large principles of wound healing and management

Question 1

what questions are you asking during the first assesment of a wound in large animals?

Answer 1

• How and why has this happened?
• What structures are involved?
• Is it traumatic? Surgical? Thermal? Chemical?
• How much contamination is present?
• location

Question 2

why is the location of a wound important in la?

Answer 2

the location will determine the healing potential nad if underlyign structures could implicate healing.
the healing rate is determined by location - trunk heals quicker than distal limb

Question 3

what do you need to think about regarding being able to examine the wound and blood loss in la wounds?

Answer 3

Sedation may be required:
High blood loss could be a contraindication with sedative hypertension

therefor could consider regional anesthesia to allow closer evaluation

Question 4

after evaluation of a wound in la what is the next step?

Answer 4

Taking the history is crucial:
- How old is the wound
- What caused it?

Systematic assessment required:
- Provides systemic compromise of the animal (co-morbidities)
- Skin or Underlying structures that could cause problems (anatomy is key!)

Question 5

In LA what do you need to consider relating to wounds that does not need to be evaluated as strongly in SA and why

Answer 5

lameness :
* High levels of mobility needed for welfare and for animal purpose
* Is level of lameness catastrophic for future work

Question 6

what are you inital thoughts about this wound (think about anatomy)?

Answer 6

Severe
Assumptions here are bracialplexus damage and penetration of thoracic cavity - thinking these are not damaged/penetrated
Horse likely to recover ok

Question 7

what are you inital thoughts about this wound (think about anatomy)?

Answer 7

Small
Specific synovial structure implications (calcaneal bursa)
This injury likely to have poor outcome
Sepsis = level of lameness not compatible with animal welfare

Question 8

when dealing with wounds over synovial structures, synovial fluid samples can be taken, what are you looking at with these?

Answer 8

• cellularity
• total solids
• inflammation or infection

Question 9

how can you see what damage has been done in LA wounds that are over joints?

Answer 9

• inject sterile contrast solution into buras and radiograph
• ultrasonography - object casting acoustic shadow or soft tissue damage
• radiograph - chronic wounds can cause sequestrum (devitalized/necrotic bone) acts as a foreign body

Question 10

what are you itital thoughts about these two wounds?

Answer 10

Image A
chronic wound
bone exposure

Image B
Acute
Bone exposure
Close to carpus
Carpal-metacarpal joint may be associated here
What other structures are involved