Module 4: Wound care

Question 1

what is the largest organ for a horse

Answer 1

• the skin

Question 2

what functions does the skin hold

Answer 2

• 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

Question 3

what are the three layers of the skin

Answer 3

• epidermis (53um)
• dermis (1-6 mm)
• subcutaneous fatty tissue

Question 4

what is the stratum basal

Answer 4

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

Question 5

what is the stratum corneum

Answer 5

• highly keratinized anuclear corneocytes surrounded by hydrophobic secretions
• sloughs off (desquamation)

Question 6

what are keratinocytes

Answer 6

• make keratin fibrous protein
• immunity and healing
• > 90% epidermal cells
• structural protection

Question 7

what are melanocytes

Answer 7

• responsible for skin and coat colour
• Uv protection

Question 8

what are langerhan cells

Answer 8

• regulate immune response
• maintain homeostasis
• present antigen T-cells

Question 9

what are merkle cells

Answer 9

• sense external stimuli = mechanoreception
• pass sensory info to nervous system = mechanotransduction
• cutaneous circulation
• sweat protection
• hair cycle - shedding a summer coat

Question 10

what is the dermis

Answer 10

• collagen types 1 and 3
• strength
• elastin PSGAG - resiliance
• fibroblasts, mast cells and macrophages

Question 11

what is the basement membrane

Answer 11

• anchors epidermis to dermis
• laminin, collagen (IV VII)
• hemidesmosomes

Question 12

what are closed wounds

Answer 12

• 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

Question 13

what is a hematoma

Answer 13

• blood collection

Question 14

what is a seroma

Answer 14

• serum collected

Question 15

how can you help heal closed wounds

Answer 15

• hot/ cold therapy (3x 5 minutes 4 times a day)
• some require a surgical drain

Question 16

what is the issue with adding a drain to a closed wound

Answer 16

• that opens up an area for bacteria to come in

Question 17

what is a puncture wound

Answer 17

• 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

Question 18

how do you take care of a puncture wound

Answer 18

• completely remove any foreign material
• drain wound
• thoroughly clean
• continue to maintain dranage

Question 19

what are potential complications for puncture wounds

Answer 19

• infection spreads
• tissue necrosis
• tetanus

Question 20

what are open wounds

Answer 20

• they do not provide a home for anerobs
• disrupt integrity of the skin
• damage underlying tissues

Question 21

what is partial

Answer 21

not so deep (abrasions)
- leave them alone

Question 22

what is full thickness

Answer 22

deeper

Question 23

what are the 4 phases of full thickness healing

Answer 23

• hemostasis = blood loss control (stops blood flow through vasoconstriction)
• inflammation = remove foreign body
• proliferation = granultion of tissue (
• remodeling = scare tissue

Question 24

what is inflammation

Answer 24

• 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

Question 25

what happens when inflammatory response fails

Answer 25

• the growth of proud flesh
• overgrowth of skin cells
• can run rampid quickly

Question 26

how do you clean a wound

Answer 26

• hand syringe
• irrigation antiseptics ( balance bacteria effects)
• break up biofilms with dishsoap
• apply honey

Question 27

what is wound contraction

Answer 27

• rate depending on rate of healing

Question 28

what are the three layers of wound padding

Answer 28

• contact layer - not adherant (it cannot stick to the wound)
• padding layer : protectant , exudate absorbtion
• outer layer = compressive elastic

Question 29

what are the different types of wound dressing

Answer 29

• 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

Question 30

what id wound dressing dictated by

Answer 30

• site and size of wound
• stage of healing
• amount of exudate
• level of contamination

Question 31

how can you prevent proud flesh

Answer 31

• avoid caustic agents, occlusive bandages
• use foam dressing to absorb exudate and bacteria to prevent occlusions

Question 32

what are red alert sugns for wound managment

Answer 32

• eye
• joint
• spirting blood
• prolonged lamness

Question 33

what are treatments of proud flesh

Answer 33

• corticosteroids creams
• excisions

Question 34

what are causes of proud flesh

Answer 34

• distal limb
• large wound
• hypoxia ( no O2 to the area)
• inflamatory mediators (no vasiline)
• causic agents
• trauam