Final exam - Bites & wounds

Question 1

Treatment of animal bites

Answer 1

1. cleanse with mild soap and water or 1% povidone-iodone (Betadine) solution to remove the animal’s saliva
2. Irrigate with 500 to 2,000mL of normal saline with a 30mL syringe with an 18- to 20- gauge plastic catheter to achieve a pressure of 5 to 8 psi.
3. Tetanus booster if not given within last 5 years
4. Antibiotics for 3-5 days

Bite wounds of the hand should not be sutured.

If a dog or cat is healthy and available for 10 days of observation and shows no signs of rabies, no treatment of the exposed person is necessary.

Question 2

Tetanus immunization

Answer 2

All patients with wounds should be asked about prior tetanus immunization.

If more than 5 years have elapsed, a tetanus booster should be administered.

Question 3

Time frame for suture removal: Face

Answer 3

4-6 days

Question 4

Time frame for suture removal: Scalp

Answer 4

6-10 days

Question 5

Time frame for suture removal: Trunk

Answer 5

7-10 days

Question 6

Time frame for suture removal: Arms

Answer 6

10-14 days

Question 7

Time frame for suture removal: Legs

Answer 7

10-14 days

Question 8

Time frame for suture removal: Joints

Answer 8

14 days

Question 9

Patient education for wounds and bites

Answer 9

• red streaks
• increased warmth at the wound site
• increasing pain
• foul odor
• increased drainage from the bite wound
  —> the patient to seek urgent assessment in the clinic or ED.

Question 10

Pain management for animal bites

Answer 10

NSAIDS and tylenol

Toradol 30-60mg if those not effective

Question 11

Cleansing a lacerated wound

Answer 11

Saline irrigation or even soapy water is preferred to a dilute povidone-iodine (Betadine) solution

Povidone-iodine can be irritating and cytotoxic to lacerated tissue.

Avoid hydrogen peroxide (H2O2), because it can be irritating to the wound.

Question 12

Puncture wounds

Answer 12

All puncture wounds should be assessed for skin integrity, vascular and neurological function and range of motion

Question 13

Flexor-tendon injury

Answer 13

Flexor tendon injuries (tendons that allow you go bend your fingers) usually require primary wound closure by an orthopedic specialist. There is a high morbidity associated with flexor tendon injuries.

Question 14

Goals of care for abscess treatment

Answer 14

relieve symptoms

promote healing

prevent complications

Question 15

Treatment for abscess

Answer 15

• Incision and drainage
• Antibiotics
• Pain relief
• Warm compresses
• Wound care
• Follow-up to evaluate