3: Wound healing Flashcards
How long is inflammatory phase?
0-3 days
How long is proliferation phase?
3-14 days (weak scar)
How long is maturation phase?
3 weeks - 3 months
Why do you always need to debride a wound in the horse?
Periphery tends to invert
What do you check for in limb wounds?
Synovial space, tendon, bone
What do you check for in the head, neck or trunk?
Body cavities, muscles, or vessels
What is the number one determinant of how a wound will heal?
Location critical
How do you debride?
Focal pressure lavage or bucket or water and then sharp excision
What should you ensure you do during wound palpation?
Put limb through full range of motion
How often do you give tetanus vaccine?
Every two years
What can you do if you are treating a wound in a horse that is already vaccinated?
Booster (cheap)
What do you do if vaccination history is unknown?
Antitoxin then begin vaccination 2 and 4 weeks later
Which three factors may prevent wound healing?
Tension, motion, infection
What are two further complications of wound healing?
May also become neoplastic or metaplastic (sarcoid)
How do you debride by sharp excision?
Preserve skin and use base of blade to scrape subcutaneous tissue
Why does periosteal damage not allow granulation tissue migration?
Fibroblasts can’t migrate
Why is primary closure ideal?
Shorter proliferative phase so cheaper and quicker return to function
What happens if you see a wound outside the “golden period”?
Can probably still close
How do bacteria cause dehiscence?
Produce collagenases
What should you do if a wound in infection?
Establish drainage for exudate
What two situations can cause tension?
Retraction or oedema
What can you do to get more movement?
Undermine skin
What is the advantage of walking sutures?
Reduce tension and obliterate dead space
Which type of sutures should you use?
Absorbable
What’s the advantage of mattress sutures?
Redistribute suture tension, provide eversion which will heal
What should you avoid being the holding layer?
Skin
What happens following a stented suture?
Linear scarring
Why might you do tension releasing incisions parallel to wound following undermining?
Can close the incision with less tension
Why should you try to immobilise a wound?
Faster healing
Depending on location, what can you do if you can’t suture the wound?
Keep it clean and allow to heal by 2ry intention
Where is exuberant granulation tissue usually found?
Distal limb
How do you treat exuberant granulation tissue?
Will never heal, so excise until it is flat
How many nerves does exuberant granulation tissue contain?
None - aneural
Which type of grafts are the most common?
Full thickness
Where do you get full thickness grafts from?
Pectoral region
What’s the problem with partial thickness grafts?
Less effective
