The document discusses wounds and wound infections. It defines a wound as a disruption of the skin or mucous membranes with possible underlying tissue damage. Wounds are classified based on their cause, character, presence of infection, relation to bodily cavities, and presence of complications. The stages of wound healing are inflammatory, proliferative, remodeling, and epithelialization. Factors that can affect wound healing include age, nutrition, disease states, medications, and local wound characteristics. Treatment involves first aid, debridement, closure, and management of infected wounds.

1. Wound and wound
infection
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2.  Wound – is injury with disruption of
skin or mucous membranes and
possible underlying tissues injuries
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3. Classification of wounds
 1. Depending on the cause
 - surgical (aseptic)
 - accidental (casual)
 - battle (wartime)
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4.  2. According to the character:
 - incised (knife, blade)
 - stab (bayonet, awl)
 - chopped (axe, sabre)
 - contused (blunt tools)
 - crushed (blunt tools)
 - lacerated (traction with sharp retractor)
 - bite (animals, human)
 gunshot (wound canal, primary traumatic
necrosis, concussion area)
 - poisoned (spiders, snakes)
 combined
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5.  3. Depending on the presence of infection:
 - aseptic
 - infected
 - purulent
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6.  4. In relation to the bodily cavities:
 - penetrating
 - non-penetrating
 5. Depending on the presence of
complications:
 - non-complicated
 - complicated
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7. Clinical manifestation
 Pain
 Bleeding
 Gaping
 Dysfunctions
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8. Complications of wounds
 Bleeding with hemorrhagic shock
 Injury of vital organs
 Infection
 Longterm consequences (contractures,
organs insufficiency etc)
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9. Healing of the wound:
 by primary intention
 by secondary intention
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10. Wound healing phases:
 Inflammatory phase
 Proliferative phase
 Remodeling phase
 Epithelialization
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11. Inflammatory phase
 In the inflammatory phase, bacteria and are
debris are phagocytosed and removed, and
factors are released that cause the
migration and division of cells involved in the
proliferative phase.
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12. Basic signs of inflammation
 Redness (rubor)
 Swelling (tumor)
 Pain (dolor)
 Increase in local temperature (calor)
 Functions disorder
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13. Proliferative phase
 The proliferative phase is characterized by
angiogenesis, collagen deposition,
granulation tissue formation,
epithelialization, and wound contraction.
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14. Remodeling phase
 In the maturation and remodeling phase,
collagen is remodeled and realigned along
tension lines and cells that are no longer
needed are removed by apoptosis.
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15. Epithelialization
 In epithelialization phase, epithelial
cells migrate across the tissue to form
a barrier between the wound and the
environment.
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16. Factors affecting wound healing
 A. General factors:
– age
– debilitation results in malnutrition
– diabetic patients
– jaundice, uremia
– cytotoxic drugs and malignancy
– generalized infection
– Corticosteroides
 B. Local factors:
– poor blood supply
– local infection
– haematoma
– faulty technique of wound closure
– tension while suturing
– oxygen
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17. First aid
 Haemostasis (temporary or definitive)
 Cleaning of surrounding skin with an
antiseptic solution
 Application of aseptic dressing on the
wound
 Transport immobilization
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18. Primary surgical wound debridement
 Early (within 24 hours)
 Delayed (within 24-48 hours)
 Late (more than 48 hours after injury)
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19. Primary surgical wound debridement
 Main purpose – prophylaxis of wound
infection development
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20. Primary surgical wound debridement
involves:
 Excision of wound edges, bases and walls
up to the intact tissues
 Removing all non-vital tissues, foreign
bodies, clots of blood
 Repair of blood vessels, nerves, muscles
 Suturing the wound
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21. Wound closure
or wound suturing:
 Primary suturing
 Wound excision and primary suturing of skin
 Wound excision and delayed primary suture
 Secondary suturing
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22. Secondary surgical wound
debridement:
 Main purpose – surgical treatment of
purulent wound
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23. Secondary surgical wound
debridement involves:
 Wide long incisions
 Opening all pockets in wound and combined
in one cavity
 Excision all necrotic tissues
 Insertion of drainage tubes, washing
systems for permanent cleaning the wound
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24. Treatment of purulent wounds
 1. In hydration phase:
 - removing pus
 - washing with antiseptic solutions (H2O2,
furacilin, KMnO4)
 - bandages with hypertonic solutions
 - proteolytic enzymes
 - laser, ultrasound cavitation
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25. Treatment of purulent wounds
 2. In dehydration phase
 - ointments with antibiotics
 - ointments with substances, which stimulate
reparative processes in wound (solcoseril,
actovegin, metyluracil)
 - physiotherapy
 - secondary sutures
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26. Thank you for your attention
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