3: Wound healing

Question 1

How long is inflammatory phase?

Answer 1

0-3 days

Question 2

How long is proliferation phase?

Answer 2

3-14 days (weak scar)

Question 3

How long is maturation phase?

Answer 3

3 weeks - 3 months

Question 4

Why do you always need to debride a wound in the horse?

Answer 4

Periphery tends to invert

Question 5

What do you check for in limb wounds?

Answer 5

Synovial space, tendon, bone

Question 6

What do you check for in the head, neck or trunk?

Answer 6

Body cavities, muscles, or vessels

Question 7

What is the number one determinant of how a wound will heal?

Answer 7

Location critical

Question 8

How do you debride?

Answer 8

Focal pressure lavage or bucket or water and then sharp excision

Question 9

What should you ensure you do during wound palpation?

Answer 9

Put limb through full range of motion

Question 10

How often do you give tetanus vaccine?

Answer 10

Every two years

Question 11

What can you do if you are treating a wound in a horse that is already vaccinated?

Answer 11

Booster (cheap)

Question 12

What do you do if vaccination history is unknown?

Answer 12

Antitoxin then begin vaccination 2 and 4 weeks later

Question 13

Which three factors may prevent wound healing?

Answer 13

Tension, motion, infection

Question 14

What are two further complications of wound healing?

Answer 14

May also become neoplastic or metaplastic (sarcoid)

Question 15

How do you debride by sharp excision?

Answer 15

Preserve skin and use base of blade to scrape subcutaneous tissue

Question 16

Why does periosteal damage not allow granulation tissue migration?

Answer 16

Fibroblasts can’t migrate

Question 17

Why is primary closure ideal?

Answer 17

Shorter proliferative phase so cheaper and quicker return to function

Question 18

What happens if you see a wound outside the “golden period”?

Answer 18

Can probably still close

Question 19

How do bacteria cause dehiscence?

Answer 19

Produce collagenases

Question 20

What should you do if a wound in infection?

Answer 20

Establish drainage for exudate

Question 21

What two situations can cause tension?

Answer 21

Retraction or oedema

Question 22

What can you do to get more movement?

Answer 22

Undermine skin

Question 23

What is the advantage of walking sutures?

Answer 23

Reduce tension and obliterate dead space

Question 24

Which type of sutures should you use?

Answer 24

Absorbable

Question 25

What’s the advantage of mattress sutures?

Answer 25

Redistribute suture tension, provide eversion which will heal

Question 26

What should you avoid being the holding layer?

Answer 26

Skin

Question 27

What happens following a stented suture?

Answer 27

Linear scarring

Question 28

Why might you do tension releasing incisions parallel to wound following undermining?

Answer 28

Can close the incision with less tension

Question 29

Why should you try to immobilise a wound?

Answer 29

Faster healing

Question 30

Depending on location, what can you do if you can’t suture the wound?

Answer 30

Keep it clean and allow to heal by 2ry intention

Question 31

Where is exuberant granulation tissue usually found?

Answer 31

Distal limb

Question 32

How do you treat exuberant granulation tissue?

Answer 32

Will never heal, so excise until it is flat

Question 33

How many nerves does exuberant granulation tissue contain?

Answer 33

None - aneural

Question 34

Which type of grafts are the most common?

Answer 34

Full thickness

Question 35

Where do you get full thickness grafts from?

Answer 35

Pectoral region

Question 36

What’s the problem with partial thickness grafts?

Answer 36

Less effective