Module 4: Wound care Flashcards
what is the largest organ for a horse
- the skin
what functions does the skin hold
- protection = anatomic and physical barrier
- thermoregulation = hair coat, regulation of continuous blood supply and sweat glands
- sensory organ = how sensitive the skin is depends on innate features
- vitamin D synthasis
what are the three layers of the skin
- epidermis (53um)
- dermis (1-6 mm)
- subcutaneous fatty tissue
what is the stratum basal
stratum basale = germinal cells generate all cells of the epidermis
- produces cells to replenish and repair outer layers
- produces basement memebrane, an adhesive interface between epidermis and dermis
what is the stratum corneum
- highly keratinized anuclear corneocytes surrounded by hydrophobic secretions
- sloughs off (desquamation)
what are keratinocytes
- make keratin fibrous protein
- immunity and healing
- > 90% epidermal cells
- structural protection
what are melanocytes
- responsible for skin and coat colour
- Uv protection
what are langerhan cells
- regulate immune response
- maintain homeostasis
- present antigen T-cells
what are merkle cells
- sense external stimuli = mechanoreception
- pass sensory info to nervous system = mechanotransduction
- cutaneous circulation
- sweat protection
- hair cycle - shedding a summer coat
what is the dermis
- collagen types 1 and 3
- strength
- elastin PSGAG - resiliance
- fibroblasts, mast cells and macrophages
what is the basement membrane
- anchors epidermis to dermis
- laminin, collagen (IV VII)
- hemidesmosomes
what are closed wounds
- bruises
- traumatic injuries that did not breach the skin
- they can swell up
- can be both hard and soft lump
- some can clear up on their own
- some cant
what is a hematoma
- blood collection
what is a seroma
- serum collected
how can you help heal closed wounds
- hot/ cold therapy (3x 5 minutes 4 times a day)
- some require a surgical drain
what is the issue with adding a drain to a closed wound
- that opens up an area for bacteria to come in
what is a puncture wound
- small entry hole, breaking dermis and epidermis
- problem areas - joints, body cavity, or eye
- cause shock
- potentially the most dangerous because they can go undetected and porvide an entry point for bacteria
how do you take care of a puncture wound
- completely remove any foreign material
- drain wound
- thoroughly clean
- continue to maintain dranage
what are potential complications for puncture wounds
- infection spreads
- tissue necrosis
- tetanus
what are open wounds
- they do not provide a home for anerobs
- disrupt integrity of the skin
- damage underlying tissues
what is partial
not so deep (abrasions)
- leave them alone
what is full thickness
deeper
what are the 4 phases of full thickness healing
- hemostasis = blood loss control (stops blood flow through vasoconstriction)
- inflammation = remove foreign body
- proliferation = granultion of tissue (
- remodeling = scare tissue
what is inflammation
- heats area
- liberate mediators to amplify and sustain healing
- prepare for healing
- remove foreign substances
- removal of dead tissues
- activated neutrophils - phagcytize bacteria ( eating)
- macrophages coordinate healing
what happens when inflammatory response fails
- the growth of proud flesh
- overgrowth of skin cells
- can run rampid quickly
how do you clean a wound
- hand syringe
- irrigation antiseptics ( balance bacteria effects)
- break up biofilms with dishsoap
- apply honey
what is wound contraction
- rate depending on rate of healing
what are the three layers of wound padding
- contact layer - not adherant (it cannot stick to the wound)
- padding layer : protectant , exudate absorbtion
- outer layer = compressive elastic
what are the different types of wound dressing
- occlusive - not reccomened past initial stages - can stimulate proud flesh (exception silicon gell pads)
- semi occlusive - generally perferred
- non- occlusive - may require more frequent changing
what id wound dressing dictated by
- site and size of wound
- stage of healing
- amount of exudate
- level of contamination
how can you prevent proud flesh
- avoid caustic agents, occlusive bandages
- use foam dressing to absorb exudate and bacteria to prevent occlusions
what are red alert sugns for wound managment
- eye
- joint
- spirting blood
- prolonged lamness
what are treatments of proud flesh
- corticosteroids creams
- excisions
what are causes of proud flesh
- distal limb
- large wound
- hypoxia ( no O2 to the area)
- inflamatory mediators (no vasiline)
- causic agents
- trauam
