Day 2 - Wound healing to tetanus

Question 1

Classifications of wounds (4)

Answer 1

1. Mechanical caused trauma (biggest group)
   o Open injuries, wounds
   o Closed injuries (commotion, rupture, etc.)
   o Bone fracture
2. Chemicals caused injuries
   o Acids – cause coagulation necrosis
   o bases – cause colliquative necrosis
3. Thermal origin injuries
4. Radioactive injuries

Question 2

Burn – combustion
1 degree

Answer 2

C. Erythematosa

Dry fur, swollen skin, edema, warm, loss of epithels

Question 3

Burn – combustion
2 degree

Answer 3

C. Bullosa

Vasodilation, leak of serum, vesicles
The base of this type of burn is the corium
* Origin of the pain

Question 4

Burn – combustion
3 degree

Answer 4

C. Escharctica

Cell injuries, protein aggregation, thrombosis, necrosis

Question 5

Burn – combustion
4 degree

Answer 5

Carbonisation

Question 6

Frostbite – congelation
1 degree

Answer 6

Ischemia, hyperaemic, leak of serum, not sensitive

Question 7

Frostbite – congelation
2 degree

Answer 7

Stasis, thrombus, vesicles, infection

Question 8

Frostbite – congelation
3 degree

Answer 8

Cell degeneration, stop of circulation, necrosis, loss of larger body parts

Question 9

Classification of wounds

Answer 9

1. Localisation
2. Shape and size
3. Types
4. Origin
5. Age
6. Healing stadium
7. In what way

Question 10

INCISED WOUNDS (VULNUS SCISSUM ET CAESUM)

Answer 10

• Produced by sharp objects
• Tissue damage minimal (in most cases)
• Edges of wound linear and smooth
• Pain minimal
• Underlying tissue damaged only in the line of the wounds
• Prognosis good

Question 11

LACERATED WOUNDS (VULNUS LACERUM S. RUPTUM)

Answer 11

• Produced by irregular objects
• Tissue damage extensive
• Edges of wound smooth
• Lacerated, loss of material
• Pain painful
• Underlying tissue extensive damage
• Prognosis depends on the injury
• Secondary healing
• In summer: be careful with myiasis

Question 12

CONCENTRATION DEPENDENT

Answer 12

• Aminoglycosides and fluoroquinolines

Question 13

Time dependent

Answer 13

b-lactams and macrolides
have to be above MIC to have an effect

Question 14

What AB do we normally use?

Answer 14

Bacteriostatics
* Penicillin
* Cephalosporin
* Trimethoprim/sulphonamide

Question 15

What do we use for regional limb perfusion?

Answer 15

Amikacin

Question 16

INTERRUPTED VERTICAL MATTRESS SUTURE

Answer 16

Better tension holding than interupted horizontal

Skin, subcutis, fascia

Question 17

ALLGOWE STITCH (MODIFIED DONATI)

Answer 17

Skin, subcutis

Question 18

INTERRUPTED CRUCIATE (CROSS MATTRESS)

Answer 18

Stronger than simple inverted

Skin, subcutis

Question 19

CONTINUOUS LOCK AND FORD INTERLOCKING

Answer 19

More secure when broken

Skin, horse uterus

Question 20

CONTINUOUS INTRADERMAL/INTRACUTAN

Answer 20

minimal impact on blood vessels of skin

Question 21

CONTINUOUS LAMBERT S.

Answer 21

Penetrates the submucosa, but not the lumen.

Closure of hollow viscera

Question 22

CONTINUOUS CUSHING S (CONNELL SUTURE PATTERN)

Answer 22

Cushing: Inverting. Penetrates the submucosa, but not the lumen of bowel.

Connell: Penetrates submucosa into the lumen.

Both: Closure of hollow viscera.

Question 23

Hoof bandage

Answer 23

• Dry or wet
• Covering the hoof after surgical procedures, softening hoof capsule
• Extends under fetlock joint
• Usually applied for 3 days

Question 24

Distal limb bandage

Answer 24

• Covering surgical sites, or covering after intraarticular injections
• Extends from coronary band to the carpus or tarsus
• Fixed to the hoof capsule by impermeable tape

Question 25

Robert jones

Answer 25

- Immobilization of the limb and joints - Consists of a standard bandage strengthened by additional layers of sheet cotton - Has to be 1.5 x the circumference of the limb - Splint can be applied over it for strengthening

Question 26

Carpal bandaging

Answer 26

- Extends from coronary or fetlock up above the carpus - Pressure releasing pads of the accessory carpal bone - Standard bandage or strengthened by additional layers - Splint can be applied

Question 27

Tarsal bandaging

Answer 27

- Extends from coronary or fetlock up above the tarsus - Pressure releasing pads over the calcaneal tendon - Standard bandage or strengthened by additional layers - Splint can be applied - Dorsal or plantar splint can be applied over it

Question 28

Bacteria causing infection - Aerobe

Answer 28

- Staphylococcus - Streptococcus - Enterobacterium - Pseudomonas

Question 29

Bacteria causing infection - Anaerobe

Answer 29

Clostridium (Gasphlegmone) Tetanus

Question 30

Fungi causing infection

Answer 30

Phythius spp.

Question 31

Types of infections

Answer 31

- Primary infection - Secondary infection -Exogen (contact, aerogenic) – most common - Endogen (haematogen)

Question 32

Pyogenic infection - causes and signs

Answer 32

- Staphylococcus - Streptococcus, Rhodococcus - Corynebacterium - Pseudomonas - E. coli Signs -Thrombotisation of vessels -Necrosis and neutrophils -Leukocytosis

Question 33

LOCAL SIGNS OF PYOGENIC WOUND INFECTION IN SPECIFIC CLINICAL FORMS

Answer 33

- Sutured wounds - Opened fresh wounds

Question 34

SPECIAL CLINICAL FORMS OF PYOGENIC WOUND INFECTION

Answer 34

-Erysipelas -Phlegmone -Abscess

Question 35

Erysipelas (obs Tx)

Answer 35

-Pyogenic germs specially streptococci in the skin -Fastly progrediated and demarcated -Pustule, phlegmone and gangrene -Thr.: AB, sulfonamides (recidivate)

Question 36

Phlegome (3) (Obs Tx)

Answer 36

- Subcutaneous - Subfascial and intermuscular: Therapy: AB, rest, hyperaemisa bandage , ointment, NSAIDs

Question 37

Phlegome can become abscess

Answer 37

- Empyema: pus in a natural body cavity - Sequester: abscess in the bone - Result of haematoma, seroma, phlegmone or foreign body infection - Demarcated inflammation and necrotic tissue

Question 38

Definition of pus

Answer 38

Serum and necrotic tissue part with dead leucocytes and bacteria

Question 39

Cause of putrid wound infection (pathogens) (3)

Answer 39

-Clostridium -Proteus -Pseudomonas

Question 40

Results of pyogenic infection (4)

Answer 40

- Toxaemis - Septicaemia - Pyemia - Fistulation (bursitis)

Question 41

GASPHLEGMONE

Answer 41

-Clostridium -Manifestation of signs (1 – 4 hours) -Emphysematous gas production -Severe signs Thr.: surgical approuche

Question 42

Tx: tetanus

Answer 42

Thr.: -Active – vaccination -Passive – tetanus serum -AB, diazepam, artificial feeding (infusion), ear plugs, silence and dark