Dr. Jeffrey Kalei

Dr. Jeffrey Kalei

Author and illustrator for Hyperexcision. Interested in emergency room medicine. I have a passion for medical education and drawing.

Management of Chronic Wounds

Overview The goal of managing chronic wound is to identify and address the conditions that impair wound healing. By correcting these condition, the wound behaves like an acute wound and can be managed as such through closure, skin graft, or…

Management of Wounds

Overview The goals of wound care include: The steps in management of wound usually involve assessment → preparation → repair → follow-up Wound preparation Types of injuries and considerations Type of injury Nota bene Animal bite Cat bites are deep…

Assessment of a Wound

Crosss section of a wound

TIME mneomnic for assessment of wounds Tissue: presence of granulation or hypergranulation tissue, devitalized or necrotic tissue, and surrounding tissue Inflammation or infection: areas within or surrounding the wound site that may indicate the presence of infection or inflammation Moisture:…

Classification of Wounds

Depth-ischemia classification of diabetic foot ulcer

Tidy vs Untidy wound Type of wound Characteristic Examples Healing Tidy wound Incised, Clean, no tissue loss Surgical incision, Stab, Cuts Primary intention Untidy wounds Irregular, tissue loss, devitalized tissue, contaminated Crush, Avulsion/Degloving, Burn Secondary intention Open wounds The skin…

Excess Wound Healing

Excess healing Description Excessive scarring Excess proliferation of fibroblasts and collagen due to dysregulation of the proliferative and maturation stage Hypertrophic scar Excess proliferation of fibroblasts and collagen leading to a raised scar that does not grow beyond the boundaries…

Abnormal Wound Healing

Relative difference in normal, delayed, and impaired wound healing

Overview There are 2 major types of abnormal wound healing: impaired wound healing and delayed wound healing Impaired vs Delayed wound healing Abnormal healing Description Cause Delayed healing Though at a slower rate of healing, the wound ultimately achieves mechanical…

Healing in Specific Tissue

Healing of Bones Healing of bones resembles dermal healing with some notable differences and specific terms. Phase Process Nota bene Hematoma and Inflammation Accumulation of blood, devitalized soft tissue, dead bone and necrotic marrow at the fracture site → Breakdown…

Wounds and Wound Healing

Extracellular matrix content with time

Overview Knowing the physiology and pathology behind wounds is important in surgery since it is a specialty that primarily deals with wounds. Term Definition Wound A break in the integrity of skin or tissue, often associated with disruption of structure…

Special Burns

Paediatric Burns Additional measures when treating burns in children should be considered since their anatomy and physiology is different compared to adults. In addition, children may have special psychososcial and educational needs when it comes to burns. Majority of burns…

Management of Burns

Pre-Hospital Treatment and First Aid Outpatient management Outpatient management is reserved for burns that cover <10% BSA (<5% in children and elderly) and no third-degree burns. Treatment involves disinfection, dressing, and pain management. Inpatient observation overnight is recommended for patients…