Wound Healing
Terms
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- hard, knot-like structure under skin
- suture knot
- small, sore red area draining small amt of pus & seals over
- stitch abscess
- complete wound remodeling & maturation time frame
- 6 months
-
hypertrophic, raised scar, w/in limits of incision
next step? -
1.observe (until scar stable)
2.consider revision
3.steroid injections & local pressure dressings - hypertrophic scar, outside incision limits
- keloid
-
wound infection suspected
next step? -
1.drain infection
2.debridement
NO ABX!!! - most wound infections do/don't require abx
- DO NOT
- wound infections - abx indicated when...?
- cellulitis spreading despite drainage
-
after draining purulent material fr/wound w/viable edges...
next step? - apply daily moist gauze
- secondary healing
-
healing by leaving wound open
(bacteria removed instead of collecting) - factors delaying wound healing
-
1.poor nutrition
2.infection
3.poor physiological condition - important process for gaining wound strength
- collagen production
- collagen production - 1st detected...
-
w/in 10 hrs of wounding
(peaks 5-7 days) - 2ndary intention healing - myofibroblasts cause...
- wound contraction
- healing GFs
-
1.PDGF
2.TGF-B
3.FGF
4.EGF - wound classification
-
1.clean
2.clean-contaminated
3.contaminated -
ventral hernia repair + mesh
abx? - yes! perioperative abx
- prophylactic abx adminstration schedule
-
1 dose 1 hr pre-op,
1 dose post-op -
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next step? -
close wound (rich blood supply)
would leave open if not rich blood supply area - split-thickness graft
- layer of epidermis + part of dermis