Drains, sutures, and wound healing

Question 1

passive drain

Answer 1

thin walled, collapsible, latex rubber tubes, fluid escapes along the side of the drain

Question 2

active drain

Answer 2

works with negative pressure, uses force of suction

Question 3

Jackson Pratt drain

Answer 3

active drain
uses thick walled suction ball called a grenade

Question 4

mechanical suction drain

Answer 4

electrical machine continuously suctions, aids in healing and granulation tissue
ex: vacuum assisted closure (VAC)

Question 5

what is each suture tie called?

Answer 5

each suture tie is a throw

Question 6

what is it called when there is 3-5 suture throws?

Answer 6

a suture knot

Question 7

suture reactions

Answer 7

surgical gut is most reactive, may notice small bump over suture knot

Question 8

skin glue

Answer 8

used for skin closure on lacerations, cat declaws, cuts, tail docking
contraindications: infected wounds, deep punctured wounds
monomeric formulation which upon contact with alkaline environment, polymerizes and forms thin flexible and waterproof bandage
must prep wound 1st
contains dye to help differentiate skin glue from body fluid

Question 9

layered suture closure

Answer 9

most common
typically closed in 3-4 layers with small sutures on each layer

Question 10

modified Smead-Jones suture closure

Answer 10

closed in 3 layers
small sutures on fascia and skin layers with a bigger one on the subcutaneous/subcuticular layers

Question 11

mass suture closure

Answer 11

closed in 2 layers
a bigger suture around the fascia and subcutaneous layers and a smaller suture on the skin layer

Question 12

retention suture closure

Answer 12

a small suture on the subcutaneous layer and a big suture around all 4 layers of the skin

Question 13

purse string suture

Answer 13

commonly used for anal suture to prevent contamination during surgery

Question 14

wound healing

Answer 14

requires inflammation and blood supply
heals from inside out and pushes debris to the surface

Question 15

inflammation signs

Answer 15

erythema, heat, pain, edema, altered function

Question 16

how do you prevent a nosocomial infection?

Answer 16

wear gloves, use aseptic technique, pack with sterile lube when clipping hair, flush with sterile saline and can use 0.05% chlorohexidine solution, dress wound

Question 17

inflammatory phase

Answer 17

predominates 1st 6 hours ~ 5 days
initial vasoconstriction followed by vasodilation to control bleeding and then to clean and fill wound
exudates (high protein and cellular content) leak into wound which helps dilute contamination and spread WBCs into the wound

Question 18

debridement phase

Answer 18

starts after 6-12 hours
neutrophils and monocytes phagocytize organisms and debris
lymphocytes join in later

Question 19

repair phase

Answer 19

begins 3-5 days after injury
granulation tissue forms
fibroblasts make collagen and elastin
endothelial cells created= capillary infiltration
lympathic vessels develop
neutrophil numbers decrease while macrophages increase
epithelialization occurs over bed of granulation tissue
wound contraction begins (myofibroblasts)

Question 20

maturation phase

Answer 20

starts after ~2-3 weeks
can last years in certain tissues
collagen remodeling slowly increases tissue strength
scar develops and is remodeled with time (flatten and contract)
scars are pale due to less capillaries in fibrous tissue

Question 21

1st intention healing

Answer 21

bone fractures: internal fixation
promotes faster healing and less scarring

Question 22

2nd intention healing

Answer 22

bone fractures: external fixation (casts, splints, etc)

Question 23

proud flesh

Answer 23

exuberant granulation tissue produced in horses
can be prevented through primary wound closure and decreased movement
can be treated through Sx removal, caustic substance applied, steroid creams, and skin grafting

Question 24

skin graft

Answer 24

removing skin from 1 location of the body and suturing it over the wound
its survival depends on having a well-vascularized recipient bed and rapid re-establishment of circulation

Question 25

skin flaps

Answer 25

detaching an area of healthy skin adjacent to the wound, elevating it on all but 1 side, then rotating and suturing it onto the wound
more resistant to infection because blood supply is maintained which also helps improve circulation to recipient bed