seminar - small animal wounds Flashcards
what is the wound healing continuum?
4 stages of wound healing, wounds should always go from left to right
necrotic - sloughy, granulating, epitheliasation
At what stage to wounds get stuck at in vet med?
granulating
what stage of wound healing produces the most moisture and how does this relate to healing?
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
what stage is this wound at?
granulation with sloughly patches
what stage is this wound at?
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
when closing a wound what type of tissue needs to be under the skin?
the skin needs to be placed over a healthy granulation bed
what is th key to wound management in small animals
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)
what are the option for bringing in new epithelium to a wound?
- pinch/puch graft
- free skin graft
do granulation beds have feeling?
no they have no nerve endings
what wound dressings absorb moisture?
what dressign are neutral (maintian moisture)?
what dressings add moisture?
what criteria needs to be thought about when selecting a dressing?
- Frequency of change
- Ease or difficulty of dressing change procedure
- Availability of products
- Cost of products
- **Requirement for hospitalisation **
- Requirement for topical antimicrobial agent
what is the most common foam dressing the UK?
Allevyn (smith and nephew)
what is the composition of faom dressing?
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
how much fluid can a 10x10cm 40ml allevyn foam dressing absorb?
40ml
what is the issue with bandaging over the top of foam dressing?
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
what can saturated foam dressings cause to wounds?
maceration of healthy skin - the softening and breaking down of skin resulting from prolonged exposure to moisture.
what are hyrdogel dressings?
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
what is the concern with putting cling film on a wound?
water vapour impermeable - maceration concern
what can be used topically on wounds instead of antibiotics?
sliver - ions, nitrates, creams, crystals
honey - antibacterial, anti-inflammatory, debriding effect
what is the common mistake that people make when using honey ?
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
when are tie over dressing used?
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
