seminar - small animal wounds

Question 1

what is the wound healing continuum?

Answer 1

4 stages of wound healing, wounds should always go from left to right
necrotic - sloughy, granulating, epitheliasation

Question 2

At what stage to wounds get stuck at in vet med?

Answer 2

granulating

Question 3

what stage of wound healing produces the most moisture and how does this relate to healing?

Answer 3

the sloughly wound produces the most moisture - the amount of moisture will affect the healing stage.
sloughing wounds need a dry dressing and a granulating wound needs a moist dressing

Question 4

what stage is this wound at?

Answer 4

granulation with sloughly patches

Question 5

what stage is this wound at?

Answer 5

necrotic skin with sloughy patches and epithelisation around the edge
eschar - dead tissue that forms over healthy skin and then, over time, sheds. It is caused by a burn or cauterization

Question 6

when closing a wound what type of tissue needs to be under the skin?

Answer 6

the skin needs to be placed over a healthy granulation bed

Question 7

what is th key to wound management in small animals

Answer 7

need to ge tskin to a healthy granulation bed and then can:
can let wound heal by its self - secondary intntion
or
can close the wound - third intenstion (second surgical closure)

Question 8

what are the option for bringing in new epithelium to a wound?

Answer 8

• pinch/puch graft
• free skin graft

Question 9

do granulation beds have feeling?

Answer 9

no they have no nerve endings

Question 10

what wound dressings absorb moisture?

Answer 10

Question 11

what dressign are neutral (maintian moisture)?

Answer 11

Question 12

what dressings add moisture?

Answer 12

Question 13

what criteria needs to be thought about when selecting a dressing?

Answer 13

• Frequency of change
• Ease or difficulty of dressing change procedure
• Availability of products
• Cost of products
• **Requirement for hospitalisation **
• Requirement for topical antimicrobial agent

Question 14

what is the most common foam dressing the UK?

Answer 14

Allevyn (smith and nephew)

Question 15

what is the composition of faom dressing?

Answer 15

Foam dressings are absorbent, sponge-like polymer dressings (polyurethane).
In addition to providing thermal insulation, they help create a moist wound environment.

Have a silicon layer that allows water to pass through and sit in the absorbant foam layer, this fluid will then evapourate out through the waterproof, vapour-permeable film on the back - this is why they keep it moist and not wet

Suitable for all types of exuding wounds, but not for dry wounds

Foam dressings vary in their ability to absorb exudate some are suitable only for lightly to moderately exuding wounds, others have greater fluid-handing capacity and are suitable for heavily exuding wounds

Question 16

how much fluid can a 10x10cm 40ml allevyn foam dressing absorb?

Answer 16

40ml

Question 17

what is the issue with bandaging over the top of foam dressing?

Answer 17

the bandage will constrict the faom and therefore reduce its capacity therfore wound more wet. will also affect the evaporation ability of the dressing, therefore wound will remain too wet. need to be checked regualarly

Question 18

what can saturated foam dressings cause to wounds?

Answer 18

maceration of healthy skin - the softening and breaking down of skin resulting from prolonged exposure to moisture.

Question 19

what are hyrdogel dressings?

Answer 19

Made up of primarily water in a polymer to maintain moist wound base

Available in amorphous or sheet formulations
Can take up the shape of the wound
A secondary, non-absorbent dressing is needed
Generally used to donate liquid to ‘dry’ wounds
Avoid in presence of infection
Unsuitable for heavily exuding wounds

Question 20

what is the concern with putting cling film on a wound?

Answer 20

water vapour impermeable - maceration concern

Question 21

what can be used topically on wounds instead of antibiotics?

Answer 21

sliver - ions, nitrates, creams, crystals
honey - antibacterial, anti-inflammatory, debriding effect

Question 22

what is the common mistake that people make when using honey ?

Answer 22

as the honey has osmotic effect, it draws water out of the wound, this can be mistaken as adding water to the wound (this is not occuring), be careful when using honey on granulation tissue as we want a moist enviroment for granulation tissue and honey creates a dry enviroment, should only use on granulation tissue for antimicrobial effect

Question 23

when are tie over dressing used?

Answer 23

on ares that cannot be wrapped in a bandage, or on limbs where bandage would slip off
place some loose sutures around the wound then place gauze and tie inplace, and cover with a nappy