Lecture 16 4/1/25 STAR SLIDES Flashcards
What are the characteristics of primary wound closure?
-immediate closure
-clean, fresh wounds less than 6-8 hrs old
-no infection or exudative discharge
-minimal edema
-less aftercare
-rapid healing
-may trap infection; traumatized skin may have progressive necrosis
What are the characteristics of delayed primary closure?
-wounds closed after 1 to 2 days of open management
-mild contamination with no gross infection
-granulation tissue has not formed
What are the characteristics of secondary closure?
-wound closure after granulation tissue has formed
-provides time to clear infection, necrotic tissue, and/or debris
-gives wound time to “declare” extent of trauma
-requires debridement and culture
-may need flaps and/or reconstruction to close
What are the characteristics of second intention healing?
-wounds heal via contraction and epithelialization
-severely traumatized wounds
-minimal remaining tissue
-cheaper than surgical repair
-new skin/scar is easily traumatized and susceptible to damage
What are the characteristics of tie-over bandages?
-hold dressing in place in areas not easily bandaged
-stretches skin to facilitate closure
-can be used to reduce tension on primary closure
-can apply pressure to a site for hemostasis and/or dead space elimination
What are the characteristics of walking sutures?
-advances skin over wound
-only for skin with good blood supply
What are the characteristics of releasing and relaxing decisions?
-used in areas of high tension closure but with good supply
-want to use as few incisions as necessary
-incisions should be >/= 1 to 2 cm if multiple
-one single long releasing incision may be best
What are the characteristics of random pedicle flaps?
-local skin flaps to wound
-rely on subdermal plexus for blood supply
-want to test skin laxity to determine orientation and options
-should be as short as possible to cover wound with minimal tension
-flap should be widest at the base
-survival is dependent on local blood supply; tips tend to necrose
What are the characteristics of advancement flaps?
-do not produce a second wound
-can be unilateral or bilateral/H shaped
-single long releasing incision can be made for bipedicle advancements; does produce a wound
-large flaps will result in dog ears
What are the characteristics of axial pattern flaps?
-contain a direct cutaneous artery; better chance of living
-remains attached to local skin base
-many different flaps from around the body; named based on main arterial supply
-placed onto surgical wounds or granulation beds
What are the potential complications of flaps?
-donor site morbidity
-local structures can be distorted
-flap necrosis or dehiscence
What should be done if a flap necroses?
-necrosis can be left until healing is “complete,” then it is resected and the new wound is closed or managed
-wounds that form from the flap should be cultured
What should the owner be warned about regarding flap appearance?
-changes in hair and/or skin color
-changes in hair length and/or orientation
What are the characteristics of skin grafts?
-full thickness mesh grafts are most common and most successful
-can be placed onto muscle or healthy granulation beds
-must be stabilized to prevent motion
-need continuous contact with underlying tissue to revascularize
-referral procedure; complications with “graft take” are high
What are the indications for anal sacculectomy?
-recurrent anal sac impaction
-chronic anal sacculitis or abscessation
-perianal fistulas
-anal sac tumors
What is it important to treat local cellulitis prior to anal sacculectomy?
the anatomy is very difficult to identify when infected; can lead to complications
What are the characteristics of AGASACA?
-most common anal sac tumor in dogs
-hypercalcemia common; can lead to PUPD, vomiting, constipation
-removal of tumor/gland can alleviate hyperCa
-diagnosed via FNA
-patient should be staged for metastasis; many have mets at time of diagnosis
-recommended treatment is surgical removal +/- lymphadenectomy
What are the characteristics of vulvar fold dermatitis?
-excessive skin fold traps debris and moisture and leads to infection
-vulvar infection can lead to ascending UTI
-prior to surgery patient should be treated for UTI with topical antiseptic wipes or antibiotics
-surgery should be considered with recurrent dermatitis or UTI
What are the characteristics of ingrown tail/screw tail?
-most common in brachycephalics
-dorsal fold can be managed medically with topical antiseptics and wipes
-ventral fold compresses/covers anus; can trap feces, cause infections, and lead to severe pain
-surgical complications include nerve damage, neuroma, tail chasing, tenesmus, infection, and dehiscence
-referral procedure due to complication risks
