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WOUND HEALING.Dr Gunabhi Ram Das.pptx
1. Dr. GUNABHI RAM DAS
Associate Professor of Surgery
Assam Medical college and Hospital
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17. Include those in which no infection is present;
only skin microflora potentially contaminate
the wound and no hollow viscus that contains
microbes is entered.
Examples – Hernia repair, breast surgeries
Class I B wounds are similar except that a
prosthetic device ( e.g. mesh or valve ) is
inserted.
18. Include those in which hollow viscus such as
the respiratory, allimentary or genito urinary
tracts with indigenous bacterial flora is
opened under controlled circumstances,
without significant spillage of contents.
E.g. cholecystectomy, elective G I surgery
19. Include open accident wounds encountered
early after injury, those with extensive
introduction of bacteria into a normally sterile
area of the body due to major breaks in
sterile technique.
e.g. Penetrating abdominal trauma, large
tissue injury, enterotomy during bowel
surgery
20. Include traumatic wounds in which a
significant delay in treatment has occurred
and in which necrotic tissue is present.
E.g Perforated diverticulitis, Necrotizing soft
tissue infections
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60. Treatment options for
hypertrophic scars include:
● the application of
pressure garments or
topical silicone sheets;
● laser therapy;
● re-excision with linear
closure, which is most
useful in cases of excess
scar caused by infection or
dehiscence
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69. Examine the whole patient according to acute trauma life support
(ATLS) principles
Tetanus cover should be given.
A bleeding wound should be elevated and a pressure pad applied
Clamps should not be put on vessels blindly as nerve damage is
likely and vascular anastomosis is rendered impossible
adequate analgesia and/or anaesthesia (local, regional or general)
are required
After assessment, a thorough debridement is essential to the limit of
blood staining.
The use of copious saline irrigation or pulsed jet lavage can be less
destructive than knife or scissors when debriding.
Adequate antibiotics and analgesics
Regular dressings and debribement.
