3. Wounds Flashcards
What is important to know about wounds?
Anatomical loc
cause of trauma
degree of contaimination
duration of injury
What are some questions to ask as part of history?
When did it happen, how, where (inside/outside/unseen)?
If a bite -> lg dog, sm dog, wild, is either rabies vxinated?
Puncture wound - what was object
has first aid been provided
What is an erosion type of wound?
The depth of wound does not go past the basement membrane of the dermis
What is an ulcer type of wound
the depth of the wound goes past the basement membrane of the dermis
What is important when describing the wound?
Location
overall shape
width
length
depth
edges
What is a laceration wound?
Cut or tear that only affect a specific area w/ a fairly defined edges and little to no tissue loss (also most surgical wounds)
What is avulsion? What’s its other name?
Degloving injury - A peeling injury where there is significant loss of skin
What is a puncture wound?
A small entry point that may or may not be easily visible, potential to extend deep into tissue
What is a blunt trauma wound?
A would result of force of impact, such as hit by car. Usually massive soft tissue +/- bone injury
What are bite wounds?
A combo of laceration, avulsion, puncture wound and blunt trauma.
Always containimated
Why are large dog bites more complicated than cats?
Cats usually cause deep wounds with lacerations
Lg dogs grab and shake which tears the skin from underlying subcutis which can rip blood vessel supply to the skin -> risk of ischemic injury, tissue necrosis, infected pockets of muscle
What are thermal burns?
Burns caused from fires, radiation injury or inappropriate heating sources
Why differentiates each degree of burns?
1st degree: only superficial epidermis affected
2nd degree: epidermis affected, hair follicles not affected
3rd degree: complete loss of epidermis, all hair gone, can extend to bone
What is a chemical burn?
Inappropriately applied medications, disinfectants. Can include feces, urine, serum
Describe a clean wound, what is the infection risk?
Surgical wounds using aseptic technique
infection risk is <2.5% depending on cleanliness of surgery
What is a clean-contaiminated wound? What is its infection risk?
Minimal contaimination
surgical wound w/ a dran; surgical wounds near area with normal flora (bladder)
infection risk ~5%
What is a contaminated wound? What is its infection risk?
GI surgery, open fresh woulds <4 hrs old that do not appear to have debris and caused by a non-contaminated object
infection risk 5-20%
What is a dirty wound? What is its infection risk?
ANy wound over 4 hrs. Wound w/ visible debris, foreign objects, feces. All bite wounds
20-40% infection risk
left open for 8_ hours have 100% infection risk
What is the golden wound period?
The first 8 hrs of any wound. If they’re cleaned + dressed within the first 8 hrs have a much better prognosis
What is stage 1 in wound healing? What happens?
Acute inflammation - trauma to blood vessels release signal for inflam response
inflam cells and proteins enter damaged area and clean out foreign material and damaged tissue
platelets, fibrin, clotting factors enter damaged area and stop bleeding
inflam stage is PRISS, starts minutes of wound
What is stage 2 in wound healing? What happens?
Epithelialization - epithelial cells at edges of wound start to replicate and migrate towards centre of wound, early as 24 hrs after wound
What is stage 3 of wound healing?
Cellular phase - Fibroblasts enter area, wall of damaged area create scaffold for repair/regrowth of blood vessels and tissue
endothelial cells and other cells enter into wound area and start to fill in space w/ appropriate tissue
what is stage 4 of wound healing?
Blood vessels reform, tissue will raise and be red + slightly moist (bleeds if disturbed). <- granulation tissue
Around 7-14days
What is proud flesh?
Where it extends past the natural borders of the wound and prevents proper healing
