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Equine Med and Surgery > Lacerations & Wound Management > Flashcards

Lacerations & Wound Management Flashcards

1
Q

Is skin thicker in younger or older horses?

A

older

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2
Q

Is skin thicker at extensor surface or flexor surface of legs?

A

thick at extensor surface

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3
Q

Wound that are parallel to what lines heal best?

A

equine cleavage lines

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4
Q

where is a distal limb wound?

A

below carpus and tarsus

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5
Q

where do equine cleavage lines run?

A

parallel to long axis of legs, head, and torso and perpendicular to long axis of neck and flank

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6
Q

where should incisions be made in relation to cleavage lines?

A

parallel

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7
Q

what are things to consider when having a distal limb wound?

A

tension
close to ground
synovial structure

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8
Q

why do most repaired wounds fail?

A

improper assessment & preparation

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9
Q

Describe initial preparation for wounds

A

order important

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10
Q

what is the purpose of debridement?

A

effective way to reduce bacterial load within a wound and minimize necrotic tissue

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11
Q

what are the advantages and disadvantages of sharp debridement?

A

advantage - least traumatic
disadvantage - when tissue is removed cannot be put back (be conservative)

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12
Q

what tools are considered sharp debridement?

A

scalpel, scissors, and lasers

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13
Q

which sharp debridement is the least traumatic and should be used?

A

scalpel

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14
Q

what are the methods of mechanical debridement?

A

woven gauze, lavage, wet to wet dressings, wet to dry dressings

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15
Q

what should be used when lavage?

A

solution - non-cytotoxic cleansing solution
delivery - 19G, 10-15 psi (don’t want high pressure to push it further into tissue)

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16
Q

when should chemical debridement be used?

A

reserved for very contaminated wounds, non-selective

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17
Q

what is used for chemical debridement?

A

hydrogen peroxide
hypertonic saline

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18
Q

what is used for biological debridement?

A

sterile medical grade larvae (maggots)

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19
Q

what do maggots digest?

A

necrotic tissue & pathogenic bacteria, healthy tissue is unharmed

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19
Q

which is more effective at removing necrotic tissue?

A
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20
Q

what is the least traumatic method of debridement?

A

autolytic debridement

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21
Q

what is autolytic debridement? what type of wounds can it only occur in?

A

leave wound fluid in contact with wound bed
only in moist wounds

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21
Q

define contamination

A
22
Q

define colonization

A
23
Q

define infection

A
24
Q

what does a qualitative assessment in wounds do?

A

determine type of bacteria in wound
guide antibiotic decision

25
Q

what does a quantitative assessment in wounds do?

A

bacterial counts
considered when wound is not progressing as anticipated

26
Q

when do you use an antiseptic?

A

used for normal skin surrounding wound and not on wound bed itself

27
Q

when do you use a topical antimicrobial agent?

A

BS to wound surface diminished (chronic infections), based on culture/sensitivity or judgement on most likely bacteria to be found in wound

28
Q

match the wound healing phases with the wound classifications

A
29
Q

what wounds are best candidates for primary or delayed primary closure?

A

early stages (inflammatory or debridement phase) and clean or clean contaminated

30
Q

List the wound closure techniques

A

primary closure, delayed primary closure, second intention, skin grafting, combinations

31
Q

The type of closure used depends on the following…

A

what caused the wound, time from injury, degree of contamination, extent of injury, potential dead space, surgical skills

32
Q

what type of wounds can get primary closure?

A

minimal tissue loss, minimal bacterial contamination, and minimal tension on wound edges after closure

33
Q

Define primary closure

A

wound is closed immediately and completely using strict aseptic technique

34
Q

How do you reduce tension in a wound?

A

suture patterns: near-far-far-near, interrupted vertical or horizontal mattress with stents
use large diameter suture material
undermine wound edges

35
Q

What can failure to obliterate dead space lead to?

A

hematoma/seroma development > excellent medium for bacterial growth

36
Q

How can you close dead space?

A

suture, meshing skin, passive or active drains, pressure bandages

37
Q

what is delayed primary closure?

A

wound initially left open to allow for debridement and reduce bacterial contamination then closed primarily

38
Q

what is delayed primary closure useful in managing?

A

contaminated wounds

39
Q

what closure method would you use?

A
40
Q

what is second intention healing?

A

heal via contraction, granulation, and epithelialization

41
Q

when is second intention healing used?

A

gross contamination and moderate to severe tissue loss makes closure difficult

42
Q

When do you use a wound dressing?

A

open wound changes as it heals - different dressings for different stages

43
Q

Describe ideal wound dressing

A

keeps wound bed moist and surrounding skin dry
manage amount of exudate while making sure wound does not dry out

44
Q

what is the benefit of head wounds?

A

extensive vascular supply
good soft tissue support

45
Q

what do you always do with a head wound?

A

neurologic exam

46
Q

what diagnostic aids do you use for head wounds?

A

radiographs, ultrasound, computed tomography, MRI

47
Q

what are the important structures to consider in head wounds?

A

brain, eyes, ears, paranasal sinuses, salivary ducts, nerves

48
Q

what cannot be used to clean the orbit?

A

chlorhexidine - can cause corneal damage, use betadine

49
Q

when dealing with eyelides how should lacerations be closed? why?

A

small diameter absorbable suture in many layers
provides more stability in high motion area without adding foreign body volume to wound

50
Q

How should ear wounds be addressed?

A

closed primarily

51
Q

what is very important for thorax wounds?

A

use aseptic techniques to determine their depth

52
Q

when do you use a stent bandage?

A

thorax wound
prevents air from getting sucked into it

53
Q

what should you listen for with a thorax wound?

A

air getting sucked into wound during inspiration

54
Q

what do you do for a wound with pleural penetration?

A

broad-spectrum antibiotics and referral

55
Q
A

Equine Med and Surgery (18 decks)

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