Vitamins
Types of Sutures
Wound Healing
Wound Management
Nonhealing Wounds
100

This vitamin is involved in hydroxylation of collagen

Vitamin C

100

Name the absorbable sutures

Vicryl, monocryl, chromic, PDS
100

First cell to arrive in inflammation

Neutrophils

100

Types of debridements

Sharp, mechanical, autolytic, enzymatic

100

Radiation affects which two cells in wound healing

Keratinocytes and fibroblasts

200
A deficiency in this mineral leads to poor epithelialization and acrodermatitis

Zinc

200

Name the non absorbable sutures

Ethibond, silk, nylon, Prolene

200

Role of macrophages in wound healing

phagocytosis of foreign debris, signal migration of fibroblasts during proliferation phase

200

Describe the difference between closure with primary, secondary, and tertiary intention

Primary intention where skin edges are approximated without debridement, secondary intention skin edges not approximated (open wounds), tertiary is delayed primary closure

200

Describe the stages of classifying a sacral decubitus ulcer

Stage 1: superficial, skin intact, nonblanching erythema

Stage 2: partial thickness injury, injury, loss of dermis, shallow ulceration w/ red/pink wound bed or intact bullae

Stage 3: full thickness skin loss, exposure of subcutaneous tissue layer

Stage 4: full thickness, exposed muscle, tendon, bone

Stage 5: unstageable ulcer due to eschar

300

A deficiency in this vitamin causes bleeding and petechiae

Vitamin K

300

Which wounds do you use staples for closure

Scalp and wounds greater than 5cm

300

Proliferative phase includes which two types of cells?

fibroblasts and myofibroblasts

300

What are the 4 phases of skin graft healing

Adherence, imbibition, inoculation, remodeling

300

What is the difference between hypertrophic scar and a keloid

Hypertrophic scar contains type 3 collagen laid within the boundary of the wound and spontaneously regresses

Keloid is where collagen lays excessively and grows beyond the boundary of the wound

400

Name the symptoms of pellagra and what vitamin it is associated with

4 D: dermatitis, diarrhea, dementia, death

Associated with Vitamin B3 or niacin

400

Name an example of when you use an absorbable suture

Dermal or buried sutures

400

Remodeling phase begins at ___weeks where collagen type ___ is replaced with type ___

3 weeks, 3, 1

400

Classes of surgical wounds and examples of each

Clean, clean-contaminated, contaminated, dirty

400

What are the factors that influence wound healing

Infection, nutrition, perfusion, steroids, radiation, DM, smoking

500

Which vitamin has an affect with chronic steroid use

Vitamin A reverses impaired wound healing that occurs with chronic steroid tx
500

Name an example of when you use non-absorbable sutures

Can be used anywhere. Usually when tension is needed

500

Collagen type __ is deposited into the matrix. Collagen is cross-linked through hydroxy____ and hydroxy____ (hint: amino acids)

3; lysine, proline

500

What is the difference between partial thickness, full thickness and split thickness skin grafts

Partial thickness relies on recipient site for nutrients, oxygenation and neovascularization

Full thickness- contain entire dermis, size of graft is smaller, harvested from areas with tissue laxity

Split thickness- have more secondary contracture, should be avoided where function and cosmetics are important

500

Describe the Gustilo Classification 

  • Type I: Wound measuring 1 cm or less, minimal contamination or muscle damage
  • Type II: Wound measuring 1 to 10 cm, moderate soft tissue injury
  • Type IIIA: Wound usually larger than 10 cm, high energy, extensive soft-tissue damage, contaminated adequate tissue for flap coverage injuries are automatically at least Gustilo IIIA 
  • Type IIIB: Extensive periosteal stripping, wound requires soft tissue coverage (rotational or free flap)
  • Type IIIC: Vascular injury requiring vascular repair, regardless of degree of soft tissue injury.