LASx Exam 1: Wound Management Flashcards
T/F: The golden period of wounds in horses is the period of
time where there is less than 10^5 bacteria per gram of tissue
FALSE! THERE IS NO GOLDEN PERIOD IN EQUINE WOUNDS!
What type of closure have you done if you close a wound 2 to 5 days after injury, but before granulation tissue production?
Delayed primary closure
What type of closure have you done if you close a wound 5 or more days after injury, and granulation tissue is present?
Secondary closure
T/F: Epithelialization starts IMMEDIATELY after wounding
TRUE
Collagen deposition begins ______ days after wounding
2 - 3 days
What is angiogenesis initiated by?
Decreased oxygen tension
Increased lactate
Decreased pH in the wound
The final scar after wounding is ______% weaker than original
15 - 50 % weaker
What is the best type of debridement in equine patients?
Sharp and autolytic
What is the best thing to use for wound lavage?
SALINE! (not dilute antiseptics)
T/F: Nitrofurazone is a good topical agent for treatment of wounds
FALSE! It is carcinogenic
_______ is the most common hypertonic saline dressing and
is used for exudative or necrotic wounds
CURASALT
What is the best antimicrobial dressing for post-op wounds
to prevent infection
KERLIX AMD
What is the active antimicrobial agent of Kerlix AMD?
Polyhexamethylene Biguanide (PHMB)
T/F: Corticosteroids are good for reducing granulation tissue
formation in acute wounds
FALSE! NEVER USE CORTICOSTEROIDS
In the equine there are differences in healing based on
wound locations.
BODY wounds are more efficient at contraction ( ____ mm/day)
and
LIMB wounds are slow at contraction ( ____ mm/day)
Body (1 mm/day)
Limb (0.2 mm/day)
The best way to close a distal limb wound is with
___________ closure
PRIMARY closure (and tight bandages)
How do you treat proud flesh of a distal limb wound?
Resection + bandage + delayed secondary closure +/- skin grafts
Why does proud flesh occur?
Inefficient protracted inflammatory phase results in
excessive proliferation phase
T/F:
You must anesthetize when removing proud flesh
FALSE- exuberant granulation tissue is void of nervous tissue- it is just fibroblasts and capillaries and is not painful
What is the most important step in skin grafting?
Granulation bed preparation!
Determines if the graft will fail or not
What is the most common bacteria with granulation tissue
and grafting?
Pseudomonas
What is the most effective topical Abx therapy
against pseudomonas- the most common bacteria with
granulation tissue and skin grafting?
TICARCILLIN
A skin graft that remains connected to the donor site is called a
pedicle graft
This type of graft requires a dermatome
Split-thickness graft
What are the two steps that occur during revascularization
of a new graft and when do they occur?
Inosculation - 48 hours
Neovascularization - 4 - 5 days
In a horse, where do you harvest tissue for a punch graft?
Under the mane or the ventrolateral abdomen.
Must excise SQ fascia and fat!
For a punch graft, recipient holes are placed _____ mm apart
in a symmetrical pattern, and recipient holes
must be _______ than the donor holes
6 mm apart
Recipient holes must be smaller than the donor holes
T/F:
Full thickness sheet grafts resist trauma better than split thickness
grafts, but are much more fragile
TRUE
What is the purpose of meshing sheet grafts?
Allow the graft to cover a wound larger than itself AND
PREVENT FLUID from disrupting graft from fibrinous and vascular attachments
T/F:
Clean, healthy granulation tissue is needed at the
recipient site of a free graft
TRUE
Which topical Abx do you use 24 - 48 hours prior to
grafting on the recipient site?
TICARCILLIN
Which two bacterias can infect a wound at much lower
concentrations in the horse?
B-hemolytic strep and pseudomonas
