CLINICAL SCIENCE SESSION

WOUND
Raudatul Agustina
G1A219032

Pembimbing:
dr. Amran Sinaga, Sp. B
 Preface
Wounds is a lost or partial damaged of tissue. This can
happen by sharp object or blunt trauma, temperature
changes, chemicals, explosions, electric shock, or
animal bites.
 Chapter II
Referance
Definition
Wounds is a lost or partial damaged of tissue. When a wound
occurs, several effects will appear:
Loss of all or partial of organ function
1. Sympathetic stress response
2. Bleeding and blood clots
3. Bacterial contamination
4. Cell death
 Wound Healing
A. The Wound Healing Phase
1. Inflammantory Phase = the inflammatory
phase lasts from the time of injury until
approximately the fifth day
2. Proliferation Phase = this phase lasts from the
end of the inflammatory phase until about the
end of the third week
3. Remodelling Phase = this phase can last for
months and is declared to end if all signs of
inflammation have disappeared.
B . Particular Tissue Healing
1. Bone : Fracture healing short bone move faster because of
richer bleeding.
2. Tendo : If the tendon which is the end of the striated
muscle will dead, the hematoma that occurs will
experience a natural healing process and become a
connective tissue attached to the surrounding tissue.
3. Fascia : Injuries to the fascia will experience normal
natural healing.
4. Muscle : Striated muscle and smooth muscle are known
to heal by forming connective tissue.
4. Intestine
Wounds in the small intestine must be sewn, of course not allowed to heal as
soon as intention because leakage of intestinal contents will cause peritonitis
5. Nerve Fibers
Nerve trauma can be in the form of trauma that cuts the nerve or blunt trauma
that causes pressure or pull on the nerve.
6. Nerve Tissue
If the nerve tissue is traumatized, damaged nerve cells will not recover
7. Blood Vessels
The process of wound healing in blood vessels depends on the size of the
wound, the swift flow of blood that comes out, and the ability of the
surrounding tissue tamponade
Wound Healing Disorder
Wound healing can be disrupted by causes from inside the
body (endogenous (such as : coagulopathy and immune
system disorders)) or from outside the body (exogenous(
such as : ionizing radiation).
 Type Of Wound
Based on wound healing time :
1. Acute wound : wound with a healing period in accordance with the healing
process
2. Chronic wound : wound that fail to recovery due to exogenous and
endogenous factors.
Based on the cause :
1. Incised wounds 4. Punctured Wound
2. Contusion Wound 5. Lacerated Wound
3. Abraded Wound 6. Penetrating Wound
4. Vulnus Marsom 7. Combustio
Based on the level of contamination :
1. Clean Wounds
2. Clean-contamined Wounds
3. Contamined Wounds
 Wound Treatment
Diagnosis
Check carefully to see if there is bleeding. Then, determine the type of trauma,
sharp or blunt, extent of tissue death, the contaminations, and severity of injury.
Treatment
- Do local or general anastesi.
-Depends on the wound grade and location
-Clean the wound and surroundings with antiseptic, if necessary washed with
water beforehand.
-Cover the wound surrounding with a sterile cloth.
-Do debridement, cleaned with a rinse, splash, or spray of NaCl. After that, sew the
wound
 Chapter III
Conclusion
Wounds is a lost or partial damaged of tissue.
Three phase of wound healing:
1. Inflammatory
2. proliferation
3. Remodelling phase
Wound healing can be distrupted from inside of body (endogeneus) or
from outside of body (exogeneus).
Wounds can be classified according to certain categories :
-Wound healing time: acute and chronic wounds
-Process of occurrence: incision wounds, bruises, abrasions, stab
wounds, scratches, penetrating wounds, bite wounds, burns.
-degree of contamination: clean wound, clean wound contaminated,
contaminated wound.
 References
• Sjamsuhidajat, R dan Jong WD. Buku Ajar Ilmu Bedah. Edisi 3 –
Jakarta: EGC. 2010
• Sudjatmiko, Gentur. Petunjuk Praktis Ilmu Bedah Plastik
Rekonstruksi. Jakarta : Yayasan Khasanah Kebajikan. 2010
• Julia S. Garner. 2000. Guideline For Prevention of Surgical Wound
Infections Hospital Infections Program Centers for Infectious
Diseases Center for Disease Control.
http://wonder.cdc.gov/wonder/prevguid/p0000420/p0000420.asp#he
ad004000000 000000 ( diakses 20 Oktober 2019)
Terimakasih