Term
| The correct sequence of events involved in the body’s defense mechanisms for a wound is as follows |
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Definition
Stop the blood loss (hemostasis)
Clean up pathogens/debris in the wound
Seal the would against infection
Regenerate the natural epidermal covering
Repair deeper tissue damage |
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Term
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Definition
Inflammation: Edema
Phagocytosis
Hemostasis
Proliferation: Epithlialization
Neovascularization
Collagen Synthesis
Contraction
Remodeling: Collagen Remodeling
Tensile Strength |
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Term
| Why is collagen production so important in wound healing? |
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Definition
| • Important phase that contributes to the tensile strength of the wound |
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Term
. Matching the types of healing
Primary Union (First Intention) |
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Definition
| Minimal tissue loss, wound margins approximated. |
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Term
Matching the types of healing:
Granulation or second intention – |
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Definition
| significant tissue loss. Wound left open and allowed to heal from the inner layer to the outer surface without additional surgery |
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Term
Matching the types of healing:
Delayed Primary closure (third intention) |
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Definition
| Wound kept open to monitor infection, gauze packing, closed on day 3-5. |
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Term
| What are the Preoperative systemic factors that negatively affect wound healing? |
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Definition
Inadequate Nutrition
• Protein deficiency
• Carb and fat deficiency
• Deficiency in Vitamin A, B, C and mineral zinc
Physical conditions
• Older age
• Medications such as sterioids
• Obesity
• Smoking
• Chronic diseases such as diabetes |
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Term
Classifications:
CLASS I CLEAN WOUNDS |
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Definition
• No inflammation encountered
• No breaks in sterile technique
• No hollow viscous entered
• Respiratory, alimentary, genital or infected urinary tracts are not entered
• Examples
• Thyroidectomy, mastectomy, ganglion excision, herniorrhaphy, laminectomy |
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Term
Classification:
Class II Clean contaminated |
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Definition
• Nontraumatic wounds
• No inflammation encountered
• No breaks in sterile techniques
• Hollow viscous entered
• Respiratory, alimentary, genital or urinary tracts entered under controlled conditions
• Examples
• Cholecystectomy, Hysterectomy abdominal or vaginal
• C-section, tracheostomy, appendectomy, cystoscopy |
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Term
Classification:
Class III CONTAMINATED WOUNDS |
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Definition
• Open fresh accidental wounds
• Major break in technique occurred
• Entrance into genitourinary or biliary tracts with infection
• Examples:
• Inflamed but unruptured appendix or gallbladder, open fractures or penetrating wounds.
• Procedures performed with unsterile instruments |
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Term
Classification:
Class IV DIRTY OR INFECTED WOUNDS |
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Definition
• Old Wounds with retained devitalized tissue
• Perforated viscera ( Perforated appendix)
• Chronic infected wounds
• Example
• Incision & drainage of an abscess |
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Term
Select the systemic factors that affect wound healing:
Age of the patient
Sex of the Patient
Preoperative Stress
Medications |
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Definition
Answers:
Preoperative Stress
Medications |
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Term
| Name 5 factors affecting healing that are controlled by the surgical team: |
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Definition
• Maintenance of sterile and aseptic techniques to prevent infection.
• Hemostasis
• Removal of necrotic tissue and foreign material
• Choice of closure material
• Closing with sufficient tension |
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Term
| Perioperative factors that affect wound healing |
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Definition
For Ex. many surgical patients are at risk for unplanned hypothermia in the relatively cool environments of the OR suite.
Hypothermia causes peripheral vasoconstriction, which can compromise wound healing. Periop RNs should implement measures that assist the patient in maintaining normothermia during operative procedures. |
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Term
| Other examples of periop factors that affect wound healing: |
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Definition
• adherence to appropriate skin preparation and sterile techniques
• duration of surgery
• amount of traffic in the OR |
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Term
Select the factors that are responsible for slower healing and postsurgical complications:
• Diabetes
• Rhinitis
• Obesity
• Ear wax |
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Definition
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Term
48. Based on what you have learned about the preoperative factors that affect wound healing. Identify the nutritional component that supports collagen formation and increases capillary formation:
• Vitamin A
• Vitamin B
• Vitamin C
• Zinc
• Protein |
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Definition
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Term
From the list of wound examples, list the wound type:
Colon resection |
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Definition
| Class II clean contaminated wounds |
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Term
From the list of wound examples, list the wound type:
Ruptured appendix |
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Definition
| Class IV Dirty or infected wounds |
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Term
From the list of wound examples, list the wound type:
Fresh surgical incision |
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Definition
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Term
From the list of wound examples, list the wound type:
open leg wound from a car accident |
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Definition
| Class III Contaminated wounds |
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Term
| Methods used to stop bleeding. Examples of hemostatic products include |
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Definition
Fibrin Sealants:
• These products promote blood clotting by increasing the amounts of fibrinogen and thrombin at a bleeding site. The fibrin in these products is derived from pooled or individual human plasma, equine or bovine collagen and bovine thrombin.
• Synthetic sealants are also available.
• Examples:
• Tisseel, Tachosil, Vitgel, Coseal, Duraseal, Progel, Bioglue, Omnex. |
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Term
| Methods used to stop bleeding. Examples of hemostatic products include: |
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Definition
Flowables
• These are combinations of passive and active hemostatic agents. They work by mechanically obstructing the flow of blood and converting fibrinogen into fibrin at the bleeding site. They do not contain fibrinogen and require direct contact with blood to make this conversion work.
• Examples:
• Floseal and Surgiflo. |
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Term
Methods used to stop bleeding.
Active Hemostatic Agents: |
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Definition
• These agents contain thrombin and products mixed with thrombin. They Enhance clotting at the bleeding site.
• Examples:
• Thrombin, topical, bovine origin
• Thrombin, topical, human
• Thrombin, topical recombinant |
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Term
Methods used to stop bleeding:
Passive or mechanical hemostatic agents |
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Definition
• These agents are applied at the bleeding site and provide a barrier to stop blood flow.
• Collagens: Avitene, Ultrafoam, Helistat, Helitene and Instat
• Cellulose: Surgical and Nu-Knit
• Gelatins: gelfoam and Surgifoam
• Polysaccharide spheres: Aristak, hemostase & Vitsuire |
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Term
Always clean open wounds with:
Sterile water
Iodine
Alcohol
Chlorhexidin gluconate |
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Definition
Answer: STERILE WATER
some antiseptic solutions are suitable for healthy unbroken skin but are too caustic for an open wound |
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Term
During which phase of wound healing does contraction occur?
Epithelialization
Inflammation
Proliferation
Remodeling |
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Definition
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Term
| Identify the proper sequence of events in the body’s defense mechanism: |
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Definition
Hemostasis
Cleaning up the pathogens
Wound sealing
Regeneration of epidermal covering
Repairing deeper tissue damage |
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Term
At what point in the healing process do most wound disruptions occur?
Beginning of Proliferative
End of Proliferative
Beginning of motivation phase
End of maturation phase |
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Definition
| Beginning of Proliferative |
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Term
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Definition
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Term
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Definition
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Term
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Definition
| Open or fresh traumatic wound |
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Term
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Definition
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Term
Prolonged high dosages of steroids preoperatively delay
Hemoglobin formation
Site production
Insulin production
Collagen formation |
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Definition
| Answer: COLLAGEN FORMATION |
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Term
| The CDC’s classification of surgical wounds system is intended to: |
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Definition
| Monitor postoperative infections and suggest steps to take to decrease these infections. |
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Term
Select the intraoperative factors that negatively affect wound healing:
Surgical complication
Failure to eliminate dead space when closing the incision
Implantation of orthopedic hardware
Surgical incisions in an area of high mobility. |
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Definition
Surgical complication
Failure to eliminate dead space when closing the incision
Implantation of orthopedic hardware
Surgical incisions in an area of high mobility. |
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Term
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Definition
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Term
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Definition
| Mechanically obstructs the flow of blood |
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Term
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Definition
| Increases amount of fibrinogen at site |
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Term
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Definition
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Term
Methods of producing hemostasis include the following:
Administering blood
Applying pressure
Electrocautery
Irrigating with large amounts of sterile saline
Use of antiseptic solution containing alcohol
Use of topical hemostatic agents |
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Definition
Administering blood
Applying pressure
Electrocautery
Use of topical hemostatic agents |
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Term
The process of digestion of pathogens by neutrophils and macrophages is known as
Epithelialization
Hemostasis
Oedema formation
Phagocytosis
Proliferation |
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Definition
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Term
Matching
Gastrointestinal surgery |
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Definition
| Gastrointestinal surgery - ostomy placement |
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