2. Describe the wound, clinical examination of the injured equine patient

Question 1

What is a wound?

Answer 1

Loss of continuity in the skin, mucous membrane or in an organ or witout underlying tissue damage

Question 2

Name causes/etiology of wounds:

Answer 2

1. Mechanical caused trauma
2. Chemicals:
   - Acids = coagulation necrosis
   - Alkalis = Colliquation necrosis
3. Thermal effects
   - Burn
   - Frostbite
4. Radioactive injuries
5. Electricity caused injuries

Question 3

How would you classify a wound?

Answer 3

By:
1. Localisation
2. Shape and size
3. deep or superficial
4. Origin
5. Age
6. Healing stadium
7. What type of wound is it:

Question 4

What do we mean by localisation in classification of a wound?

Answer 4

Which anatomical region or which organ is affected (head, neck, skin, mucous membrane, muscle)

Question 5

What do we mean by Shape and size in classification of a wound?

Answer 5

point like
lime like
lobed
cavernous
loss of materia
loss of body part
regular edges
irregular edges

Question 6

What do we mean by superficial or deep in classification of a wound?

Answer 6

If its superficial = denuding of epidermis, minimal bleeding, some serum exudation

Deep = Several strucutres are affected

Question 7

What do we mean by Origin in classification of a wound?

Answer 7

Surgical or traumatical

Surgical = aseptic

Traumatical = Always contaminated

Question 8

What do we mean by age in classification of a wound?

Answer 8

If its fresh or old

Old = granulation tissue is deep, epithelisation - no primary closure indicated

Question 9

What do we mean by healing stadium in classification of a wound?

Answer 9

Regular healing
Irregular healing
Infected or with compulsion

Question 10

What do we mean by type in classification of a wound?

Answer 10

We have 6 type of wounds:
1. Incised
2. Laceratged
3. Contused
4. Punture
5. Gunshot
6. Bite

Question 11

Latin name for incised wound:

Answer 11

Vulnus scissum et caesum

Question 12

Latin name for lacerated wound:

Answer 12

Vulnus lacerum s. ruptum

Question 13

Latin name for contused wound:

Answer 13

Vulnus contusum

Question 14

Latin name for puncture wound:

Answer 14

Vulnus punctum

Question 15

Latin name for Gunshot wound:

Answer 15

Vulnus sclopetarium

Question 16

Latin name for bite wound:

Answer 16

Vulnus morsum

Question 17

Which type of wound is this?

Answer 17

Vulnus scissum et caesum

Question 18

What type of wound is this?

Answer 18

Vulnus lacerum s ruptum

Question 19

What type of wound is this?

Answer 19

Vulnus contusum

Question 20

Vulnus scissum et caesum.
Cause, edges, tissue damage, painful?, prognosis

Answer 20

Produced by sharp objects

Wound edges: linear, smooth

Minimal tissue damage
Underlying tissue may be damaged only in the line

Minimal pain

Prognosis: in general good

Question 21

Vulnus lacerum s ruptum
Cause, edges, tissue damage, painful?, prognosis

Answer 21

Produced by irregular objects

Wound edges: Smooth-lacerated

Extensive tissue damage, loss of materia
Extensive damage of the underlying tissue

Painful

Prognosis: Depends on the individual case

Question 22

Vulnus contusum
Cause, edges, tissue damage, painful?, prognosis

Answer 22

Produced by dull objects

Wound edges: irregular

Extensive tissue damage
Extensive damage to underlying tissue
-> check for synovial cavity involvement; fill the joint with aspetic fluid, check for leakage

Very painful, initially block

Prognosis: unfavourable, anaerobic wound infections are common

Question 23

Vulnus punctum
Cause, edges, tissue damage, painful?, prognosis

Answer 23

Produced by sharp objects

Have both penetration and perforation
Penetration: Into tissue byt does not go through, only the entrance of the wound
Perforation: Both entrance and exit wound

Prognosis: Highly depends on presence of anaerobic infections

Question 24

Vulnus morsum
Cause, edges, tissue damage, painful?, prognosis

Answer 24

Caused by teeth

Carnivores: produce puncture wounds, risk of anaerobic infections

Herbivores: Produce contused wound

Prognosis: Depends on the level of tissue damage and presence of anaerobic infections

Question 25

Vulnus sclopetarium Cause, edges, tissue damage, painful?, prognosis

Answer 25

Cause: gunshot wound, arrow, ball, bullet, splinter, shrapnel Inlet: primer necrotical zone Channel: Necrobiotical zone Outlet: Molecular commotional zone Possibilities of a bullet: - Can wonder within the tissue - Can produce a capsule around it

Question 26

Which steps would you do for the clinical examination of the injured horse?

Answer 26

1. Emergency help and stabilization for transport to clinic 2. Relief anxiety and pain 3. Clinical examination 4. Rule out the risks in case of wounds 5. Examination of wounds

Question 27

Emergency help and stabilization for transport to clinic, which measures do we do?

Answer 27

1. check circulatory and mental stata briefly 2. Stop bleedings 3. Prevent further injury 4. Wounds: sterile coverage, gauze bandage, self-aticky gauze 5. Allow safe transport

Question 28

What to use for anxiety and pain relief?

Answer 28

Seadtion -> Alpha-2 agonists - Xylazine - Detomidine - Butorphanol NOT ACE = hypotensive effects Orthopaedic painkillers: - COX-2: firocoxib - be carefull in severe hydration/shock

Question 29

Which parameters do we check in clinical examination?

Answer 29

We check the circulatory system and mental state. Heart rate: Normal=28-42 Respiratory rate: Normal 10-18 MucousMembrane, CRT: Normal: light pink, CRT=below 2 Temperature: Normal: 37-38 Check for hydration: check for skin turgor Take blood sample: biochemistry, electrolyte

Question 30

Name some risks in case of wound injuries:

Answer 30

1. Shock 2. Pneumothorax 3. Internal bleedings 4. Perforation of internal organs Especially important to assess the risks if the wound is above the chest

Question 31

How would you examine the wound?

Answer 31

1. Take a swab for microbiology before cleaning 2. Pre-OP antibiotics 3. Aseptic preparation of the wound 4. Wound debridement 5. Lavage 6. Check for involvement of underlying strucutre: joints, tendon sheaths, tendons, bones 7. check for presence of foreign material 8. Primary wound healing: closure 9. Secondary wound healing in case of: high contamination, lack of tissue, huge loss of materia, location with huge moveability = results in formation of granulation tissue

Question 32

Steps for aseptic preparation of the wound:

Answer 32

1. Clipping hair 2. Disinfection of the skin: Povidine iodine, chlorhexidine

Question 33

What is lavage, and precasionally steps:

Answer 33

Cleans the wound of debris and bacteria, and stimulates the microcirculation. Precautions: - Avoid too much pressure - Solution: Sterile isotonic, normothermic, non-toxic (NaCl, Lavanid solutions

Question 34

What is meant by wound debridement?

Answer 34

Remove injured and necrotic tissue to get fresh, intact wound margins for primary wound closure.