Upload
indah-lusiadi
View
14
Download
2
Tags:
Embed Size (px)
DESCRIPTION
Wound Basic and Diagnostic Kecil
Citation preview
Wound Basic And Diagnostic
DefinitionsGreek word tpavua'an injury or wound. Structural alteration and/or physiologic imbalance that results when energy is imparted or vital functions compromised during interaction with physical or chemical agents. Wide range of mechanisms of injuryOxford Textbook of Surgery (3-Volume Set) 2nd edition (January 15, 2000): by Peter J. Morris (Editor), William C. Wood (Editor) By Oxford Press
Classification by OnsetAcute woundRecent wound that has yet to progress through the sequential stages of wound healing. Chronic woundwound that is arrested in one of the wound-healing stages (usually the inflammatory stage) and cannot progress further. Usually defined as 30 days
Acute WoundsChronic Wounds
Mechanism of TraumaBluntMotor vehicle crash, Fall, Assault, CrushPenetratingStab, Gunshot, Laceration by Foreign bodiesPoisoningSolid, LiquidsDivingBurnsThermal, Electrical, RadiationBites and StingsOxford Textbook of Surgery (3-Volume Set) 2nd edition (January 15, 2000): by Peter J. Morris (Editor), William C. Wood (Editor) By Oxford Press
Crush Injury
Blunt trauma
Penetrating Wounds
Thermal Injury
Bites and Stings
Incised Wounds- Clean cut, sharp instrumentContused Wounds- Blunt force, bruising and swelling not breaking the skinLacerated Wounds- Tissues tearing jagged, irregular edgesPuncture Wounds- By pointed instruments ice pick, bullet, nailAvulsion Wounds- Strong shearing forces and friction significant tearing and tissue destructionBurn Woundsthermal, chemical, electrical
Wounds TypeWound and Skin Care Clinical Guidelines April 2007
Incised Wound
Contused Wounds
Lacerated Wounds
Avulsion Wounds
Puncture Wounds
Burn Wounds
Classification By Infection RateACS Surgery, Principles and Practice (2004)
ClassificationWound CharacteristicInfection Rate (%)Clean (Class I)Atraumatic, uninfected, no entry of GU, GI or respiratory tract (RT)1.5 5.1Clean Contaminated (Class II)Minor break in sterile technique, entry of GU, GI or RT without significant spillage7.7 10.8Contaminated (Class III)Traumatic Wounds, gross spillage into infected tissue, bone, urine or bile15.2 16.3Dirty (Class IV)Drainage of abscess, debridement of soft tissue infection28.0 40.0
Wound Healing Stage ClassificationEpithelialsing TissueTranslucent colour, small island of epithelial cells from hair follicels, sebaceous sweat glands.Granulating TissueGranular, slightly uneven, pinky red colourSloughy TissueYellow, dry / slimy, adherent to wound bedInfected TissueInflamation, pus, odor, pain, exudate, darkNecrotic TissueBlack leather, hard skin, depth unknownMalignant (Fungating) TissueRaised malignant tissue, bleeds, odor to bacterial colonisisation
Epithelialising TissueTranslucent coloursmall island of epithelial cells from hair follicels, sebaceous sweat glands.
Granulating WoundGranular, slightly uneven, pinky red colour
Sloughy TissueYellow, dry / slimy, adherent to wound bed
Infected TissueInflamation, pus, odor, pain, exudate, dark
Necrotic TissueBlack leather, hard skin, depth unknown
Malignant Tissue
The wound characteristics (size, depth, infection, necrotic tissue component, edema, drainage) are documented, and local wound care is initiated
Consult to the consultantopen fractures of long bonesnerve or vascular injuriesexor tendon disruptionsjoint capsule disruptionsrepair of specialized structures, such as the parotid or lacrimal ductreplacement of skin loss by a ap or graftextensive debridement