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Flashcards in Wound Healing and Management Deck (21)
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1
Q

What are the 7 stages of wound healing?

A

Vascular, inflammatory, Re-epithelialisation, Granulation and fibroplasia, wound contraction, neovascularisation, remodelling

2
Q

Describe stage one, the vascular stage

A

Vasoconstriction occurs to limit blood loss, vasodilation allows fibrinogen and WBCs to reach wound. Fibronectin forms a mesh in the wounds and platelets clot the blood.

3
Q

Describe the second stage, ‘inflammatory’

A

Two WBCS appear: Neutrophils attack debris and bacteria. Macrophages then engulf pathogens and release enzymes which digest blood clots/dead tissue

4
Q

Describe the third stage, ‘re-epithelialisation’

A

Epithelial cells begin migrating across fibronectin meshwork. They stop when the cells run into each other this is known as contact inhibition.

5
Q

Describe the fourth stage, ‘granulation and fibroplasia’

A

Granulation tissue begins 3/4 days after wound. Contains blood vessels and fibroblasts but NO NERVES. The fibroblasts secrete an enzyme called collagenase which clears away dead tissue.

6
Q

Describe the fifth stage, ‘wound contraction’

A

The fibroblasts can develop into myofibroblasts which can contract. Contraction seen 5-15 days later

7
Q

Describe the sixth stage, ‘neovascularisation’

A

Formation of a new blood supply occurs. Stimulated by hypoxia at the wounds centre. Once blood supply reaches centre carrying oxygen it leaves an avascular scar. This is called physiological angiogenesis

8
Q

Describe the seventh stage, ‘Matrix and collagen remodelling’

A

The type 111 collagen is replaced by type 1 collagen, where it undergoes tissue with greater tension, giving the new tissue strength.

9
Q

What factors affect wound healing?

A

Age, physical status, uraemia, malnutrition, drugs

10
Q

What is debridement?

A

Removal of dead tissue/foreign objects from a wound

11
Q

What factors increase the risk of wound breakdown?

A

Poor care of wound, infection, haematoma, poor surgical/suturing techniques.

12
Q

With wound care, what are the initial assessments ?

A

-Stop haemorrhage -Apple sterile non adherent dressing to prevent contamination/achieve haemostasis -Administer pain relief/antibiotics as prescribed by Vet -Cover wound with saline swabs

13
Q

What does lavaging the wounds consist of?

A

To flush away microscopic debris and reduce bacteria. Ideal solution is sterile isotonic lactated ringers or 0.9% saline. Lavage should be performed with 1L bag of fluids, 20ml syringe, 18G needle and 3 way tap.

14
Q

What’s the difference between surgical debridement and non surgical debridement?

A

Surgical: sharp dissection to remove dead, contaminated tissue while preserving normal tissue
Non Surgical: Wet to dry dressings, useful to remove contamination not removed by lavage.

15
Q

What is primary closure?

A

An appositional healing that is used in clean, fresh wounds under no tension. Suitable for new wounds (6-8hours old) which have minimal contamination/was lavaged.

16
Q

What are the functions of bandages?

A

Compression, immobilisation, protection, absorption

17
Q

What are the 3 layers of a bandage?

A

Inner layer, Padding/absorptive layer, Compressive/protective layer

18
Q

What’s the function of the inner layer?

A

Sits directly on skin to protect the wound or deliver medication to the area

19
Q

What’s the function of the absorptive/padding layer?

A

Holds inner layer in place, It protects, immobilises, and absorbs exudate

20
Q

What’s the function of the compressive/protective layer?

A

The middle layer is held on more tightly by a compressive and protective bandage like vet wrap

21
Q

What are some rules for bandaging?

A

Never leave more than the tips of toes out on limb bandages, check/change regularly, always attempt to apply padding layers for comfort