Surgical Tech Certification

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Surgical Tech Certification
2010-04-23 10:56:03
Surgical tech wound healing

Wound healing
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  1. 5 characteristics of first intention wound healing
    • No post op swelling
    • No serous discharge
    • No local infection
    • No separation of wound edges
    • Minimal scar formation
  2. 3 phases of first intention wound healing
    • Lag phase
    • Proliferation phase
    • Maturation phase
  3. Describe 3 stages of lag phase
    • Exudates containing blood, lymph and fibrin begin clotting/binding cut edges together
    • Fibrin, clotting blood and serum protien dry out , forming scab
    • Leukocytes remove bacteria and damaged tissue debris
  4. 3 stages of proliferation phase
    • Fibroblasts multiply rapidly, bridging wound edges and secrete collagen which forms fibers
    • Tensile strength grows rapidly because of collagen
    • New cells are formed
  5. 3 steps of maturation phase
    • Scar forms
    • Collagen reforms into cross-links that increase tensile strength
    • As colagen density increases, vascularity decreases and the scar grows pale
  6. Describe healing by second intention
    Occurs when an infection is present. Healing occurs by process of granulation from the inside out. Usually used if the wound cannot be approximated due to infection, necrosis or tissue damage. Scar formation is excessive.
  7. Abrasion
    Caused by injury or mechanical irritation such as boot rubbing, scraping, or being injured with sandpaper
  8. Avulsion
    A portion of the skin and soft tissue is partially or completely torn away
  9. Contusion
    A bruise in which the skin is not broken but the tissue below the surace is damaged and the blood vessels have ruptured causing discoloration
  10. Crushed tissue
    A wound that has been squeezed or forced by pressure that alters or destroys the tissue structure
  11. Incision
    Wound with smooth edges made by a cutting instrument; may be contaminated (glass wound) or clean (scalpel)
  12. Laceration
    Tear in the tissue with irregular edges
  13. Perforation
    Hole in which foreign object both enters and exits from the cavity
  14. Puncture
    Wound made by a sharp, pointed instrument
  15. Traumatic injury
    Chemical, thermal or other extrinsic agent or force injures living body tissue
  16. Define Closed wound
    Skin is intact, but the underlying tissue is injured
  17. Define Open wound
    Skin is broken
  18. Define Simple wound
    Skin is interrupted but without loss or destruction of underlying tissue
  19. Define Complicated wound
    Skin and underlying tissues are injured or destroyed by crushing, burning or implantation of a foreign object
  20. Define Clean wound
    • Conditions surrounding the injury and/or object that caused it are relatively clean
    • Wound is cared for within 6 hours after it occurs and heals
  21. Define Contaminated wound
    • Conditions surrounding the injury and/or the object that caused it are not clean
    • The wound is over 6 hours old
    • Heals by second or third intention
  22. Describe clean wound (5 things)
    • Elective procedure, wound made under ideal conditions
    • Primary clousre, no drain
    • No breaks in aeseptic technique
    • No inflammation present
    • Alimentary, genitourinary, respiratory tract or oropharyngeal cavity not entered
  23. Describe clean-contaminated wound (4 things)
    • Primary closure, wound drained
    • Minor breaks in aseptic technique occured
    • No inflammation present
    • Alimentary, genitourinary, respiratory tract or oropharyngeal cavity entered under controlled conditions with no contamination or spillage
  24. Describe contaminated wound (5 things)
    • Open, traumatic wound, less than 4 hours old
    • Major break in aseptic technique occured
    • Acute, nonpurulent inflammation present
    • Gross contamination, such as spillage from gastrointestinal tract
    • Entry into billiary or genitourinary tract with infected bile or urine present
  25. Describe dirty wound (3 things)
    • Traumatic wound over 4 hours old from a contaminated source or presence of necrotic tissue, FB or fecal matter
    • Microbial contamination present may be purulent or a known clinical infection
    • Presence of a perforated organ such as the bowel
  26. Decribe healing by third intention
    Similar to second intention healing except:

    When a wound is infected at the time of surgery, suturing is delayed until the infection subsides

    When a sutured wound becomes infected after surgery, primary sutures are moved and secondary sutures are put in after infection subsides

    While waiting for infection to improve, the wound begins to heal by granulation and the two surfaces tissue are now united by the delayed or secondary sutures
  27. Define dehiscence
    A separation of the layers of the surgical wound
  28. Define evisceration
    Protrusion of the internal organs while the wound remains closed