CLINICAL - Equine Wounds

Question 1

What are the six steps to the clinical approach of an equine wound?

Answer 1

1. Triage
2. Examination of wound
3. Further investigation of wound if indicated
4. Diagnosis
5. Treatment
6. Monitoring and treatment of any complications

Question 2

What are the main steps involved in triage?

Answer 2

Identify your patient using their passport, take a history, carry out a general clinical exam and wound inspection, followed by carrying out immediate treatment if the injury is a threat to life or life changing

Question 3

List four injuries to the musculoskeletal system that would be considered life threatening/life changing?

Answer 3

Fractures
Septic synovitis
Tendon or ligament transection
Blood supply impairment

Question 4

What are the five main factors that should be examined during a wound examination?

Answer 4

Wound type
Wound location
Defect size/depth
Contamination
Phase of healing

Question 5

Why is examining the wound type so important for treatment?

Answer 5

Examining the wound type reflects the severity of the wound and indicates the likelihood of infection or tissue necrosis

Question 6

Why is examining the wound location so important for treatment?

Answer 6

Examining the wound location reflects which of the surrounding structures may have been damaged

Question 7

Why is examining the defect size/depth so important for treatment?

Answer 7

Examining the wound size/depth indicates whether healing by first or second intention will occur

Question 8

Why is examining for contamination of the wound so important for treatment?

Answer 8

Contamination will indicate the use of antimicrobials during treatment

Question 9

Why is examining the phase of healing so important for treatment?

Answer 9

Examining the phase of healing will determine if the wound is healing normally or if a complication has occurred

Question 10

What is the main indication of a wound infection?

Answer 10

Drainage of purulent exudate is the main indicator of wound infection

Question 11

What are the five methods that can be used to prevent and treat wound infections?

Answer 11

High pressure lavage with isotonic fluid
Wound debridement
Management of dead space
Antimicrobial wound dressing
Topical or systemic use of antimicrobials

Question 12

Why is the management of dead space so important for normal wound healing?

Answer 12

Dead space can lead to the accumulation of blood, serum or purulent exudate which promotes infection and mechanically disrupts healing

Question 13

What are the two methods that can be used to manage dead space?

Answer 13

Drainage
Compression

Question 14

How does the presence of foreign material disrupt wound healing?

Answer 14

Foreign material is a focus for infection and prolongs the inflammatory response

Question 15

What are four foreign materials commonly found in equine wounds?

Answer 15

Soil
Plant material
Metal
Grit

Question 16

Which diagnostic method can be used to identify foreign materials in equine wounds?

Answer 16

Ultrasonography

Question 17

How can necrosis disrupt wound healing?

Answer 17

Necrosis is a focus for infection and prolongs the inflammatory response

Question 18

How do you treat necrosis?

Answer 18

Wound debridement

Question 19

What can cause occlusion of blood vessels when treating equine wounds?

Answer 19

Overtight bandages

Question 20

How can movement disrupt wound healing?

Answer 20

Movement disrupts granulation tissue and re-epithelialisation and increases tension at the wound margins

Question 21

What can you do to reduce movement that would disrupt wound healing?

Answer 21

Confinement to stables
Splints/casts
Cross tying to prevent the horse lying down