Day 2 - Wound healing to tetanus Flashcards
Classifications of wounds (4)
- Mechanical caused trauma (biggest group)
o Open injuries, wounds
o Closed injuries (commotion, rupture, etc.)
o Bone fracture - Chemicals caused injuries
o Acids – cause coagulation necrosis
o bases – cause colliquative necrosis - Thermal origin injuries
- Radioactive injuries
Burn – combustion
1 degree
C. Erythematosa
Dry fur, swollen skin, edema, warm, loss of epithels
Burn – combustion
2 degree
C. Bullosa
Vasodilation, leak of serum, vesicles
The base of this type of burn is the corium
* Origin of the pain
Burn – combustion
3 degree
C. Escharctica
Cell injuries, protein aggregation, thrombosis, necrosis
Burn – combustion
4 degree
Carbonisation
Frostbite – congelation
1 degree
Ischemia, hyperaemic, leak of serum, not sensitive
Frostbite – congelation
2 degree
Stasis, thrombus, vesicles, infection
Frostbite – congelation
3 degree
Cell degeneration, stop of circulation, necrosis, loss of larger body parts
Classification of wounds
- Localisation
- Shape and size
- Types
- Origin
- Age
- Healing stadium
- In what way
INCISED WOUNDS (VULNUS SCISSUM ET CAESUM)
- 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
LACERATED WOUNDS (VULNUS LACERUM S. RUPTUM)
- 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
CONCENTRATION DEPENDENT
- Aminoglycosides and fluoroquinolines
Time dependent
b-lactams and macrolides
have to be above MIC to have an effect
What AB do we normally use?
Bacteriostatics
* Penicillin
* Cephalosporin
* Trimethoprim/sulphonamide
What do we use for regional limb perfusion?
Amikacin
INTERRUPTED VERTICAL MATTRESS SUTURE
Better tension holding than interupted horizontal
Skin, subcutis, fascia
ALLGOWE STITCH (MODIFIED DONATI)
Skin, subcutis
INTERRUPTED CRUCIATE (CROSS MATTRESS)
Stronger than simple inverted
Skin, subcutis
CONTINUOUS LOCK AND FORD INTERLOCKING
More secure when broken
Skin, horse uterus
CONTINUOUS INTRADERMAL/INTRACUTAN
minimal impact on blood vessels of skin
CONTINUOUS LAMBERT S.
Penetrates the submucosa, but not the lumen.
Closure of hollow viscera
CONTINUOUS CUSHING S (CONNELL SUTURE PATTERN)
Cushing: Inverting. Penetrates the submucosa, but not the lumen of bowel.
Connell: Penetrates submucosa into the lumen.
Both: Closure of hollow viscera.
Hoof bandage
- Dry or wet
- Covering the hoof after surgical procedures, softening hoof capsule
- Extends under fetlock joint
- Usually applied for 3 days
Distal limb bandage
- 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
Robert jones
- 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
Carpal bandaging
- 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
Tarsal bandaging
- 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
Bacteria causing infection - Aerobe
- Staphylococcus
- Streptococcus
- Enterobacterium
- Pseudomonas
Bacteria causing infection - Anaerobe
Clostridium (Gasphlegmone)
Tetanus
Fungi causing infection
Phythius spp.
Types of infections
- Primary infection
- Secondary infection
-Exogen (contact, aerogenic) – most common - Endogen (haematogen)
Pyogenic infection - causes and signs
- Staphylococcus
- Streptococcus, Rhodococcus
- Corynebacterium
- Pseudomonas
- E. coli
Signs
-Thrombotisation of vessels
-Necrosis and neutrophils
-Leukocytosis
LOCAL SIGNS OF PYOGENIC WOUND INFECTION IN SPECIFIC CLINICAL FORMS
- Sutured wounds
- Opened fresh wounds
SPECIAL CLINICAL FORMS OF PYOGENIC WOUND INFECTION
-Erysipelas
-Phlegmone
-Abscess
Erysipelas (obs Tx)
-Pyogenic germs specially streptococci in the skin
-Fastly progrediated and demarcated
-Pustule, phlegmone and gangrene
-Thr.: AB, sulfonamides (recidivate)
Phlegome (3)
(Obs Tx)
- Subcutaneous
- Subfascial and intermuscular:
Therapy: AB, rest, hyperaemisa bandage , ointment, NSAIDs
Phlegome can become abscess
- 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
Definition of pus
Serum and necrotic tissue part with dead leucocytes and bacteria
Cause of putrid wound infection (pathogens) (3)
-Clostridium
-Proteus
-Pseudomonas
Results of pyogenic infection (4)
- Toxaemis
- Septicaemia
- Pyemia
- Fistulation (bursitis)
GASPHLEGMONE
-Clostridium
-Manifestation of signs (1 – 4 hours)
-Emphysematous gas production
-Severe signs
Thr.: surgical approuche
Tx: tetanus
Thr.:
-Active – vaccination
-Passive – tetanus serum
-AB, diazepam, artificial feeding (infusion), ear plugs, silence and dark
