Wound Care and Types Quiz

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Questions and Answers

What type of wound results from planned surgical treatment?

  • Traumatic wound
  • Intentional wound (correct)
  • Unintentional wound
  • Chronic wound

Which term refers to wounds that do not progress through normal stages of healing?

  • Chronic wounds (correct)
  • Acute wounds
  • Superficial wounds
  • Intentional wounds

What characterizes an acute wound?

  • Heals slowly without intervention
  • Goes through the normal healing process (correct)
  • Has an intact epithelial cover
  • Is caused by unintentional trauma

Which of the following is a characteristic of an open wound?

<p>Caused by a sharp instrument (B)</p> Signup and view all the answers

What type of injury does an abrasion represent?

<p>Superficial injury (A)</p> Signup and view all the answers

Which of the following describes a closed wound?

<p>Has an intact epithelial cover (B)</p> Signup and view all the answers

What is a common cause of unintentional wounds?

<p>Burns from hot surfaces (D)</p> Signup and view all the answers

How does an abrasion typically heal?

<p>Through epithelialization (B)</p> Signup and view all the answers

What is the primary definition of a wound?

<p>Disruption of the continuity of the skin, mucous membrane, or soft tissue. (C)</p> Signup and view all the answers

Which type of wound is characterized by being caused by sharp instruments during surgical procedures?

<p>Open penetrating wound (A)</p> Signup and view all the answers

Which of the following is NOT a cause of wounds as mentioned?

<p>Chronic disease (D)</p> Signup and view all the answers

What type of wounds can result from accidents like gunshots or stabbings?

<p>Open, penetrating wounds (A)</p> Signup and view all the answers

Which of the following does NOT represent a type of mechanical wound?

<p>Chemical burn (C)</p> Signup and view all the answers

What is one example of a closed wound?

<p>A bruise from a fall (C)</p> Signup and view all the answers

Which type of wound is characterized by skin or mucous membrane necrosis?

<p>Chemical wounds (B)</p> Signup and view all the answers

What are the characteristics of surgical trauma wounds compared to accidental wounds?

<p>They are cleanly cut and orderly. (D)</p> Signup and view all the answers

What is a critical feature of an ideal suture material?

<p>It should have high tensile strength. (A)</p> Signup and view all the answers

Which of the following statements about contaminated wounds is correct?

<p>Skin closure is not recommended. (B)</p> Signup and view all the answers

What are the components of wound healing?

<p>Wound contraction and granulation tissue formation. (C)</p> Signup and view all the answers

During the early phase of wound healing, which process is primarily focused on establishing hemostasis?

<p>Coagulation and platelet plug formation. (B)</p> Signup and view all the answers

What is true about the phases of wound healing?

<p>They overlap with one another. (A)</p> Signup and view all the answers

Which type of suture material is considered superior when managing infection risk?

<p>Monofilament sutures. (D)</p> Signup and view all the answers

What is the primary aim of the hemostasis and inflammatory phase of wound healing?

<p>To establish hemostasis and mobilize the immune system. (B)</p> Signup and view all the answers

Which of the following accurately describes the vascular response in the early phase of wound healing?

<p>Vasoconstriction is a primary response. (B)</p> Signup and view all the answers

What is the primary role of fibroblasts during wound healing?

<p>Producing collagen and ground substance (A)</p> Signup and view all the answers

What color characterizes healthy granulation tissue?

<p>Beery red (A)</p> Signup and view all the answers

Which factor acts as a co-enzyme in the maturation of collagen fibers?

<p>Vitamin C (B)</p> Signup and view all the answers

During which phase of wound healing does collagen synthesis primarily occur?

<p>Intermediate phase: proliferation (D)</p> Signup and view all the answers

What happens to the capillaries during the late phase of wound healing?

<p>They regress (D)</p> Signup and view all the answers

Which process occurs first during epithelization?

<p>Cellular detachment (B)</p> Signup and view all the answers

What type of collagen is primarily produced in the early phases of wound healing?

<p>Type III (C)</p> Signup and view all the answers

What characteristic indicates unhealthy granulation tissue?

<p>Edematous and hemorrhagic (A)</p> Signup and view all the answers

What is the primary function of the platelet/fibrin plug in wound healing?

<p>To seal blood vessels and provide scaffolding for healing (A)</p> Signup and view all the answers

Which cells are predominantly involved during the first 24 hours of acute cellular inflammation?

<p>Neutrophils (B)</p> Signup and view all the answers

Which of the following substances are released to increase vascular permeability during the inflammatory response?

<p>Histamine from mast cells (C)</p> Signup and view all the answers

What is the main role of monocytes/macrophages after 2-5 days post-injury?

<p>To phagocytose necrotic debris and release cytokines (A)</p> Signup and view all the answers

What are the key nutrients needed for collagen synthesis during the intermediate phase of wound healing?

<p>Vitamin C, iron, zinc, magnesium, and protein (B)</p> Signup and view all the answers

When does the process of epithelialization begin after an injury?

<p>Within hours of the injury (D)</p> Signup and view all the answers

What is a potential consequence of the neutrophil's activity during the inflammatory response?

<p>Destruction of viable local tissue (A)</p> Signup and view all the answers

Which of these phases follows immediately after the inflammatory response in the wound healing process?

<p>Proliferative phase (B)</p> Signup and view all the answers

What is the expected tensile strength of a wound site after 1 year of healing?

<p>80-90% of pre-injury strength (A)</p> Signup and view all the answers

Which vitamin deficiency is specifically noted to cause failure of collagen maturation?

<p>Vitamin C (D)</p> Signup and view all the answers

What factor is NOT directly mentioned as affecting wound healing?

<p>Hydration levels (A)</p> Signup and view all the answers

What is the significance of hydroxylation of lysine and praline in collagen?

<p>It is essential for cross-linking. (A)</p> Signup and view all the answers

What change occurs to scar tissue as it matures?

<p>It becomes softer and flatter. (B)</p> Signup and view all the answers

Which class of medication is known to inhibit macrophages and interfere with wound healing processes?

<p>Steroids (C)</p> Signup and view all the answers

Which of the following conditions is noted to delay wound healing?

<p>Diabetes (C)</p> Signup and view all the answers

What does a good blood supply in a wound site promote?

<p>Faster healing (B)</p> Signup and view all the answers

Flashcards

Wound

An injury that breaks the skin or mucous membrane, caused by a mechanical, chemical or biological force.

Abrasion

A wound caused by friction or scraping against a rough surface, leaving the skin superficial and abraded.

Cut Wound

A wound caused by a sharp object, resulting in a clean, incised cut.

Stab Wound

A wound caused by a pointed object, such as a blade or a needle, penetrating the skin deeply.

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Shot Wound

A wound caused by a gunshot, resulting in a penetrating injury with potential for significant tissue damage.

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Chemical Wound

A wound caused by exposure to chemicals, leading to tissue damage and necrosis.

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Burns

A wound caused by heat or cold, resulting in tissue damage and necrosis.

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Electricity Wound

A wound caused by the passage of electrical current through the body, leading to tissue damage and potential burns.

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Intentional Wounds

Wounds caused by planned medical procedures like surgery.

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Unintentional Wounds

Wounds caused by unexpected events like accidents, burns, or shootings.

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Superficial Wounds

Wounds affecting only the superficial layers of the skin.

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Deep Wounds

Wounds that extend deeper into the tissues, potentially reaching muscle, tendons, or bones.

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Acute Wounds

Wounds that go through the normal healing process in a timely manner.

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Chronic Wounds

Wounds that fail to heal normally and may take a long time to close.

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Open Wounds

Wounds that involve a break in the skin, revealing underlying tissues.

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Closed Wounds

Wounds where the skin remains intact, but underlying tissues may be damaged.

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Ideal Suture Material

The ideal suture material should be strong enough for the site, flexible enough for knotting and secure enough to be tied. It should also minimize tissue reaction and resist infection.

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Wound Healing

Wound healing is the body's natural process of repairing and regenerating damaged tissue to restore its form and function.

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Early Phase of Wound Healing

The initial response to injury, lasting about 3-5 days, focusing on stopping bleeding and activating the immune system for healing.

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Coagulation & Platelet Plug Formation

A process involving blood vessel constriction, activation of the clotting cascade to produce thrombin, and platelet aggregation to form a clot at the site of injury.

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Components of Wound Healing

Wound contraction, granulation tissue formation, and epithelialization are the essential components of wound healing.

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Stages of Wound Healing

The stages of wound healing, including the early phase, proliferative phase, and remodeling phase, overlap and occur simultaneously.

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Proliferative Phase of Wound Healing

The proliferative phase of wound healing involves cell division and growth, leading to the formation of new tissue.

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Remodeling Phase of Wound Healing

The remodeling phase of wound healing involves the reorganization of the newly formed tissue, resulting in a scar and increased strength.

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Platelet Activation

The process where platelets become sticky and activate other platelets, necessary for forming a clot.

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Platelet/Fibrin Plug

Small blood vessels are sealed and a framework for healing is formed by a net of fibrin and platelets.

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Acute Cellular Inflammation

The initial stage of inflammation that involves redness, heat, pain, and swelling. It is caused by vasodilation and increased vascular permeability.

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Neutrophils

A type of white blood cell that arrives first at the site of injury, cleaning up debris and bacteria.

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Monocytes/Macrophages

A type of white blood cell that arrives later and helps clean up the wound and stimulates healing process.

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Proliferative Phase

The stage of wound healing where new tissue is formed and the wound is strengthened.

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Epithelialization

The process of epithelial cells covering the wound surface, protecting it from bacteria and fluid loss.

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Nutrients for Collagen Synthesis

Important nutrients for collagen synthesis, which is the primary building block of new tissue.

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What layer is fragile and needs moisture to grow?

A layer that needs a moist environment to thrive and is easily damaged by harsh cleaning.

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Wound healing in elderly

Old patients have slower wound healing due to reduced protein turnover.

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What type of wound heals quickly with minimal cell migration?

Incisional wounds with a very small gap where cells migrate less than 1mm. The wound seals quickly within 24-48 hours.

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How smoking affects wound healing

Nicotine causes vasoconstriction, reducing blood flow to the wound. Carbon monoxide binds to hemoglobin, reducing oxygen delivery. Both impair healing.

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What happens to cells in the first 24 hours of wound healing?

The process where cells detach from the basement membrane during the first 24 hours of wound healing.

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How malnutrition impacts wound healing

Lack of protein reduces collagen and ground substance production. Vitamin C is vital for collagen maturation. Vitamin A is needed for epithelialization.

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Impact of steroids on wound healing

Steroids suppress immune cells and interfere with collagen formation, angiogenesis, and wound contraction. They delay wound healing.

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When does cell proliferation begin in wound healing?

The proliferation of cells starts 48-72 hours after PMNs and macrophage differentiation in wound healing.

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How do cells move and stop during wound healing?

Cells migrate until they meet cells from the opposite direction, then stop due to contact inhibition during wound healing.

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Debilitating diseases and wound healing

Conditions like diabetes, kidney failure, liver disease, and infections can all impair the body's ability to heal properly.

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How vascularity affects wound healing

A good blood supply in areas like the face or scalp leads to faster healing compared to areas with poor blood flow, like wounds below the knee.

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What is the process of forming new blood vessels called?

The formation of new blood vessels that are crucial for wound healing.

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Describe healthy granulation tissue.

Healthy granulation tissue is a vibrant red color with a granular texture and no offensive discharge. It is sensitive and bleeds easily on touch.

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Influence of wound type and environment

Tidy wounds heal faster than untidy ones, and moist environments are better than dry ones for healing.

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Describe unhealthy granulation tissue.

Unhealthy granulation tissue is less vascular, swollen, bleeds easily, and may have sloughs.

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Role of oxygen in wound healing

Oxygen is essential for collagen synthesis and extracellular matrix formation. It also prevents infections.

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Study Notes

General Surgery Department

  • Located at Damietta University, Faculty of Medicine.

Wounds

  • Definition: Disruption of the continuity of skin, mucous membrane or soft tissue caused by physical, chemical, or biological insult.

  • Causes:

    • Mechanical: Abrasions, cuts, stab wounds, insect bites, or gunshot wounds
    • Chemical: Burns, frostbite
    • Electrical: Electrical injury
  • Classification:

    • Closed (blunt): e.g. motor vehicle accidents, falls
    • Open (penetrating):
      • Accidental: gunshot, cuts, stab wounds, bites.
      • Surgical: caused by sharp instruments.
  • Intention:

    • Intentional: planned treatment
    • Unintentional: traumatic/accidental
  • Severity

    • Superficial
    • Deep
  • Onset:

    • Acute: normal/timely healing
    • Chronic: fails to go through the normal stages of healing, no timely progress in healing
  • Types of Open Wounds

    • Abrasions: Scraping away superficial layers of skin
    • Penetrating wounds: Pressure by sharp objects (e.g., nail, needle).
    • Incised wounds: A neat cut wound (e.g., surgical scalpel)
    • Lacerations: Severe violence with blunt objects (e.g., road traffic accident)
    • Stab wounds: Caused by sharp, flat objects (e.g., knife)
    • Bites: Caused by animal or human teeth
    • Stings: Caused by insects, spiders, or scorpions
    • Cut wounds: Caused by sharp objects with minimal blunt force
  • Types of Closed Wounds

    • Crushed wounds: Extreme pressure smashing skin and underlying tissue
    • Contusions (bruises): Intradermal bleeding from minor capillaries with interstitial tracking.
  • Important characteristics of lacerated wounds: Severely traumatized, devascularized, irregular in shape, usually contaminated, risk of high infection

Wound Healing

  • Definition: Physiological process where the body repairs damaged tissue to restore form and function.
  • Components: Wound contraction, granulation tissue formation, epithelialization
  • Hemostasis & Coagulation: Blood clot formation
  • Inflammation: Characterized by redness, heat, pain, and swelling
  • Proliferative Phase: Cellular proliferation, cellular migration, angiogenesis (formation of new blood vessels). Synthesis of collagen
  • Remodeling Phase: Capillary regression. Collagen synthesis. scar formation.

Wound Complications

  • Wound Failure (Dehiscence): Wound gaps after closure.
  • Stretching of the scar: In wounds with delayed healing due to infection.
  • Hypertrophied scar: More cellular, vascular scar.
  • Keloid formation: Extreme overgrowth of scar tissue beyond the original wound.
  • Contracture: Scar tissue shortening, resulting in joint deformity.
  • Surgical Site Infection: Infection at the site of the surgery.
  • Injury and ischemia (reduced blood supply in tissues), lymphedema/hematoma/seroma (fluid buildup and abnormal accumulation of blood): Post surgical complications.

Wound Management

  • General: Follow ATLS protocol, wound assessment, tetanus prophylaxis.
  • In the Theatre:
    • Wound cleansing
    • Wound debridement
    • Ligature/electrocautery for bleeding points
    • Proper wound dressing (e.g., non-allergic, allow gas exchange)
  • Sutures:
    • Primary sutures: applied at the time of injury
    • Delayed primary sutures: applied 5-7 days later to doubtful wounds
    • Secondary sutures: applied to clean wounds after granulation.
  • Reconstruction: replacing lost skin or tissues.
  • Additional Management of Keloids/Hypertrophic Scars: pharmacologic therapy, pressure, lasers, radiation therapy, compression garments, surgical excision

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