LA Wounds & Suture Knowledge (16)

Question 1

What type of closure should be performed on this type of laceration?

Answer 1

delayed primary closure

Question 2

What is involved in a delayed primary closure?

Answer 2

apply a wet to dry bandage to remove debris

close the wound in 1-2 days after it is as clean as possible

Question 3

What nerve block should you use to suture this wound?

Answer 3

abaxial nerve block

Question 4

Label the nerve blocks from top to bottom

Answer 4

low 4 point nerve block
abaxial sesamoid nerve block
palmar digital nerve block

Question 5

Which nerve block?

Answer 5

abaxial nerve block

Question 6

After closure, what is the best way to manage the wound?

Answer 6

foot cast - faster than a foot bandage

Question 7

What are the advantages to a foot cast?

Answer 7

• decrease motion
• wounds communicating with the coronary band will heal faster
• can be applied in the field

Question 8

What are the disadvantages to a foot cast?

Answer 8

• higher upfront cost
• cannot examine the wound daily
• open wounds will have copious discharge

Question 9

How do you manage equine foot casts?

Answer 9

stall rest - change elastic at the top of the cast every 1-2 days
- remove in 2-3 weeks

Question 10

What synovial structures might communicate with this wound?

Answer 10

pastern joint
coffin joint
navicular bursa
flexor tendon sheath

Question 11

How would you definitively determine the involvement of a synovial structure?

Answer 11

pressurize the synovial structure

Question 12

How would you treat this if it didn’t involve a synovial structure?

Answer 12

foot cast & second intention healing

Question 13

What type of closure should be used on this laceration?

Answer 13

delayed secondary

lots of granulation tissue which halts healing, need to cut granulation tissue off then allow it to heal

Question 14

Following closure, what would be the best method to protect the wound?

Answer 14

foot cast

Question 15

When closing large body wounds, what is the #1 complication that should be discussed with owners?

Answer 15

dehiscence

Question 16

What type of needle would you use to close the muscle layers?

Answer 16

taper point

Question 17

What suture pattern would you use to close the muscle?

Answer 17

simple continuous

Question 18

What suture would you use to close the skin of the wound?

Answer 18

prolene - nonabsorbable, monofilament

Question 19

What type of needle would you use to close the skin?

Answer 19

reverse cutting

Question 20

What tension relieving pattern would you use to close the skin of the wound?

Answer 20

vertical mattress

Question 21

What most likely causes dehiscence of the wound?

Answer 21

fluid accumulation, infection, inflammation

Question 22

What will you do to reduce the change of dehiscence of this wound?

Answer 22

all of the above

Question 23

Which wound was made parallel to Langer’s lines?

Answer 23

A

Question 24

What is the purpose of the drape in this picture?

Answer 24

provide a sterile field in case you drop your suture

Question 25

What joint may be involved in this hindlimb wound?

Answer 25

tarsometatarsal and distal intertarsal joints

Question 26

How would you debride this wound?

Answer 26

lavage with saline

Question 27

Which suture/needle would you use to close this wound?

Answer 27

0 prolene on a reverse cutting

Question 28

What suture patterns would be appropriate to close the wound?

Answer 28

simple interrupted vertical mattress near-far-far-near