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The Surgical Wound Cormac Joyce November 6 th  2008
Surgery ,[object Object],[object Object],[object Object],[object Object]
Surgery ,[object Object],[object Object],[object Object]
Surgery ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
Mask does not come with beard attached!!
Operating Theatre
Surgery ,[object Object],[object Object],[object Object],[object Object],[object Object]
Wound Infection
Wound Infection
Wound Dehiscence
Healthy Wound
Surgery ,[object Object],[object Object],[object Object]
Operation Types ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
Class I :Clean wounds ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
Class II: Clean - Contaminated ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
Class III: Contaminated ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
Class IV : Dirty ,[object Object],[object Object],[object Object],[object Object],[object Object]
Signs of Infection ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
? Wound infection
Signs of Infection ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
Prevention ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
Wound Healing ,[object Object],[object Object],[object Object],[object Object]
Wound Healing ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
Primary wound healing ,[object Object],[object Object],[object Object],[object Object],[object Object]
Primary wound healing
Primary Intention Keloid Scar
The importance of good… ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
Delayed Primary healing ,[object Object],[object Object],[object Object],[object Object],[object Object]
Delayed Primary healing
Delayed Primary healing
Secondary Healing ,[object Object],[object Object],[object Object],[object Object],[object Object]
Secondary Intention Healing Fungal sinusitis
Secondary Intention Healing Post Op
Secondary Intention Healing 2 weeks post op – healing by 2 ° intention
Epithelialization ,[object Object],[object Object],[object Object]
Epithelialization: Mechanisms ,[object Object],[object Object],[object Object]
Epithelialization: Mechanisms ,[object Object],[object Object],[object Object],[object Object]
Normal Wound Healing ,[object Object],[object Object],[object Object],[object Object]
Wound Healing ,[object Object],[object Object],[object Object],[object Object],[object Object]
Haemostasis ,[object Object],[object Object],[object Object],[object Object],[object Object]
Haemostasis ,[object Object],[object Object],[object Object]
Haemostasis ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
Haemostasis ,[object Object],[object Object],[object Object],[object Object]
Inflammatory Phase ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
Inflammatory Phase ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
Inflammatory Phase ,[object Object],[object Object],[object Object],[object Object],[object Object]
Inflammatory Phase ,[object Object],[object Object]
Macrophage functions in healing ,[object Object],[object Object],[object Object],[object Object],[object Object]
Proliferative Phase ,[object Object],[object Object],[object Object],[object Object]
Proliferative Phase ,[object Object],[object Object],[object Object],[object Object]
Proliferative Phase ,[object Object],[object Object]
Granulation Tissue ,[object Object],[object Object]
Granulation Tissue
Granulation Tissue
Granulation Tissue Occasionally overgranulation can occur (as above following a flexor tendon repair)  Treatment is steroid topical cream (1% hydrocortisone cream)
Proliferative Phase ,[object Object],[object Object],[object Object]
Remodelling Phase ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
Remodelling Phase ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
Microbiology: Dr. Lynda Fenelon
Wound Strength ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
Abnormal Scars ,[object Object],[object Object]
Hypertrophic Scars ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
Hypertrophic Scars
Hypertrophic Scars
Hypertrophic Scars ,[object Object],[object Object],[object Object]
Hypertrophic Scars ,[object Object],[object Object]
Keloid Scars ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
Keloid scar
Keloid scar
Keloid scar ,[object Object],[object Object],[object Object],[object Object],[object Object]
Factors influencing scarring ,[object Object],[object Object],[object Object]
Patient Factors ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
Patient Factors ,[object Object],[object Object],[object Object],[object Object]
Patient Factors ,[object Object],[object Object],[object Object],[object Object]
Patient Factors ,[object Object],[object Object],[object Object],[object Object]
Surgical factors ,[object Object],[object Object],[object Object],[object Object],[object Object]
Everted Edges
Inverted Edges
Surgical factors ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
Langers Lines
Langers Lines
Acute Inflammation ,[object Object],[object Object],[object Object],[object Object]
Acute Inflammation: Causes ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
Stages of Acute Inflammation ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
Stages of Acute Inflammation ,[object Object],[object Object],[object Object]
Complement Cascade ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
Complement Cascade ,[object Object],[object Object],[object Object]
Acute Inflammation: Neutrophils ,[object Object],[object Object],[object Object],[object Object],[object Object]
Acute Inflammation: Neutrophils ,[object Object],[object Object],[object Object]
Chemical messengers in AI ,[object Object]
Chemical messengers in AI ,[object Object],[object Object],[object Object],[object Object]
Cytokines: Examples ,[object Object],[object Object],[object Object],[object Object],[object Object]
Effects of AI: beneficial ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
Effects of AI: beneficial ,[object Object],[object Object]
Effects of AI: non beneficial ,[object Object],[object Object],[object Object],[object Object],[object Object]
Outcomes of Acute Inflammation ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
Ruptured Abscess
Chronic Inflammation ,[object Object],[object Object],[object Object],[object Object]
Chronic Inflammation ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
Chronic Inflammation ,[object Object],[object Object],[object Object],[object Object]
Chronic Inflammation ,[object Object],[object Object],[object Object],[object Object]
Chronic Inflammation ,[object Object],[object Object],[object Object],[object Object],[object Object]
Chronic Inflammation: Effects ,[object Object],[object Object],[object Object],[object Object]
Surgical Incisions
Surgical Incisions
Surgical Incisions
Surgical Incisions
Surgical Incisions
Surgical Incisions
Surgical Incisions
Surgical Incisions
Surgical Incisions
Surgical Incisions
Thank You

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