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LA Sx Exam 1 > Excessive Granulation Tissue and Skin Grafting > Flashcards

Excessive Granulation Tissue and Skin Grafting Flashcards

1
Q

Are wounds on the body or on the limbs more efficient at contraction?

A

On the body (1mm/d vs. 0.2mm/d)

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2
Q

Where does proud flesh most commonly occur?

A

Distal limb wounds

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3
Q

Why is healing potential of distal limb wounds limited?

A

No muscle/excessive tissue, close to contamination, constant movement

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4
Q

What is often the only option for distal limb wound closure?

A

2nd intention healing

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5
Q

Excessive granulation tissue

A

Proud flesh

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6
Q

How do you treat proud flesh?

A

Resection and bandage, delayed 2* closure, skin grafts

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7
Q

Why does proud flesh occur?

A

Inefficient and protracted inflammatory phase of healing = excessive proliferative phase

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8
Q

Maintain their synthetic role rather than differentiating into myofibroblasts (which allow for contracture)

A

Fibroblasts

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9
Q

s stay higher longer and release pro-inflamm. mediators = exuberant granulation tissue

A

PMNs

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10
Q

How does excessive granulation tissue affect healing?

A

Delays it

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11
Q

Why is only sedation and not a local block required to resect proud flesh?

A

Proud flesh doesn’t have nerves

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12
Q

How much will proud flesh bleed during resection?

A

A LOT

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13
Q

In which location is proud flesh most likely to occur?

A

MC/MT

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14
Q

Simple to perform and often performed in a standing sedated horse

A

Skin grafts

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15
Q

How can you ensure the wound bed is healthy enough to receive a skin graft?

A

Topical abx (Ticarcillin) for a few days

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16
Q

What are indications for skin grafts?

A

Wounds too large to heal otherwise, open wounds that can’t be sutured

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17
Q

Type of graft in which the graft remains connected to the donor site

A

Pedicle graft

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18
Q

Type of graft that is completely separated from the donor site blood supply

A

Free graft

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19
Q

Best cosmesis and hair growth but more difficult to survive

A

Full thickness skin graft

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20
Q

Better success but less cosmetic outcome

A

Split thickness skin graft

21
Q

Epidermis and entire dermis

A

Full thickness skin graft

22
Q

What is the amount of dermis required for a split thickness graft proportional to?

A

Durability and cosemesis

23
Q

Where are allograft donor sites most often in horses?

A

Underneath the mane or ventrum of abdomen

24
Q

How does a graft adhere to a recipient site?

A

Fibrin

25
Q

Nourisment by plasma-like fluid via capillary action

A

Serum imbibition

26
Q

How quickly does neovascularization occur at a graft site?

A

48hr

27
Q

How soon does revascularization occur at a graft site?

A

4-5d

28
Q

Why does the epidermis of the graft thicken in the first weeks?

A

Organization of collagen to match recipient site

29
Q

What are the different types of island grafts?

A

Punch, pinch, and tunnel

30
Q

Which types of island grafts are more often done because they are the least amount of work and most responsive?

A

Punch and pinch

31
Q

What are different types of sheet grafts?

A

Solid or meshed

32
Q

GA not required, minimal equipment, minimal technical expertise, complete failure is rare

A

Punch and pinch grafts

33
Q

Recipient holes of a punch graft are _____ than the harvested skin of the donor site

A

Smaller

34
Q

Poor cosmesis and little hair regrowth

A

Punch and pinch grafts

35
Q

How are recipient holes organized?

A

6mm apart in symmetrical pattern stating distally

36
Q

What is the % chance that a punch graft survives?

A

60-75%

37
Q

Tent skin and transect 3mm disc w/#11 blade

A

Pinch graft

38
Q

Where are pinch graft pieces stored prior to placing on the donor site?

A

Saline moistened gauze

39
Q

What are the 3 main reasons for graft failure?

A

Hemorrhage, motion, and infection

40
Q

What is the most common cause for graft failure in hoses?

A

Infection

41
Q

How does hemorrhage cause graft failure?

A

Hematoma prevents fibrin from attaching graft to wound

42
Q

What bacteria can infect a wound with lower concentration than 10^5 bacteria/g tissue?

A

B-hemolytic strep and Pseudomonas

43
Q

What is the most important thing for suvival of a free graft?

A

Prep of recipient site

44
Q

Resist trauma better than split thickness graft and has the best cosmetic appearance

A

Full thickness sheet graft

45
Q

Allows graft to cover wound larger than itself

A

Meshing sheet graft

46
Q

Prevents fluid from disrupting graft from fibrinous and vascular attachment

A

Meshing sheet graft

47
Q

Conforms to irregular surfaces

A

Meshing sheet graft

48
Q

How do you secure a sheet graft to a wound?

A

Tack at the wound margin

49
Q

How long should you wait to change the bandage over a graft?

A

4-5d OR change daily

LA Sx Exam 1 (17 decks)

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