Tech- Wound Managment(Stages and Phases)

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Tech- Wound Managment(Stages and Phases)
2013-09-23 15:50:00

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  1. removal of devitalized and/or necrotic tissue usually done by share excision
  2. flushing of a wound to remove foreign material, exudate, and contamination
  3. what is the most important step in proper wound healing?
  4. what type of fluid should be used to lavage?
    0.9% sterile saline
  5. should antimicrobials be added to crystalloids for wound lavage?
  6. what types of soaps and antiseptic scrubs should be used and why?
    • NONE
    • most of the solutions can be damaging to tissues
  7. what are the 3 stages of wound healing?
    • exudative
    • collagen
    • maturation
  8. what are the 2 phases that are a part of the exudative stage?
    • inflammation
    • debridement
  9. what are the 2 phases that are a part of the collagen stage?
    • lag
    • repair
  10. what is the phase that is a part of the maturation stage?
    maturation phase
  11. what are the phases of healing?
    • inflammatory
    • debridement
    • lag
    • repair
    • maturation
  12. inflammatory phase-
    when does it begin?
    what happens?
    what marks the end of this phase?
    • begins immediately after injury
    • blood fills wound and clot formation begins
    • WBCs leaking into the wound marks the end of this stage
  13. debridement phase-
    when does it occur?
    what happens?
    • 6 hours after injury
    • phagocytes remove stuff
  14. what is the stuff that is removed during the debridement phase?
    • necrotic tissue
    • bacteria
    • foreign material
  15. lag phase-
    when does it occur?
    what happens?
    • first 3-5 days post-inj.
    • body gathers cells to promote healing
  16. repair phase
    when does it occur?
    what happens?
    how does it benefit the wound?
    • aka- proliferative phase
    • after clot has formed and phagocytes have done their job
    • begins 3-5 d. post-inj.
    • what happens--->
    • 1. inc in fibroblasts- produces collagen
    • 2. granulation tissue is formed
    • how it helps- significant increase in wound strength
  17. maturation phase-
    when does it happen?
    what happens?
    how long can it last?
    • aka- remodeling phase
    • begins ~3w. post-inj.
    • new epithelium forms- scar tissue too!
    • may last from months to years
  18. as a scar fades, what is actually happening?
    # of capillaries in the wound decreases
  19. what are the 3 types of debridement?
    • layered
    • En Bloc
    • Enzymatic
  20. which type of debridement?
    -conservative, only superficial layers
    -completed over a period of days
    -indicated for large wounds
    -may be repeated for HEAVILY CONTAMINATED/TRAUMATIZED wounds
  21. what type of debridement?
    -complete excision of wound
    -indicated on small wounds with loose skin that can be closed primarily
    En Bloc
  22. what type of debridement?
    -use of trypsin to dissolve necrotic tissue
    -slowest method
    -indicated for minimally contaminated traumatized wounds
    -adjunct to sx debridement
  23. what are the types of closure?
    • primary
    • delayed primary
    • contraction/epithelialization
    • secondary
  24. what is primary closure aka?
    first intention healing
  25. what is primary closure?
    closure w. sutures
  26. what types of wounds are primary closure recommended?
    • fresh clean wounds
    • surgical incisions
  27. what is a delayed primary closure
    closure of a wound 3-5 days post-inj.
  28. what is delayed primary closure occuring before in the healing process?
    the formation of granulation tissue
  29. what is a delayed primary closure indicated for?
    • moderately contaminated wounds
    • traumatized wounds
  30. what is contraction/epithelialization closure aka?
    second intention healing
  31. what is 2nd intention healing?
    wound allowed to heal without sx closure
  32. what is the closure of the wound a result of w. second intention healing?
    • contraction
    • epithelialization
  33. what is an example of a wound that would require 2nd intention healing?
    degloving injury
  34. what is secondary closure aka?
    3rd intention healing
  35. what is secondary closure?
    sx closure  after granulation tissue has developed
  36. When does secondary closure occur?
    3-5 days post injury
  37. What is secondary closure indicated for?
    • -severely contaminated/traumatized wounds that require a lot of debridement
    • -long term wound management
  38. introduction of infectious microbes into the wound
  39. invasion and multiplication of microorganisms in body tissues causing local cellular injury
  40. Does a contamination of infection have a higher WBC count?
  41. Are all contaminated wounds infected?
  42. Are all infected wounds contaminated?
  43. Ways to determine type of infection:TDTTDH
    • time lapsed
    • degree of contamination
    • tissue damage
    • thoroughness of lavage
    • debriding
    • how much dead space