Presenter name
Vascular and Non-vascularTitle
Wounds
Christopher Stout MD FACS Date
RPVI
Associate Professor of Surgery, EVMS
Wounds
About 73,900,000
results
(0.40 seconds)
About 16,200,000
results
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(0.28 seconds)
Title
Date
No Relevant Disclosures
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Title
Date
Objectives
1.
2.
3.
4.
Classify Wound Age: Acute vs. Chronic
Classify Wound Depth
Understand Wound Color
Understand Inpatient Vs Outpatient Need for
Treatment
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5. Environment
Title
Date
Lets Try Learn About Wound
Healing to Determine Cause/Cure
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Title
Date
Wound Healing 101
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Title
Date
• http://www.vescompression.com/
Wound Healing 101
Primary Intent
– Surgical Closure
– Staples ----
– Sutures
– “Glue”
– Clean Wounds
– Heals:
• Nice & Quick
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Title
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Wound Healing 101
Delayed Primary Intent
– Close contaminated wound later, 3-5 days
– Heals faster
– Clean
Contaminated
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Title
Date
Wounds. 2007;19(12):331-333.
Wound Healing 101
Secondary Intent
– Let it close on
its own
– Takes Longest
– Infected
wounds
– Chronic
wounds
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Title
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Wound Age: NEW
– Acute
– Surgical, burns and Traumatic are examples
– Generally Heal Quickly / primary intent or delayed
primary intent
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Title
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Wound Age: Chronic
– Decubitus, Neurovascular, & Venous are examples
– Or combination of the above
– Heal slowly by secondary intent or not at all
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• Evolving Age
Wound Age
– Cancers, Radiation, or any of the Chronic brought
on by trauma
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Title
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Wound Depth
• Partial-Thickness
webmd
• Full-Thickness
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Title
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Wound Color
• RED
– Inflammation = Good
– Healing
– Too much of good thing = Infection
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Title
Date
Podiatry Today
Wound Color
• YELLOW
– Left Over Fibrin
• If gets too dry will build up quickly
– Petri dish for infection
– Chronic wound not healing correctly
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Title
Date
http://woundcare3108.150m.com/
Wound Color
• BLACK
– Dead
– Eschar limits classifying
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Environment
•
•
•
•
•
What
When
Where
How
Why
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Title
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• Dermatology
Thus…
– If wet then dry it
– If dry then wet it
• Treat and Workup Wounds Based on
–
–
–
–
–
Wound healing phase
Age
Color
Depth
Environment
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Major Acute Wounds
• Surgical
• Burns: Sun, Electrical, Radiation, Fire, etc
• Trauma
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Major Chronic Wound Types
•
•
•
•
Pressure Ulcer
Venous Ulcer
Arterial Ulcer
Diabetic Foot Ulcer
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*Can Be All Mixed: Diabetic with heel decubitus
Title with
peripheral vascular disease and leg swelling from DVT
Date
Pressure Ulcer
• Pressure Gradiant
• Shear
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Title
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Venous Ulcer
Superficial
Veins
Perforating
Veins
Deep
Veins
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Title
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Arterial Ulcer
• ABI / Toe Pressures!
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Diabetic Foot Ulcer
• Combination
– Nerves damaged
– Microvasculature
– Lose support
– Cant feel
– Pressure sore
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AAFP.org
Workup And Treatment?
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Workup and Management?
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Workup and Treatment?
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http://meded.ucsd.edu/clinicalimg/extremities_venous_ulcer&dvt.htm
Workup and Treatment?
•
•
•
•
Age
Depth
Color
Environment
Treat
-Inpt or Outpt ?????
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Date
Workup and Treatment?
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Treatment?
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Workup and Treatment
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Workup and Treatment?
VESAP
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Date
Workup and Treatment?
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Title
Date
Workup and Management?
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Workup and Treatment?
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Antimicrobe.org
Workup and Treatment?
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Venous wound? Gaiter
Distribution….W/U & Rx
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