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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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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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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