9 Flashcards
Uncomplicated simple ______^ lare usually managed by complete closure if they are not grossly contaminated.
The wound should be thoroughly ______and _______ as necessary before closure.
If tension is present on the wound edges, it should be relieved by tension-relieving suture techniques, sliding tissue flaps, or grafts.
Lacerations
lavaged and debrided
Lacerations
Deep lacerations may be treated according to the same principles, depending on the extent of the injury.
Damage to underlying structures (eg, muscles, tendons, and blood vessels) must be resolved before closure.
If a laceration is grossly contaminated with debris, primary closure of the wound may not be indicated.
Contaminated wounds may be closed with drainsor treated as an open wound.
are a major cause of injuries, especially in free-ranging animals.
Bite wounds
tend to be small, penetrating wounds that frequently become infected and must be treated as an abscess with culture, debridement, antibiotics, and wound drainage.
Cat bites
Dog bites have a more varied presentation Because of the slashing nature of dog bite injuries, the major tissue damage is usually found beneath the surface of the wound.
Although only small puncture marks or bruising may be evident on the surface, ribs may be broken or internal organs seriously damaged.
The animal should be thoroughly examined and stabilized before definitive wound care is begun. The wound should be surgically extended as far as necessary to allow a thorough examination and determination of its extent before a decision on the repair can be made.
BITE WOUNDS
After a proper assessment, debridement can be performed. Unless en bloc debridement is performed, complete wound closure is usually not recommended because the sites are considered contaminated.
Closure can be accomplished with drains, as a delayed closure, or by second intention depending on the extent of the injury.
__________ result in loss of skin and a variable amount of deeper tissue. These injuries are a result of a shear force on the skin.
Sources include fan belt injuries and loss of tissue during an accident with a motor vehicle. With a physiologic degloving injury, the skin is still present but completely freed from the underlying fascia.
Degloving injuries
If the injury results in a loss of blood supply to the affected skin area, necrosis may develop over the next several days. Degloving injuries frequently require marked and repeated debridement.
Differentiating viable and nonviable tissue may be a problem in the early wound debridement process. An attempt should be made to salvage tissue in which viability is questionable. Subsequent debridement can be used to remove any necrotic tissue.
In ________, most of the damage is not visible. As the projectile penetrates, it drags skin, hair, and dirt through the wound.
If the projectile exits the body, the exit wound is usually larger than the entrance wound. The amount of damage caused by the projectile is a function of its shape, aerodynamic stability, mass, and velocity.
gunshot injuries
High-velocity projectiles tend to produce more damage as a result of impact-induced shock waves that move through the tissue. These shock waves create the blunt force trauma that results in tissue and vascular damage.
Gunshot wounds are always considered to be contaminated, and primary closure is generally not recommended. These wounds should be managed as open wounds or by delayed primary closure. After initial assessment and stabilization of the animal, the wound may be explored to evaluate the extent of damage and to determine a plan for repair.
Gunshot wounds to the abdomen are an indication for ____________. Gunshot wounds to the thorax may require a ___________ if hemorrhage or pneumothorax cannot be conservatively managed.
exploratory celiotomy
thoracotomy
___________________ develop as a result of pressure-induced necrosis. ___________ can be extremely difficult to treat and are best prevented.
Preventive measures include changing the position of the animal frequently, maintaining adequate nutrition and cleanliness, and providing a sufficiently padded bed.
Pressure wounds or decubital ulcers
Pressure wounds
Factors that predispose to pressure wounds include
paraplegia, tetraplegia, improper coaptation, and immobility.
Mild ulcers may be managed with _________and __________ to prevent further trauma to the affected site.
debridement and bandaging
More severe wounds require extensive surgical management. After debridement and development of a granulation bed, an advancement flap or pedicle graft may be required for closure.
