or excise underlying structures | incisional |
| removal of tissue | excisional |
| six types of traumatic wounds | closed, simple, clean, open, complicated, contaminated |
| most common MVA (forced injury) | closed wound |
| hematoma may develop | closed wound |
| abrasion, laceration, penetration, and compound fractures are examples of | open wound |
| contusion, torn ligament, closed fracture, and lacerated liver are examples of | closed wound |
| closed wound can also be known as | blunt trauma |
| no loss or destruction of skin | simple wound |
| laceration is an example of | simple wound |
| crush injury, or burn is an example of | complicated wound |
| surgical wound (Class 1), or laceration are examples of | clean wound |
| wound is expected to heal by first intention | clean wound |
| standard wound healing | first intention |
| wound may be left open to heal by second intention | contaminated wound |
| skin graft may be necessary | contaminated wound |
| compound fracture and gun shot wounds are examples of | contaminated wound |
| decubitus ulcer is an example of | chronic wound |
| radiation therapy or diabetes are causes of | chronic wound |
| tissue necrosis and/or infection may be present | chronic wound |
| chronic wound may also be known as | non-healing |
| Class 1 | clean |
| Class 2 | clean contaminated |
| Class 3 | contaminated |
| Class 4 | dirty and infected |
| cases are prioritized according to the surgical wound classifications for | rate of infection |
| wound classifications are recorded during what part of the procedure | end |
| no break in sterile technique and wound is primarily closed | Class 1 |
| no drain necessary and infection rate is less than 1% | Class 1 |
| wound drain may be placed and there is a minor break in sterile technique | Class 2 |
| controlled entry into aerodigestive or GU tract | Class 2 |
| infection rate 8-11% | Class 2 |
| open traumatic wound LESS THAN 4 HOURS OLD | Class 3 |
| major break in sterile technique and inflammation present | Class 3 |
| entry into aerodigestive or GU tract WITH spillage | Class 3 |
| infection rate 15-20% | Class 3 |
| open traumatic wound GREATER THAN 4 HOURS OLD | Class 4 |
| infection prior to procedure-purulent discharge | Class 4 |
| perforated viscera or ulcer | Class 4 |
| infection rate 27-40% | Class 4 |
| healing occurs in how many phases | 3 |
| first healing phase | Lag Phase or Inflammatory Response Phase |
| begins within minutes of injury and lasts approx. 3-5 days | Lag Phase |
| fibrin weakly holds wound edges together | Lag Phase |
| during Lag Phase what produces the enzyme that dissolve and remove tissue debris | WBC |
| second healing phase | proliferation phase or healing phase |
| begins approx. the 3rd postoperative day and continues for up to 20 days | healing phase |
| collagen is secreted by fibroblasts and formed into fibers resulting in a gain in tensile strength of wound (25-30% of original tensile strength) | healing phase |
| fibroblasts multiply rapidly | proliferation phase |
| maturation phase or differentiation phase | third healing phase |
| phase begins on the 14th postoperative day and lasts for up to 12 months | maturation phase |
| as collagen density increases, vascularity decreases, and scar grows pale | differentiation phase |
| fiber pattern re-forms and meshes to increase tensile strength, also this is where ones gains most of their strength | maturation phase |
| risk of infection is great and large wounds can't be approximated | second intention |
| second intention is also known as | granulation |
| wound contraction, rather than primary union | second intention |
| heals from bottom up, but healing is delayed | granulation |
| excessive scar formation | second intention |
| delayed primary closure | third intention |
| suturing is delayed 4-6 days | third intention |
| third intention | traumatic class 3 and 4 surgical wounds |
| partial or total separation of wound layers | dehiscence |
| viscera is exposed through incision | evisceration |
| when does wound infection usually emerge | between 4th and 8th postoperative day |
| body's first initial defense to localize and contain invading microbes | cellulitis |
| sepsis accelerates the patients metabolic rate | 30-40% |
| delayed healing, discomfort, distress, dependency, disaster, dollars, disability, and deformity | "D's" of wound infection |
| infection results from interaction between | microbes, tissues, and body's defenses |
| (# of microbes x virulence) divided by host defenses | infection |
| infection occurs at site of incision within how many days following the procedure | 30 |
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