Wounds can be | Clean, clean contaminated, contaminiated or dirty |
Aldehyde as disinfectant | Toxic with sensitivity reactions, rapid active agaisnt vegatative bacteria |
Alcohols | broad spec. inc. gram pos and neg antiviral not spores or funghi |
Diguanides e.g. chlorhex | Good agasint staph aureus gram positive and some gram negative non toxic and por activity agaisnt fungi |
Antiobiotic prophylaxis | used if surgery commmonly causes infection, if patient is susceptible, if is endogenous risk |
What collagen is most abundant normally and what is more abundant in scars | Type I most abundant type II in wounds |
What are keloids | Scars- may over scar beyond intial incision if excessive inflammation may be autosomal dominant repsonse more common in afro caribs |
How are hypertrophic scars treated | Pressure garments, topical silicone sheathing, re-excision |
Prevention of wound sepsis | Careful tissue handling, short duration, skin prep, antiobiotics, saline lavage, debridement of devitalised tissue, removal of foreign material |
What are langs lines | Areas of skin tension to be avoided to avoid unsightly scars |
Acheiving haemostasis- | TBD with haemologist, reversing acquired coagulopathy e.g. vitamin K, may consider permissive hypotension |
Locally achieving haemostasis- | Pressure, cautery, absorbable haemostatic agent e.g. surgery |
How does floseal work | Works low down coag cascade by helping convert fibrinogen to fibrin |
What is an absess | Infection wound- progresses as collection of pus with neutrophils and necrotic debris is within an actual or potential body cavity |