Wound Classification and Healing Concepts
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Questions and Answers

When is the wound classification recorded on the intra-operative record?

At the end of the procedure.

When reviewing a chart, the wound classification tells us the degree of microbial contamination that was present or occurred during the operation.

True

What is the definition of abrasion?

Scrape.

What is the definition of laceration?

<p>Cut or tear.</p> Signup and view all the answers

What is the definition of contusion?

<p>Bruise.</p> Signup and view all the answers

What is the definition of a chronic wound?

<p>Persists for an extended period.</p> Signup and view all the answers

What is the definition of a puncture?

<p>Penetrating wound.</p> Signup and view all the answers

What is the definition of a clean wound?

<p>Incision made, sutured, heals by first intention.</p> Signup and view all the answers

What is the definition of a complicated wound?

<p>Tissue is lost/destroyed or contains a foreign body.</p> Signup and view all the answers

What is the definition of a contaminated wound?

<p>Dirty object damages skin.</p> Signup and view all the answers

What is the definition of a thermal wound?

<p>Occurs by heat or cold.</p> Signup and view all the answers

What is the definition of a closed wound?

<p>Skin intact with damage to underlying tissue.</p> Signup and view all the answers

What is released from the damaged cells that causes an inflammatory response?

<p>Histamine.</p> Signup and view all the answers

Normal healing of wounds occurs from ____ across the wound, not from the inside out.

<p>Side to side.</p> Signup and view all the answers

Describe the 5 signs of the inflammatory process.

<p>Pain, heat, redness, swelling, loss of function.</p> Signup and view all the answers

What is the definition of Phase 1 in wound healing?

<p>Lag phase or inflammatory response phase approximately 3-5 days.</p> Signup and view all the answers

What is the definition of Phase 2 in wound healing?

<p>Proliferation phase. Continues for up to 20 days.</p> Signup and view all the answers

What is the definition of Phase 3 in wound healing?

<p>Maturation or differentiation phase begins on the 14th postoperative day and lasts up to 1 year.</p> Signup and view all the answers

How can age affect wound healing?

<p>Pediatric and geriatric patients may have decreased vascularity or poor muscle tone.</p> Signup and view all the answers

How can nutrition affect wound healing?

<p>Dietary deficiencies can alter the healing process.</p> Signup and view all the answers

How can disease affect wound healing?

<p>Metabolic disease, cardiovascular or respiratory insufficiency, malignancy, and infection all negatively impact wound healing.</p> Signup and view all the answers

How can radiation exposure affect wound healing?

<p>Patients undergoing radiation treatment in large doses may experience a decrease in blood supply to the irradiated tissue.</p> Signup and view all the answers

How can smoking affect wound healing?

<p>Causes vasoconstriction, diminishes O2 levels, can put stress on healing the wound.</p> Signup and view all the answers

How can an immunocompromised or immunosuppressed patient affect wound healing?

<p>The patient's immune system may be deficient due to congenital or acquired conditions.</p> Signup and view all the answers

What is the definition of adhesion?

<p>Abnormal attachment between surfaces.</p> Signup and view all the answers

What is the definition of dehiscence?

<p>Partial or total separation of layers.</p> Signup and view all the answers

What is the definition of evisceration?

<p>Exposure of viscera (organs).</p> Signup and view all the answers

What is the definition of fistula?

<p>Tract between two surfaces open at both ends.</p> Signup and view all the answers

What is the definition of hemorrhage?

<p>Excessive blood loss.</p> Signup and view all the answers

What is the definition of herniation?

<p>Results from wound dehiscence; found 2-3 months postoperatively.</p> Signup and view all the answers

What is the definition of infection?

<p>Microbial contamination occurs.</p> Signup and view all the answers

What is the definition of keloid?

<p>Hypertrophic scar formation.</p> Signup and view all the answers

What is the definition of sinus tract?

<p>Tract between two surfaces open at one end.</p> Signup and view all the answers

What is the definition of a suture complication?

<p>Splitting or suture material.</p> Signup and view all the answers

When does wound dehiscence most commonly occur? Describe 5 possible causes of wound dehiscence.

<p>Between the 5th and 10th postoperative day. Causes include abdominal distention, too much tension in the wound, inappropriate type of strength of suture material, or improper suturing technique.</p> Signup and view all the answers

Distinguish the difference between dehiscence and evisceration.

<p>Evisceration is the protrusion of the visceral through the edges of a totally separated wound. Dehiscence is the total or partial separation of a layer of tissue after closure.</p> Signup and view all the answers

Which abdominal incision is most likely to be a factor in the cause of dehiscence?

<p>Using special closing technique.</p> Signup and view all the answers

Study Notes

Wound Classification and Healing

  • Record wound classification at the end of the surgical procedure.
  • Wound classification indicates microbial contamination degree, affecting postoperative infection likelihood.

Types of Wounds

  • Abrasion: A scrape on the skin.
  • Laceration: A cut or tear in the skin.
  • Contusion: A bruise resulting from trauma.
  • Chronic wound: Persists over an extended timeframe.
  • Puncture: A penetrating wound that can introduce infection.
  • Clean wound: Sutured incision that heals by first intention.
  • Complicated wound: Tissue loss or presence of a foreign body.
  • Contaminated wound: Damage from a dirty object.
  • Thermal wound: Injury caused by extreme heat or cold.
  • Closed wound: Skin is intact, but underlying tissue is damaged.

Inflammatory Response and Healing Phases

  • Histamine release from damaged cells initiates the inflammatory response.
  • Normal wound healing progresses from side to side, not from the inside out.
  • Five signs of inflammation: pain, heat, redness, swelling, loss of function.
  • Phase 1: Lag phase (3-5 days) focuses on inflammatory response.
  • Phase 2: Proliferation phase lasts up to 20 days, involving tissue formation.
  • Phase 3: Maturation phase begins after 14 days and can last up to a year.

Factors Affecting Wound Healing

  • Age: Pediatric and geriatric patients may experience decreased vascularity and poor muscle tone, affecting healing.
  • Nutrition: Deficiencies in diet can hinder the healing process.
  • Disease: Conditions like metabolic disorders and malignancies adversely influence healing.
  • Radiation exposure: Can reduce blood supply to tissues in patients receiving large doses.
  • Smoking: Leads to vasoconstriction and lower oxygen levels, complicating healing.
  • Immune status: Immunocompromised patients may face heightened risk due to deficient immune systems.
  • Adhesion: Abnormal attachment between surfaces, potentially causing complications.
  • Dehiscence: Partial or total separation of tissue layers post-surgery.
  • Evisceration: Protrusion of internal organs through a completely separated wound.
  • Fistula: An abnormal connection between two body surfaces that open at both ends.
  • Hemorrhage: Loss of excessive blood surrounding a wound.
  • Herniation: A condition resulting from wound dehiscence, observed 2-3 months post-surgery.
  • Infection: Occurrence of microbial contamination at the wound site.
  • Keloid: Formation of hypertrophic scars after a wound heals.
  • Sinus tract: A passage between two surfaces that opens at one end.

Wound Dehiscence

  • Most common occurrence of wound dehiscence between postoperative days 5-10, particularly in debilitated patients.
  • Possible causes include abdominal distention, excessive tension on the wound, inappropriate suturing techniques, and unsuitable suture material.
  • Distinction: Dehiscence is the separation of tissue layers, whereas evisceration involves protrusion of viscera through the separated wound edges.

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Description

This quiz explores various types of wounds, their classifications, and the healing processes involved. Understanding the inflammatory response and healing phases is crucial for effective wound management. Test your knowledge on wound types and healing mechanisms essential for surgical procedures.

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