Question

Chapter11 Hemostasis, Wound Healing and Wound Closure 193 CASE STUDY 3 s a 12-year-old boy, lost control of his trail bike while riding on a course that he and some friends con- a vacant lot. He flew over the handlebars into the dirt onto his left arm. His arm is broken, anc is sticking out through the skin. Immediate first aid included stabilization of the wound with a pressure due to bleeding and immobilization of the wound with a splint. It is 10:00 a.m stnu is broken, and the lames has sustained a traumatic injury to his left am. What classfication s) does/do his wound fall in o? o 2 James was immediately taken to the Urgent Care Center. It is determined that James will need surgical treat- ment and will be transferred by ambulance to the nearest hospital, which is 150 miles away. The surgery is scheduled for 4:00 p.m. How will the surgical wound be classified? Why? 3. Is James at risk for surgical site infection (SS0? Why? What steps can be taken to minimize the risk of ss 1 Once the pressure dressing is removed in the operating room, the surgeon notes a bleeder and asks for a hemostat. This is passed to him. Once the prep, draping, and time out are completed, the surgeon will igate the vessel. What types of tie techniques might he use? How will you pass each type e th trand is tied, he asks you to cut the multifilament strand with a tag. I cut that strand

Answer 1

1.The injury falls into the classification of open wound with a compound fracture of the arm

2. Class III contaminated wound because it is open fresh accidental wound

3. Yes he is at risk of surgical site infection.

This is because it is an open wound through which microbes can enter flourish in the wound

To avoid this the wound needs to be irrigated with by a antiseptic solution and a bandage needs to be applied firmly to avoid infection till reaching the hospital for surgery

4.he first applies a ligature with a sutures thread around the blood vessel and the applies a transfixing ligature distal to the tie by passing the thread through the vessel before securing it around the vessel. This is to prevent pulsation of vessel loosening the tie

5. The strand would be cut using a scissor leaving a gap of 1 cm from the tie to avoid opening of the tie