Chapter 14: Wounds

Question 1

Primary wound closure

Answer 1

Suture wound closed immediately (a.k.a. “first intention”)

Question 2

Secondary wound closure

Answer 2

• Wound is left open and heals over time without sutures (a.k.a. “secondary intention”)
• it heals by granulation, contraction, and epithelialization over weeks (leaves a larger scar)

Question 3

Delayed primary closure (DPC)

Answer 3

Suture wound closed 3 to 5 days AFTER incision (classically 5 days)

Question 4

How long a sutured wound epithelializes?

Answer 4

24 to 48 hours

Question 5

After a primary closure, when should the dressing be removed?

Answer 5

POD #2

Question 6

When can a patient take a shower after a primary closure?

Answer 6

Anytime after POD #2 (after wound epithelializes)

Question 7

What is a wet-to-dry dressing?

Answer 7

Damp (not wet) gauze dressing placed over a granulating wound and then allowed to dry to the wound; removal al_lows for “microdébridement” of the woun_d

Question 8

What inhibits wound healing?

Answer 8

• Infection
• ischemia
• diabetes mellitus
• malnutrition
• anemia
• steroids
• cancer
• radiation
• smoking

Question 9

What reverses the deleterious effects of steroids on wound healing?

Answer 9

Vitamin A

Question 10

What is an abdominal wound dehiscence?

Answer 10

• Opening of the fascial closure (not skin)
• treat by returning to the O.R. for immediate fascial reclosure

Question 11

What is Dakin solution?

Answer 11

Dilute sodium hypochlorite (bleach) used on contaminated wounds

Question 12

What is negative-pressure wound therapy (a.k.a. “wound vac”)?

Answer 12

Occlusive dressing with sponge and negative pressure system used to accelerate wound healing in acute and chronic wounds

Question 13

What are the components of an negative pressure wound therapy (NPWT) system?

Answer 13

1. Negative pressure unit
2. Occlusive dressing
3. Foam sponge

Question 14

What are the potential advantages of negative-pressure woundtherapy?

Answer 14

• Draws wound edges together
• removes exudates and infectious materials
• reduces edema
• promotes perfusion
• facilitates formation of granulationtissue