1. Wound healing occurs in three phases: the inflammatory phase (days 1-4), proliferative phase (days 4-42), and remodeling phase (from 3 weeks onward).
2. Clean wounds are closed primarily through direct approximation of tissue, while contaminated wounds may be closed primarily after debridement or left open to heal secondarily.
3. Proper wound management includes cleansing, debridement, careful closure, dressing, and follow up to monitor for infection. Factors like adequate blood supply, minimal tissue trauma, and control of infection are important for optimal healing.
Skin grafts and flaps are used to treat wounds and provide skin coverage. There are two types of non-vascular skin transfers - split-thickness and full-thickness skin grafts. Physical therapy aims to prevent complications after grafting like infection, contractures, and impaired healing. Treatment includes exercises, splinting and compression to promote mobility and graft adherence while avoiding shearing forces. Goals are wound healing, edema reduction, and regaining function.
1. Open fractures require prompt treatment including wound debridement, antibiotic prophylaxis, fracture stabilization, and early wound coverage to prevent infection.
2. Gustilo's classification system grades open fractures based on wound size, soft tissue damage, and contamination. Higher grades have higher risks of infection and amputation.
3. Proper treatment of open fractures includes thorough wound irrigation and debridement of all dead tissue, stabilization of the fracture, and temporary or permanent wound closure depending on the severity of soft tissue damage.
1. Cellulitis is a spreading bacterial skin infection of the dermis and subcutaneous tissues. It is commonly caused by Streptococcus pyogenes and other gram-positive bacteria.
2. Symptoms include fever, swelling, pain, tenderness, and redness of the infected area. It can progress rapidly and spread deeper without treatment.
3. Treatment involves oral antibiotics such as dicloxacillin or amoxicillin for mild cases. More severe infections require intravenous antibiotics in the hospital. Prevention focuses on good skin hygiene and wound care.
WOUND HEALING AND CARE. THIS IS WOUND HEALING NOTES.txSamoeiJK
This document summarizes the phases of wound healing and factors that affect it. It discusses the four phases of wound healing: coagulation, inflammation, proliferation, and maturation. The inflammation phase occurs from the time of wound formation up to 4-6 days and is characterized by the classical signs of inflammation. Proliferation occurs around the 7th day for 6 weeks and involves fibroblast, epithelial and endothelial proliferation and collagen synthesis. Maturation can extend for up to one year and involves equilibrium between protein synthesis and degradation. Local and systemic factors can affect wound healing, such as ischemia, infection, diabetes and malnutrition. The document also discusses different types of wound closure and healing.
this a basic presentation which I got inspired to do after seeing some presentations made on slideshare. It basically covers types of wounds,wound healing process,factors affecting wound healing and wound care.
The document provides information on different types of wound debridement. It defines debridement as the removal of foreign material and devitalized or contaminated tissue from a wounded area. Various debridement methods are described, including sharp, mechanical, enzymatic, and larval therapies. Factors to consider when selecting a debridement method are outlined in an algorithm, such as time required, patient pain tolerance, environment, and caregiver skill level. The overall conclusion is that debridement should be performed when needed according to the algorithm guidelines and contraindications.
This document discusses the management of non-healing wounds, which requires a multidisciplinary approach involving thorough assessment and wound bed preparation. It outlines the key factors in assessment including patient history, wound characteristics, and factors affecting healing. Wound bed preparation principles of debridement, control of inflammation and infection, and maintenance of moisture balance are explained. Various debridement methods and appropriate dressings to promote healing are also described.
Skin grafts and flaps are used to treat wounds and provide skin coverage. There are two types of non-vascular skin transfers - split-thickness and full-thickness skin grafts. Physical therapy aims to prevent complications after grafting like infection, contractures, and impaired healing. Treatment includes exercises, splinting and compression to promote mobility and graft adherence while avoiding shearing forces. Goals are wound healing, edema reduction, and regaining function.
1. Open fractures require prompt treatment including wound debridement, antibiotic prophylaxis, fracture stabilization, and early wound coverage to prevent infection.
2. Gustilo's classification system grades open fractures based on wound size, soft tissue damage, and contamination. Higher grades have higher risks of infection and amputation.
3. Proper treatment of open fractures includes thorough wound irrigation and debridement of all dead tissue, stabilization of the fracture, and temporary or permanent wound closure depending on the severity of soft tissue damage.
1. Cellulitis is a spreading bacterial skin infection of the dermis and subcutaneous tissues. It is commonly caused by Streptococcus pyogenes and other gram-positive bacteria.
2. Symptoms include fever, swelling, pain, tenderness, and redness of the infected area. It can progress rapidly and spread deeper without treatment.
3. Treatment involves oral antibiotics such as dicloxacillin or amoxicillin for mild cases. More severe infections require intravenous antibiotics in the hospital. Prevention focuses on good skin hygiene and wound care.
WOUND HEALING AND CARE. THIS IS WOUND HEALING NOTES.txSamoeiJK
This document summarizes the phases of wound healing and factors that affect it. It discusses the four phases of wound healing: coagulation, inflammation, proliferation, and maturation. The inflammation phase occurs from the time of wound formation up to 4-6 days and is characterized by the classical signs of inflammation. Proliferation occurs around the 7th day for 6 weeks and involves fibroblast, epithelial and endothelial proliferation and collagen synthesis. Maturation can extend for up to one year and involves equilibrium between protein synthesis and degradation. Local and systemic factors can affect wound healing, such as ischemia, infection, diabetes and malnutrition. The document also discusses different types of wound closure and healing.
this a basic presentation which I got inspired to do after seeing some presentations made on slideshare. It basically covers types of wounds,wound healing process,factors affecting wound healing and wound care.
The document provides information on different types of wound debridement. It defines debridement as the removal of foreign material and devitalized or contaminated tissue from a wounded area. Various debridement methods are described, including sharp, mechanical, enzymatic, and larval therapies. Factors to consider when selecting a debridement method are outlined in an algorithm, such as time required, patient pain tolerance, environment, and caregiver skill level. The overall conclusion is that debridement should be performed when needed according to the algorithm guidelines and contraindications.
This document discusses the management of non-healing wounds, which requires a multidisciplinary approach involving thorough assessment and wound bed preparation. It outlines the key factors in assessment including patient history, wound characteristics, and factors affecting healing. Wound bed preparation principles of debridement, control of inflammation and infection, and maintenance of moisture balance are explained. Various debridement methods and appropriate dressings to promote healing are also described.
This document discusses wound management. It defines a wound and outlines the specific objectives of understanding wound classification, types, healing process, and management. It describes the typical stages of wound healing as inflammatory, proliferative, and remodeling phases. Wounds are classified by factors like depth, contamination level, and amount of tissue loss. Primary intention healing involves closing tissue surfaces while secondary and tertiary intention involve tissue loss. Proper wound management includes assessment, debridement, irrigation, antibiotics, dressing and factors that can complicate healing.
The document defines a wound and outlines the phases of wound healing. It classifies wounds as open or closed and discusses factors like contamination. The phases of wound healing are described as traumatic inflammation, destructive/demolition, proliferation and maturation. Management of wounds includes debridement, asepsis and closure. Factors affecting healing and potential complications are also mentioned.
The document defines wounds and describes the phases and processes of wound healing. It classifies wounds as open or closed and discusses various types of open wounds like incised, lacerated, and penetrating wounds. It also outlines the cells and factors involved in wound healing, potential complications, and treatments for different wound types like surgical/aseptic wounds, contaminated wounds, and accidental traumatic wounds. Treatments include cleaning, debridement, drainage, antibiotics, and closure techniques. Abscesses and hematomas are also discussed.
The document defines wounds and describes the phases and processes of wound healing. It classifies wounds as open or closed and discusses various types of open wounds like incised, lacerated, and penetrating wounds. It also outlines the cells and factors involved in wound healing, potential complications, and treatments for different wound types like surgical/aseptic wounds, contaminated wounds, and accidental traumatic wounds. Treatments include cleaning, debridement, drainage, antibiotics, and closure techniques. Abscesses and hematomas are also discussed.
The document discusses wound healing principles and treatment. It begins by defining wounds and describing the different types, such as acute and chronic wounds. It then explains the four phases of normal wound healing: inflammation, proliferation, maturation, and remodeling. It discusses factors that can delay or prevent healing, leading to chronic wounds. The document also covers wound bed preparation principles like debridement and infection control. It provides details on various wound dressing types and their indications and contraindications.
This document provides an overview of wound management. It begins with objectives of defining wounds, classifying them, explaining wound healing and general management. It then covers wound classification including by origin, bacterial contamination and shape. The stages of wound healing - hemostasis, proliferation and remodeling - are outlined. Wound management techniques like irrigation, debridement, closure methods and dressings are described. Potential complications are also mentioned.
Wounds can be intentional from medical procedures or unintentional from accidents. There are four main types based on mechanism of injury: incised, contused, lacerated, and puncture wounds. Wound healing involves three phases: inflammatory, proliferative, and maturation. The inflammatory phase begins healing and the proliferation phase involves new tissue growth. Eventually the maturation phase strengthens the scar tissue. Proper wound management includes cleaning, antibiotics, tetanus shots, and dressings. Abnormal healing can involve excessive scarring like keloids or poor healing with dehiscence. Many factors can influence the healing process.
The document discusses wound healing and fracture healing. It defines wounds and their classification. The main stages of wound healing are inflammation, proliferation and maturation. Wounds can heal by primary or secondary intention. Fracture healing involves an initial inflammatory response, formation of a blood clot (hematoma) and callus, and later remodeling of the bone. Key cell types involved in healing include fibroblasts, endothelial cells and macrophages. Growth factors influence various phases of the healing process.
This document discusses wound care and healing over multiple pages. It covers the wound healing process, different types of wounds and wound healing, methods of hemostasis including chemical, mechanical, and thermal methods like diathermy. It also discusses factors that influence wound healing and choices of suture materials based on wound and patient characteristics. Proper hand hygiene for wound care is also emphasized.
This document discusses wound classification and management. It defines a wound and classifies wounds into different types such as abrasions, contusions, lacerations, gunshot wounds, and more. It also discusses wound healing processes and factors that affect healing. Treatment approaches are provided for surgical wounds, contaminated wounds, infected wounds and maggot wounds. Skin grafting is also summarized as a treatment approach for large wounds.
What are the steps for wound care?
2. Gather supplies and prepare a clean work area
3. Perform hand hygiene and don gloves
4. Inspect wound for signs of infection
5. Cleanse wound from center outward using NSS
6. Apply prescribed medication
7. Apply sterile dressing
8. Secure dressing in place
9. Dispose of supplies and perform hand hygiene
This document provides an overview of wound healing. It begins by defining different types of wounds, such as acute vs chronic wounds and open vs closed wounds. It then describes the four main stages of wound healing: hemostasis, inflammation, proliferation, and maturation. Factors that can affect wound healing are also outlined, such as smoking, stress, hypertension, infection, and necrosis. The document concludes by mentioning some topical agents that are used to manage wounds, such as antiseptic solutions and antibiotic solutions.
Wound healing and management of wound in surgeryuser177571
The document discusses wound healing and management of wounds. It begins by describing the anatomy of skin including the epidermis, dermis and subcutaneous tissue. It then discusses the functions of intact skin including protection, thermoregulation, fluid balance and vitamin D synthesis. It classifies wounds and describes healing by primary, secondary and tertiary intention. The phases of wound healing are described including inflammation, proliferation and maturation. Risk factors for surgical wound infection and appropriate antibiotic use are outlined. Fetal wound healing and pressure ulcer staging are also summarized. Hypertrophic scars and keloids are defined and their treatment discussed.
The document defines burns and classifies them into first, second, and third degree burns based on the depth of skin damage. It describes methods to estimate burn extent using the "rule of nine" and factors that determine burn severity such as depth, size, location, and patient history. Signs and symptoms are explained for each degree of burn. Emergency management of burns is outlined in 17 steps along with complications that can occur.
Department of oral & maxillofacial surgery (Wound healing )Kalam Khan
Wound healing is a complex process that involves inflammation, tissue formation, and remodeling to restore integrity. It can occur through primary, secondary, or tertiary intention. The stages are inflammation, proliferation, and maturation. Factors like infection, nutrition, and medication can affect healing. Complications include infection and scarring. Extraction wounds typically heal over 4 weeks as the blood clot is replaced by granulation tissue, new bone forms, and the socket epitheliases. Dry socket is a painful complication if the blood clot is disrupted. Care involves cleaning and medication to promote healing.
This document discusses wound classification, types of wound healing, and the wound healing process. It classifies wounds based on degree of contamination and causal agents/morphology. The types of wound healing include first, second, and third intention. The phases of wound healing are the lag/preparatory phase, repair/proliferative phase, and maturation phase. Key elements of wound healing include epithelialization, wound contraction, and connective tissue formation. Factors affecting wound healing and potential wound complications are also outlined.
Test bank clinical nursing skills a concept based approach 4e pearson educati...rightmanforbloodline
Test bank clinical nursing skills a concept based approach 4e pearson education
Test bank clinical nursing skills a concept based approach 4e pearson education
Test bank clinical nursing skills a concept based approach 4e pearson education
This document discusses wound management. It defines a wound and outlines the specific objectives of understanding wound classification, types, healing process, and management. It describes the typical stages of wound healing as inflammatory, proliferative, and remodeling phases. Wounds are classified by factors like depth, contamination level, and amount of tissue loss. Primary intention healing involves closing tissue surfaces while secondary and tertiary intention involve tissue loss. Proper wound management includes assessment, debridement, irrigation, antibiotics, dressing and factors that can complicate healing.
The document defines a wound and outlines the phases of wound healing. It classifies wounds as open or closed and discusses factors like contamination. The phases of wound healing are described as traumatic inflammation, destructive/demolition, proliferation and maturation. Management of wounds includes debridement, asepsis and closure. Factors affecting healing and potential complications are also mentioned.
The document defines wounds and describes the phases and processes of wound healing. It classifies wounds as open or closed and discusses various types of open wounds like incised, lacerated, and penetrating wounds. It also outlines the cells and factors involved in wound healing, potential complications, and treatments for different wound types like surgical/aseptic wounds, contaminated wounds, and accidental traumatic wounds. Treatments include cleaning, debridement, drainage, antibiotics, and closure techniques. Abscesses and hematomas are also discussed.
The document defines wounds and describes the phases and processes of wound healing. It classifies wounds as open or closed and discusses various types of open wounds like incised, lacerated, and penetrating wounds. It also outlines the cells and factors involved in wound healing, potential complications, and treatments for different wound types like surgical/aseptic wounds, contaminated wounds, and accidental traumatic wounds. Treatments include cleaning, debridement, drainage, antibiotics, and closure techniques. Abscesses and hematomas are also discussed.
The document discusses wound healing principles and treatment. It begins by defining wounds and describing the different types, such as acute and chronic wounds. It then explains the four phases of normal wound healing: inflammation, proliferation, maturation, and remodeling. It discusses factors that can delay or prevent healing, leading to chronic wounds. The document also covers wound bed preparation principles like debridement and infection control. It provides details on various wound dressing types and their indications and contraindications.
This document provides an overview of wound management. It begins with objectives of defining wounds, classifying them, explaining wound healing and general management. It then covers wound classification including by origin, bacterial contamination and shape. The stages of wound healing - hemostasis, proliferation and remodeling - are outlined. Wound management techniques like irrigation, debridement, closure methods and dressings are described. Potential complications are also mentioned.
Wounds can be intentional from medical procedures or unintentional from accidents. There are four main types based on mechanism of injury: incised, contused, lacerated, and puncture wounds. Wound healing involves three phases: inflammatory, proliferative, and maturation. The inflammatory phase begins healing and the proliferation phase involves new tissue growth. Eventually the maturation phase strengthens the scar tissue. Proper wound management includes cleaning, antibiotics, tetanus shots, and dressings. Abnormal healing can involve excessive scarring like keloids or poor healing with dehiscence. Many factors can influence the healing process.
The document discusses wound healing and fracture healing. It defines wounds and their classification. The main stages of wound healing are inflammation, proliferation and maturation. Wounds can heal by primary or secondary intention. Fracture healing involves an initial inflammatory response, formation of a blood clot (hematoma) and callus, and later remodeling of the bone. Key cell types involved in healing include fibroblasts, endothelial cells and macrophages. Growth factors influence various phases of the healing process.
This document discusses wound care and healing over multiple pages. It covers the wound healing process, different types of wounds and wound healing, methods of hemostasis including chemical, mechanical, and thermal methods like diathermy. It also discusses factors that influence wound healing and choices of suture materials based on wound and patient characteristics. Proper hand hygiene for wound care is also emphasized.
This document discusses wound classification and management. It defines a wound and classifies wounds into different types such as abrasions, contusions, lacerations, gunshot wounds, and more. It also discusses wound healing processes and factors that affect healing. Treatment approaches are provided for surgical wounds, contaminated wounds, infected wounds and maggot wounds. Skin grafting is also summarized as a treatment approach for large wounds.
What are the steps for wound care?
2. Gather supplies and prepare a clean work area
3. Perform hand hygiene and don gloves
4. Inspect wound for signs of infection
5. Cleanse wound from center outward using NSS
6. Apply prescribed medication
7. Apply sterile dressing
8. Secure dressing in place
9. Dispose of supplies and perform hand hygiene
This document provides an overview of wound healing. It begins by defining different types of wounds, such as acute vs chronic wounds and open vs closed wounds. It then describes the four main stages of wound healing: hemostasis, inflammation, proliferation, and maturation. Factors that can affect wound healing are also outlined, such as smoking, stress, hypertension, infection, and necrosis. The document concludes by mentioning some topical agents that are used to manage wounds, such as antiseptic solutions and antibiotic solutions.
Wound healing and management of wound in surgeryuser177571
The document discusses wound healing and management of wounds. It begins by describing the anatomy of skin including the epidermis, dermis and subcutaneous tissue. It then discusses the functions of intact skin including protection, thermoregulation, fluid balance and vitamin D synthesis. It classifies wounds and describes healing by primary, secondary and tertiary intention. The phases of wound healing are described including inflammation, proliferation and maturation. Risk factors for surgical wound infection and appropriate antibiotic use are outlined. Fetal wound healing and pressure ulcer staging are also summarized. Hypertrophic scars and keloids are defined and their treatment discussed.
The document defines burns and classifies them into first, second, and third degree burns based on the depth of skin damage. It describes methods to estimate burn extent using the "rule of nine" and factors that determine burn severity such as depth, size, location, and patient history. Signs and symptoms are explained for each degree of burn. Emergency management of burns is outlined in 17 steps along with complications that can occur.
Department of oral & maxillofacial surgery (Wound healing )Kalam Khan
Wound healing is a complex process that involves inflammation, tissue formation, and remodeling to restore integrity. It can occur through primary, secondary, or tertiary intention. The stages are inflammation, proliferation, and maturation. Factors like infection, nutrition, and medication can affect healing. Complications include infection and scarring. Extraction wounds typically heal over 4 weeks as the blood clot is replaced by granulation tissue, new bone forms, and the socket epitheliases. Dry socket is a painful complication if the blood clot is disrupted. Care involves cleaning and medication to promote healing.
This document discusses wound classification, types of wound healing, and the wound healing process. It classifies wounds based on degree of contamination and causal agents/morphology. The types of wound healing include first, second, and third intention. The phases of wound healing are the lag/preparatory phase, repair/proliferative phase, and maturation phase. Key elements of wound healing include epithelialization, wound contraction, and connective tissue formation. Factors affecting wound healing and potential wound complications are also outlined.
Test bank clinical nursing skills a concept based approach 4e pearson educati...rightmanforbloodline
Test bank clinical nursing skills a concept based approach 4e pearson education
Test bank clinical nursing skills a concept based approach 4e pearson education
Test bank clinical nursing skills a concept based approach 4e pearson education
At Malayali Kerala Spa Ajman, Full Service includes individualized care for every client. We specifically design each massage session for the individual needs of the client. Our therapists are always willing to adjust the treatments based on the client's instruction and feedback. This guarantees that every client receives the treatment they expect.
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If you are interested in experiencing transformative massage treatment at Malayali Kerala Spa Ajman, you can use our Ajman Massage Center WhatsApp Number to schedule your next massage session.
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Satisfying Spa Massage Experience at Just 99 AED - Malayali Kerala Spa AjmanMalayali Kerala Spa Ajman
Our Spa Massage Center Ajman prioritizes efficiency to ensure a satisfying massage experience for our clients at Malayali Kerala Spa Ajman. We offer a hassle-free appointment system, effective health issue identification, and precise massage techniques.
Our Spa in Ajman stands out for its effectiveness in enhancing wellness. Our therapists focus on treating the root cause of issues, providing tailored treatments for each client. We take pride in offering the most satisfying Pakistani Spa service, adjusting treatment plans based on client feedback.
For the most result-oriented Russian Spa treatment in Ajman, visit our Massage Center. Our Russian therapists are skilled in various techniques to address health concerns. Our body-to-body massage is efficient due to individualized care and high-grade massage oils.
Digital Health in India_Health Informatics Trained Manpower _DrDevTaneja_15.0...DrDevTaneja1
Digital India will need a big trained army of Health Informatics educated & trained manpower in India.
Presently, generalist IT manpower does most of the work in the healthcare industry in India. Academic Health Informatics education is not readily available at school & health university level or IT education institutions in India.
We look into the evolution of health informatics and its applications in the healthcare industry.
HIMMS TIGER resources are available to assist Health Informatics education.
Indian Health universities, IT Education institutions, and the healthcare industry must proactively collaborate to start health informatics courses on a big scale. An advocacy push from various stakeholders is also needed for this goal.
Health informatics has huge employment potential and provides a big business opportunity for the healthcare industry. A big pool of trained health informatics manpower can lead to product & service innovations on a global scale in India.
At Malayali Kerala Spa Ajman we providing the top quality massage services for our customers.
Our massage center prioritizes efficiency to ensure a quality massage experience for our clients at Malayali Kerala Spa Ajman. We offer a convenient appointment system and precise massage services.
Reach us at Villa No 7, Near Ammar Bin Yasir Street Al Rashidiya 2 - Ajman - United Arab Emirates.
Phone : +971 529818279
Malayali Kerala Spa in Ajman, one among the top rated massage centre in ajman, welcomes you to experience high quality massage services from massage staffs from all ove rthe world! Being the best spa massage service providers, we take pride in offering traditional massage services of different countries, like
Indian Massage, Kerala Massage, Thai Massage, Pakistani Massage, Russian Massage etc
If you are seeking relaxation, pain relief, or wellness experience, our ajman spa is here for your unique needs and concerns. The services of our experienced therapists, and personalized attention will ensure that each visit will be memorable for you.
Book your appointment today and let us take you to a world of serenity and self-care. Because you deserves the best.
Emotional and Behavioural Problems in Children - Counselling and Family Thera...PsychoTech Services
A proprietary approach developed by bringing together the best of learning theories from Psychology, design principles from the world of visualization, and pedagogical methods from over a decade of training experience, that enables you to: Learn better, faster!
The Importance of Black Women Understanding the Chemicals in Their Personal C...bkling
Certain chemicals, such as phthalates and parabens, can disrupt the body's hormones and have significant effects on health. According to data, hormone-related health issues such as uterine fibroids, infertility, early puberty and more aggressive forms of breast and endometrial cancers disproportionately affect Black women. Our guest speaker, Jasmine A. McDonald, PhD, an Assistant Professor in the Department of Epidemiology at Columbia University in New York City, discusses the scientific reasons why Black women should pay attention to specific chemicals in their personal care products, like hair care, and ways to minimize their exposure.
Dr. Sherman Lai, MD — Guelph's Dedicated Medical ProfessionalSherman Lai Guelph
Guelph native Dr. Sherman Lai, MD, is a committed medical practitioner renowned for his thorough medical knowledge and caring patient care. Dr. Lai guarantees that every patient receives the best possible medical care and assistance that is customized to meet their specific needs. She has years of experience and is dedicated to providing individualized health solutions.
The Ultimate Guide in Setting Up Market Research System in Health-TechGokul Rangarajan
How to effectively start market research in the health tech industry by defining objectives, crafting problem statements, selecting methods, identifying data collection sources, and setting clear timelines. This guide covers all the preliminary steps needed to lay a strong foundation for your research.
"Market Research it too text-booky, I am in the market for a decade, I am living research book" this is what the founder I met on the event claimed, few of my colleagues rolled their eyes. Its true that one cannot over look the real life experience, but one cannot out beat structured gold mine of market research.
Many 0 to 1 startup founders often overlook market research, but this critical step can make or break a venture, especially in health tech.
But Why do they skip it?
Limited resources—time, money, and manpower—are common culprits.
"In fact, a survey by CB Insights found that 42% of startups fail due to no market need, which is like building a spaceship to Mars only to realise you forgot the fuel."
Sudharsan Srinivasan
Operational Partner Pitchworks VC Studio
Overconfidence in their product’s success leads founders to assume it will naturally find its market, especially in health tech where patient needs, entire system issues and regulatory requirements are as complex as trying to perform brain surgery with a butter knife. Additionally, the pressure to launch quickly and the belief in their own intuition further contribute to this oversight. Yet, thorough market research in health tech could be the key to transforming a startup's vision into a life-saving reality, instead of a medical mishap waiting to happen.
Example of Market Research working
Innovaccer, founded by Abhinav Shashank in 2014, focuses on improving healthcare delivery through data-driven insights and interoperability solutions. Before launching their platform, Innovaccer conducted extensive market research to understand the challenges faced by healthcare organizations and the potential for innovation in healthcare IT.
Identifying Pain Points: Innovaccer surveyed healthcare providers to understand their difficulties with data integration, care coordination, and patient engagement. They found widespread frustration with siloed systems and inefficient workflows.
Competitive Analysis: Analyzed competitors offering similar solutions in healthcare analytics and interoperability. Identified gaps in comprehensive data aggregation, real-time analytics, and actionable insights.
Regulatory Compliance: Ensured their platform complied with HIPAA and other healthcare data privacy regulations. This compliance was crucial to gaining trust from healthcare providers wary of data security issues.
Customer Validation: Conducted pilot programs with several healthcare organizations to validate the platform's effectiveness in improving care outcomes and operational efficiency. Gathered feedback to refine features and user interface.
Solution manual for managerial accounting 18th edition by ray garrison eric n...rightmanforbloodline
Solution manual for managerial accounting 18th edition by ray garrison eric noreen and peter brewer_compressed
Solution manual for managerial accounting 18th edition by ray garrison eric noreen and peter brewer_compressed
1. CHAPTER 1
WOUNDS
A wound can be defined as a disruption of the normal anatomical
relationships of tissues as a result of injury. The injury may be
intentional such as a surgical incision or accidental following
trauma. Immediately following wounding, the healing process
begins.
I. STAGES OR PHASES OF WOUND HEALING
Regardless of type of wound healing, stages or phases are the
same except that the time required for each stage depends on
the type of healing.
A. Substrate phase (inflammatory, lag or exudative stage or
phase — days 1-4)
1. Symptoms and signs of inflammation
a. Redness, heat, swelling, pain, and loss of function
2. Physiology of inflammation
a. Leukocyte margination, sticking, emigration
through vessel walls
b. Venule dilation and lymphatic blockade
c. Neutrophil chemotaxis and phagocytosis
3. Removal of clot, debris, bacteria, and other
impediments of wound healing
4. Lasts finite length of time (approximately four days)
in primary intention healing
5. Continues until wound is closed (unspecified time) in
secondary and tertiary intention healing
B. Proliferative phase (collagen and fibroblastic stage or
phase — approximately days 4-42)
1. Synthesis of collagen tissue from fibroblasts
2. Increased rate of collagen synthesis for 42-60 days
3. Rapid gain of tensile strength in the wound (Fig. 1-1)
C. Remodeling phase (maturation stage or phase — from
approximately three weeks onward)
1. Maturation by intermolecular cross-linking of collagen
leads to flattening of scar
2. Requires approximately 9 months in an adult - longer
in children
3. Dynamic, ongoing
1
2. 4. Although contraction (the process of contracting) is
normal in wound healing, one must beware of
contracture (an end result — may be caused by
contraction of scar and is a pathological deformity)
5. Secondary healing beneficial in some wounds,
e.g. perineum, heavily contaminated wounds, scalp
C. Tertiary healing (by third intention) — delayed wound
closure after several days
1. Distinguishing feature of this type of healing is the
intentional interruption of healing begun as
secondary intention
2. Can occur any time after granulation tissue has
formed in wound
3. Delayed closure should be performed when wound is
not infected (usually 105
or fewer bacteria/gram of
tissue except with beta-STREP)
III. FACTORS INFLUENCING WOUND HEALING
A. Local factors most important because we can control
them
1. Tissue trauma — must be kept at a minimum
2. Hematoma — associated with higher infection rate
3. Blood supply
4. Temperature
5. Infection
6. Technique and suture materials — only important
when factors 1-5 have been controlled
B. General factors — cannot be readily controlled by
surgeon; systemic effects of steroids, nutrition,
chemotherapy, chronic illness, etc., contribute to wound
healing
IV. MANAGEMENT OF THE CLEAN WOUND
A. Goal — obtain a closed wound as soon as possible to
prevent infection, fibrosis and secondary deformity
B. General principles
1. Immunization — use American College of Surgeons
Committee on Trauma recommendation for tetanus
immunization
2. If necessary, use pre-anesthetic medication to reduce
anxiety
3
II. WOUND CLOSURE
A. Primary healing (by first intention) — wound closure by
direct approximation, pedicle flap or skin graft
1. Debridement and irrigation minimize inflammation
2. Dermis should be accurately approximated with
sutures (see chart at end of chapter) or skin glue (i.e.,
Dermabond)
3. Scar red, raised, pruritic, and angry-looking at peak of
collagen synthesis
4. Thinning, flattening and blanching of scar occurs
over approximately 9 months in adults, as collagen
maturation occurs (may take longer in children)
5. Final result of scar depends largely on how the
dermis was approximated
B. Spontaneous healing (by secondary intention) — wound
left open to heal spontaneously — maintained in
inflammatory phase until wound closed
1. Spontaneous wound closure depends on contraction
and epithelialization
2. Contraction results from centripetal force in wound
margin probably provided by myofibroblasts
3. Epithelialization proceeds from wound margins
towards center at 1 mm/day
2
Fig. 1-1
3. D. Wounds of face
1. Important to use careful technique
a. Urgency should not override judgement
b. There is a longer “period of grace” during which
the wound may be closed since blood supply to
face is excellent
c. Do not forget about other possible injuries
(chest, abdomen, extremities). Very rare for
patient to die from facial lacerations alone
2. Facial lacerations of secondary importance to airway
problems, hemorrhage or intracranial injury
3. Beware of overaggressive debridement of
questionably viable tissue
4. Isolate cavities from each other by suturing linings,
such as oral and nasal mucosa
5. Use anatomic landmarks to advantage, e.g. alignment
of vermilion border, nostril sill, eyebrow, helical rim
E. Wounds of the upper extremity (See Chapter 6)
F. Special Wounds
1. Amputation of parts
a. Attempt replacement if within six hours of
injury
b. Place amputated part in saline soaked gauze in a
plastic bag and the bag in ice
2. Cheek injury — examine for parotid duct and/or
facial nerve injury
3. Intraoral injuries — tongue, cheek, palate, and lip
wounds require suturing
4. Eyelids — align grey line and close in layers —
consider temporary tarrsoraphy
5. Ear injuries
a. Hematoma — incision and drainage of
hematoma and well-molded dressing to prevent
cauliflower ear deformity
b. Through-and-through laceration requires 3 layer
closure including cartilage
6. Animal bites — debridement, irrigation, antibiotics,
and possible wound closure. Be particularly careful
of cat bites which can infect with a very small
puncture wound
5
3. Local anesthesia — use Lidocaine with epinephrine
unless contraindicated, e.g. tip of penis
4. Tourniquet to provide bloodless field in extremities
5. Cleansing of surrounding skin — do NOT use strong
antiseptic in the wound itself
6. Debridement
a. Remove clot and debris, necrotic tissue
b. Copious irrigation good adjunct to sharp
debridement
7. Closure — use atraumatic technique to approximate
dermis. Consider undermining of wound edges to
relieve tension
8. Dressing — must provide absorption, protection,
immobilization, even compression, and be
aesthetically acceptable
C. Types of wounds and their treatment
1. Abrasion — cleanse to remove foreign material
a. Consider scrub brush or dermabrasion to
remove dirt buried in dermis to prevent
traumatic tattoos (permanent discoloration due
to buried dirt beneath new skin surface) —
needs to be accomplished within 24 hours of
injury
2. Contusion — consider need to evacuate hematoma if
collection is present
a. Early — minimize by cooling with ice (24-48
hours)
b. Later — warmth to speed absorption of blood
3. Laceration — trim wound edges if necessary (ragged,
contused) and suture
4. Avulsion
a. Partial (creates a flap) — revise and suture if
viable
b. Total — do not replace totally avulsed tissue
except as a skin graft after fat is removed
5. Puncture wound — evaluate underlying damage,
possibly explore wound for foreign body, etc. Animal
bites — debride and close primarily or leave open,
depending upon anatomic location, time since bite,
etc. Use antibiotics
4
4. 4. Topical antibacterial creams — silver sulfadiazine
(Silvadene®) and mafenide acetate (Sulfamylon®)
a. Continual surface contact
b. Good penetrating ability
c. Decrease bacterial counts of wounds
5. Biological dressings (allograft, xenograft, some
synthetic dressings) debride wound, decrease pain.
6. Final closure
a. With a delayed flap, skin graft or flap
b. Convert the chronic contaminated wound
bacteriologically to an acute clean wound by
decreasing the bacterial count (debridement)
VI. WOUND DRESSINGS
A. Protect the wound from trauma
B. Provide environment for healing
C. Antibacterial medications
1. Bacitracin® and Neosporin®
a. Provide moist environment conducive to
epithelialization
2. Silver sulfadiazine (Silvadene®) and mafenide acetate
(Sulfamylon®)
a. Useful for burns or other wounds with an eschar
b. Antibacterial activity penetrates eschar
D. Splinting and casting
1. For immobilization to promote healing
2. Do not splint too long — may promote joint stiffness
E. Pressure Dressings
1. May be useful to prevent “dead space” (potential
space in wound) or to prevent seroma/hematoma
2. Do not compress flaps tightly
F. Do not leave dressing on too long (<48 hours) before
changing
7
V. MANAGEMENT OF THE “CONTAMINATED” WOUND
A. Guidelines for management of contaminated acute
wounds
1. Majority of civilian traumatic wounds can be closed
primarily after adequate debridement
a. Adequate debridement
i. Mechanical/sharp
ii. Irrigation — copious pulsatile lavage
b. Exceptions (may opt to leave wound open)
i. Heavy bacterial inoculum (human bites)
ii. Long time lapse since wounding (relative)
iii. Crushed or ischemic tissue — severe
contused avulsion injury
iv. Sustained high-level steroid ingestion
2. Antibiotics — Systemic antibiotics are only of use if a
therapeutic tissue level can be reached within four
hours of wounding or debridement
3. Wound closure
a. Buried sutures should be used to keep wound
edge tension to a minimum; however, each
suture is a foreign body which increases the
chance of infection (use least number of sutures
possible to bring wound together without
tension)
b. Skin sutures of monofilament material are less
apt to become infected
c. Porous tape closure may be used for some
wounds
4. Follow up — contaminated traumatic wounds should
be checked for infection within 48 hours after
closure
5. If doubt exists, it is always safer to delay closure
(revision can be done later)
B. Guidelines for management of contaminated chronic
wounds
1. Examples — wounds greater than 24 hours old
a. Common ingredient — granulation tissue
2. Debridement as important as in an acute wound
a. Excision (scalpel, scissors)
b. Frequent dressing changes
c. Enzymatic — seldom indicated
3. Systemic antibiotics of little use
6
5. CHAPTER 1 — BIBLIOGRAPHY
WOUNDS
1. Alster, T.S., and West,T.B. Treatment of scars: a review. Ann
Plast Surg. 1997; 39:418-32.
2. Eppley, B.L. Alloplastic Implantation. Plast Reconstr Surg.
1999; 104:1761-83.
3. Hunt,T.K., et al. Physiology of wound healing. Adv Skin Wound
Care. 2000; 13 (suppl 6-11).
4. Klein, A.W. Collagen substitutes: bovine collagen. Clin Plast
Surg. 2001; 28:53-62.
5. Lawrence,W.T. Physiology of the acute wound. Clin Plast Surg.
1998; 25: 321-40.
6. Mast, B.A., Dieselmann, R.F., Krummel,T.M., and Cohen, I.K.
Scarless wound healing in the mammalian fetus. Surg. Gynecol.
Obstet. 1992; 174:441.
7. Nwomeh, B.C.,Yager, D.R., Cohen, K. Physiology of the chronic
wound. Clin Plast Surg. 1998; 25:3.
8. Saltz, R. and Zamora, S. Tissue adhesives and applications in
plastic and reconstructive surgery. Aesthetic Plast Surg. 1998;
22:439-43.
9. Stadleman,W.K., Digenis, A.G., and Tobin, G.R. Physiology and
healing dynamics if chronic cutaneous wounds. Am J Surg.
1998; 176:26S-38S.
10. Terino, E.O. Alloderm acellular dermal graft: applications in
aesthetic soft tissue augmentation. Clin Plast Surg. 2001; 28:83-
99.
11. Witte, M.B., and Barbul,A. General principles of wound healing.
Surg Clin North Am. 1997; 77:509-28.
9
8
ETHICON*
Synthetic
Absorbable
Sutures
SUTURE
&
COMPOSITION
COLOR
&
TYPE
BSR
ABSORPTION
RATE
FREQUENT
USES
MAIN
BENEFIT
Coated
VICRYL
RAPIDE*
(polyglactin
910)
suture
Undyed
Braided
50%
at
5
days
0%
at
10
to
14
days
Essentially
complete
by
42
days
Skin
and
Mucosa:
-
Episotomy
repair
-
Lacerations
under
casts
-
Mucosa
in
oral
cavity
-
Skin
repairs
where
rapid
absorption
may
be
beneficial,
excluding
joints
and
high
stress
areas
Patient
comfort
No
suture
removal
MONOCRYL*
(poliglecaprone
25)
suture
Coated
VICRYL
(polyglactin
910)
suture
PDS*
II
(polydioxanone)
suture
Undyed/Dyed
(violet)
Monofilament
Undyed/Dyed
(violet)
Braided
Undyed/Dyed
(violet)
Monofilament
Dyed:
60
to
70%
at
7
days
30
to
40%
at
14
days
Undyed:
50
to
60%
at
7
days
20
to
30%
at
14
days
75%
at
14
days
50%
at
21
days†
40%
at
21
days‡
70%
at
14
days
50%
at
28
days
25%
at
42
days
Essentially
complete
between
91
and
119
days
Essentially
complete
between
56
and
70
days
Essentially
complete
within
6
months
Soft
Tissue
Approximation:
-
Ligation
-
Skin
Repairs
-
Bowel
-
Peritoneum
-
Uterus
-
Vaginal
Cuff
Soft
Tissue
Approximation:
-
Ligation
-
General
Closure
-
Ophthalmic
Surgery
-
Orthopaedic
Surgery
-
Bowel
Soft
Tissue
Approximation:
-
Fascia
Closure
-
Orthopaedic
Surgery
-
Blood
Vessel
Anatomoses
-
Pediatric
Cardiovascular
and
Ophthalmic
procedures
-
Patients
with
compromised
wound
healing
conditions
Unprecedented
monofilament
pliability
Smooth
tissue
passage
Strength,
preferred
performance
and
handling
Knot
security
Longest
lasting
absorbable
monofilament
wound
support
Outstanding
pliability
*
Trademark
†
Sizes
6/0
and
larger
‡
Sizes
7/0
and
larger