Lecture 12: Open Wound Management (Exam 2) Flashcards
When should wounds be covered w/ a clean & dry bandage
- Immediately after injury
- When the animal is brought for treatment
T/F: Further wound management should be done before life threatening injuries are treated & the animal’s condition stabilized
False
What are the fundamentals of wound management
- Temporarily cover the wound to prevent further trauma & contamination
- Asses the traumatized animal & stabilize its condition
- Clip & aseptically prepare the area around the wound
- Culture the wound
- Debride dead tissue & remove foreign debris from the wound
- Lavage the wound thoroughly
- Provide wound drainage
- Promote healing by stabilizing & protecting the cleaned wound
- Perform appropriate wound closure
What is the golden period
- First 6 to 7 H btw/ wound contamination @ injury & bacterial multiplication to greater than 10^5 CFU per gram of tissue
When is a wound classified as infected rather than contaminated
When bacterial #s exceed 10^5 CFU per gram of tissue
Define contamination
Presence of microbes on a surface
Define colonization
Surface microorganisms are replicating
Define infection
Invasion & replication of microbes w/in the tissue
What is the equation for microbial burden
(# of microorganisms x virulence)/ Host Resistance
Describe a class 1 wound
- 0 to 6 hours old
- Minimal contamination & tissue trauma
Describe a class 2 wound
- 6 to 12 hours old
- Microbial levels may not have reached critical level consistent w/ dev of infection
Describe a class 3 wound
- Older than 12 H
- Microbial levels may have reached critical level consistent w/ dev of infection
List the categories of wounds
- Abrasions
- Puncture wound
- Laceration
- Avulsion or degloving injury
- thermal burn
- Decubital ulcers
Describe abrasions
- Superficial & involve destruction of varying depths of skin by friction from blunt trauma or shearing forces
- Sensitive to pressure or touch & bleed min
- Heal rapidly by reepithelialization
Describe puncture wounds
- Small skin opening w/ deep tissue contamination & damage
- Wound depth & width vary depending on the velocity & mass of the object creating the wound
- The extent of tissue damage is directly proportional to missile velocity
- Pieces of hair, skin, & debris can be embedded in wounds
What can cause puncture wounds
- Penetrating foreign objects (stick, wire, or bone)
- Bite wounds
- Gunshot injuries
Describe lacerations
- Created by tearing which damages skin & underlying tissue (muscles & tendons)
- May be superficial or deep & have irregular edges
- Minimal peripheral trauma to the wound edges unless it is a concurrent avulsion injury)
Describe Avulsions
- The tearing of tissues from their attachments & the creation of skin flaps
- Exposed wound bed
- Common on distal limbs
What is degloving
Avulsion injuries on limbs w/ extensive skin loss
Define anatomic degloving
Skin & various levels of underlying tissue are torn off the limb
Define physiologic degloving
Skin surface is intact but separated or avulsed from underlying subQ tissue & blood supply (results in delayed necrosis of the skin)
Describe thermal burns
- May be partial or full thickness
- Caused by heat or chemicals
What can cause thermal burns
- Fire
- Cage dryers
- Heating pads
- Heat lamps
- Hot liquids
- Malicious incidents
What can deep extensive thermal burns cause
- Severe fluid loss
- Electrolyte loss
- Protein loss