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2025 - Intro to Surgery 737A > Exam 2: Lecture 15: Bandaging and Open Wound Management > Flashcards

Exam 2: Lecture 15: Bandaging and Open Wound Management Flashcards

1
Q

what should you always do on the initial exam FIRST

A

STOP THE BLEEDING!!

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2
Q

what are the 4 things we need to look at during our initial exam

A
  1. time elapsed
  2. blood loss
  3. prior treatment/vaccine
  4. mechanism of injury
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3
Q

how much time can pass for primary closure in horses

A

12 hours

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4
Q

how can you tell the amount of blood loss in the patient (other than looking at the blood on the ground)

A

heart rate, respiratory rate, membrane colors, CRT

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5
Q

why do we need to know if the there was any prior treatment or vaccine status for wounds

A

need to know if owner gave any meds prior to you showing up

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6
Q

why does the mechanism of injury matter

A

because higher energy at impact = greater tissue damage = vascular compromise

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7
Q

what is the most important vaccine status to check

A

tetanus!

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8
Q

what should we do if there is no history of tetanus vaccine or it is greater than 12 months

A

give tetanus toxoid and tetanus anti-toxin

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9
Q

what should we do if the tetanus vaccine status is greater than or equal to 2 months ago

A

give a tetanus toxoid booster

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10
Q

what should we do if the tetanus vaccine status is less than 2 months

A

no booster needed!

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11
Q

what can we use for patient restraint

A

twitch, ace, alpha-2 agonists, opiods

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12
Q

what should we look for when visually assessing the wounds

A

location and contamination/infection

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13
Q

what is important to look for with wound location

A

is there blood supply? Is there a synovial structure involved? Any other structures involved?

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14
Q

what should we do when clipping and cleaning wounds

A

apply sterile lube to wound and clip at least 2 inches around the wound

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15
Q

what type of antiseptic may/may not be used on wounds

A

can use - providone iodine, chlorhexidine, or sterile saline

should not use - alcohol or garden hose (causes edema)

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16
Q

what position is the horse usually in when suturing lacerations

A

standing!

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17
Q

what type of medications can we use for wound anesthesia

A

lidocaine or mepivacaine

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18
Q

what type of local anesthesia options are there for wounds

A

peripheral nerve blocks or local infiltration

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19
Q

what type of technique should we use for wound blocks

A

block away from wound

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20
Q

how can we explore wounds

A

digital palpation, sterile prob, radiographs

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21
Q

what is the correct way to lavage a wound

A

10-15 psi by using a 18g needle on 35ml or 60ml syringe

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22
Q

what do we do if there is synovial involvement in a wound

A

complete a synoviocentesis (with sterile prep away from wound), sample the fluid, pressurize the structure and inject antibiotic

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23
Q

what are the 3 types of wound debridement

A
  1. sharp
  2. mechanical
  3. autolytic
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24
Q

what is sharp wound debridement

A

using a scalpel blade to debride the most superficial layer

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25
Q

what is mechanical wound debridement

A

wet to dry bandage but do not use once epithelialization has started

26
Q

what is autolytic wound debridement

A

moist wound healing where WBCs and enzymes degrade necrotic tissue leaving the healthy tissue alone

27
Q

what are the 3 less common ways of wound debridement

A

chemical, enzymatic, and biological

28
Q

what are the 2 types of wound closure

A

primary and delayed primary

29
Q

when can we do primary closure

A

close immediately, warn owner of possible dehiscence, and must be <12 hours

30
Q

what is delayed primary wound closure

A

close after a period of debridement that is within 3-5 days of the injury

31
Q

when do we use second intention healing

A

no closure, large wound, chronic, contaminated, or skill loss, or after there is granulation tissue

32
Q

what are the different drains for wound closure

A

closed drain = jackson-pratt (doesnt have to be ventral)

open drain = penrose (must be placed most ventral)

33
Q

what type of drain is this

A

jackson-pratt

34
Q

what type of drain is this

A

penrose

35
Q

what should we remember when picking suture material

A

we want minimal tissue reactivity with sufficient strength

36
Q

what type of suture material should we use for wounds

A

non-absorbable monofilament (nylon or prolene)

37
Q

what type of suture patterns should we use for non tension areas

A

simple interrupted

38
Q

what type of suture pattern should we use for high tension areas

A

vertical mattress and near-far-far-near

39
Q

how far should should the suture be placed away from wound edge

A

0.5cm

40
Q

what are the different types of wound dressings

A

gauze, telfa pad, hypertonic saline dressing (curasalt), calcium alginate (curasorb)

41
Q

how do we use gauze for wound dressings

A

wet-to-dry bandages, debridement of heavily contaminated/exudative wounds

42
Q

when do we use telfa pads

A

on surgical wounds or sutured wounds (non-adherent or non-occlusive)

43
Q

how do we use hypertonic saline dressing (curasalt)

A

aggressive wound debridement, first few days only

44
Q

when/how do we use calcium alginate (curasorb)

A

on moderately exudative wounds and/or substantial tissue loss

creates a gel that promotes moist wound healing

45
Q

what are the guidelines for bandaging

A

even tension, appropriate tension, and cover the required areas

46
Q

what is included in the inner bandage for horses

A

non-adherent first layer held in place with kling gauze

47
Q

what is included in the outer bandage

A

sheet cotton, gamgee, or combiroll combined with vet wrap

48
Q

what type of bandage is this

A

carpal bandage

49
Q

what type of bandage is this

A

tarsal bandage

50
Q

what are some of the complications of bandages

A

pressure sores or bandage bows

51
Q

what is a bandage bow

A

extensor/flexor tendon inflammation, no actual disruption of the tendon via too little padding or wrapped too tight

52
Q

what should we always warn owners about with wounds

A

dehiscence!!!

53
Q

what is “proud flesh”

A

exuberant granulation tissue

54
Q

what are predisposing factors for exuberant granulation tissue (proud flesh)

A

bandaging after granulation tissue is present, movement, large wound with second intention healing, bone sequestrum, wound irritation

55
Q

what is the treatment for proud flesh

A

sharp debridement, topical steroids, or skin grafting

56
Q

what is bone sequestrum

A

dead, infected piece of bone via bacteria from a wound/necrosis from damage to blood supply

57
Q

what are the signs of bone sequestrum

A

a non-healing wound

58
Q

how do we treat bone sequestrum

A

typically requires surgical removal

59
Q

what is cellulitis

A

severe edema in the limb associated with a relatively small wound

60
Q

how do you treat cellulitis

A

systemic antibiotics, anti-inflammatories, and bandaging

2025 - Intro to Surgery 737A (19 decks)

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