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Puncture wounds what organisms?
Staph, strept and psuedo (OM)
What is the stimuli that affects the hypthalamus changing body temperature?
Endogenous pyrogens secreted by leukocytes
What bacteria has a greater affect on fever, gram negative or positive?
What are the signs of a systemic septic patient?
- Elevated temp
What do the ABI and toe pressure need to be to heal a wound?
ABI > .50 and pressure of 30mmHg
What are the 5 cardinal signs of infection?
- Dolor- pain
- Rubor- redness
- Calor- Heat
- Tumor- swelling
- Functio lasea- loss of function
What is the common lag time of seeing osseous changes do to infection?
What tests would you order for infection?
- CBC with diff
- Chem panel
- Blood cultures
- Urine culture
What are your agranulocytes?
What are PMN cells?
Polymorphonuclear cells- Mature Nuetrophils and contain lactoferrin and are macrophages.
Band cells are?
Immature neutrophils- left shift, can't phagocytize very well.
What cells come in around 24 hours and replace neutrophils as the main macrophages?
What is ESR?
- Mesaures the distances in mm that a erythrocyte falls in 1 hour.
- Nonspecific for inflammation, infection, malignancy, renal disease, connective tissue disease, age
- >70mm sign of OM
- >20 sign of ST infection
What are we looking for in a UTI?
Leukocytes and nitrates and organisms.
Who are our immunocompromised pts?
- Steriod Therapy
What are some situations that would need OR debridement?
- Unknown extent of infection
- Wound probes to bone or bone is exposed
- Wound tracks up fascial planes or tendon sheaths
- Gass in soft tissue
What is the closure after sx?
Usually delayed primary closure 3-4 days to do local wound care and monitor.