Wound Management: Classification, Syndrome for Surgery Notes
Feb 10, 2023
Wound management is an important topic for NEET PG exam preparation as it is a crucial aspect of patient care in the field of surgery. In the exam, you may encounter questions related to the classification of wounds, wound healing, and management of surgical wounds, including the selection of appropriate wound dressings and wound care practices.
Therefore, it is advisable to have a good understanding of the topic to perform well in the NEET PG exam and also to provide the best possible patient care.
Read this blog further to get an overview of the topic.
Wound Overview
Wound refers to a breach in continuity of skin or surface epithelium. It can be caused by various factors, including physical trauma, surgical incisions, cuts, burns, and puncture wounds. Depending on the cause and severity of the wound, the healing process can take several days to several weeks.
Surgical wound Classification
Surgical wound classification is a system used to categorize surgical wounds based on their appearance and healing process. There are several commonly used surgical wound classifications, including:
Skin + subcutaneous fat is stripped from underlying fascia by avulsion
After degloving injury exposed parts are
Bone
Neuromuscular structure
Tendon
Compartment syndrome
Compartment syndrome is a medical condition that occurs when pressure within a confined space (a muscle compartment) increases, leading to reduced blood flow and potential damage to the muscles and nerves within the compartment.
This can be caused by a variety of factors, including trauma, fractures, swelling, and certain medical procedures.
Symptoms may include pain, swelling, tightness, and impaired movement, and if left untreated, it can lead to permanent muscle and nerve damage.
Pressure in affected compartment: > 30 mm of Hg
Generally seen in closed lower limb injury
Clinical features
Severe pain
Pain on passive movement
Distal sensory disturbance
Absence of distal pulses (late sign)
Paralysis (worst prognosis)
Fasciotomy
Indications: Pressure > 30 mm Hg; signs and symptoms of compartment syndrome
Longitudinal incision on both medial and lateral side
Structures incised: skin, subcutaneous fat, fascia
Pressure Ulcer
Pressure sore / Bed sore
Ulcer because of prolonged pressure
Tissue necrosis + Ulceration
Staging
Stage I: non blanch able erythema of skin without any breach in the skin; early superficial ulcer
Stage II: partial thickness skin loss with involvement of epidermis and dermis; late superficial ulcer
Stage III: full thickness skin loss with involvement of subcutaneous tissue; early deep ulcer
Stage IV: full thickness skin loss with involvement of subcutaneous tissue, muscle,bone; late deep ulcer
Bed bound patient: should turn every 2 hourly
Wheelchair bound: should lift for 10 sec every 10 min
Most common used Flap for pressure sore: Extensor Fascia Lata Flap with lateral cutaneous nerve of thigh
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