small animal wounds Flashcards
What is the wound healing continuum
Describes stage of wound healing based on colour
If going well should always go from left to right
In what phase to wounds normally get stuck
Granulation
Describe the wound progression model
Shows colours and phases
Also degree of moisture wounds are producing
There is optimum level of moisture to help wound heal faster (so might want to add dressing to wound to increase moisture)
In sloughing might want to put on dry dressing to remove moisture
Where in wound is epithelialisation seen?
Always around the edges (never in middle) because it comes from epithelium
What needs to be done here to promote healing
Thermal injury
Skin is necrotic
Debride to remove dead tissue to create a healthy granulation bed
Once you have this healthy granulation bed, what are the options?
- Second intention healing
- contraction & epithelialisation
- takes a long time (8-10 weeks) during which dog cant do a lot of normal things
- high chance of infection - Tertiary healing
- surgically close wound over top of healthy granulation bed (important!)
- need enough skin laxity
- will heal quicker and dog needs less vet visits (may be cheaper) - Bring in new epithelium
- pinch/punch grafts
- free skin grafts
Describe pinch/punch grafting
Taking little islands of skin from other areas (usually flank) with scalpel or dermatology punch biopsy device
Seeding them onto healthy granulation bed
Dress them in and after 48 hours they’ll be sufficiently attached
Increased epithelial surface area
Describe a free skin graft
Take skin graft from flank, close wound
Take fat off back of skin
Lay on healthy granulation bed
Make sure it is in close contact with granulation bed because in first days only thing keeping skin alive is diffusion of nutrients & oxygen from granulation bed before blood vessels start to grow into the graft
Describe wound care product selection
Wounds are dynamic & will require different approaches during healing process
Continually reassess patient & wound
Topical therapy is both responsibility of vet surgeon & vet nurse – team approach
Continually remain up-to-date with products so informed decisions can be made
Describe the criteria for wound dressing product selection
Describe foam dressings
Very common
e.g. allevyn
Foam dressings are absorbent, sponge-like polymer dressings (polyurethane)
Provide thermal insulation & help create moist wound environment
Has contact inner layer (silicone prevents it from sticking to wound)
And non-contact outer layer (waterproof)
Dressings containing hydrophilic polyurethane foam (adhesive or non-adhesive)
- with or without plastic film-backing
Suitable for all types of exuding wounds, but not for dry wounds
- some have moisture-sensitive film with variable permeability dependant on level of exudate
Vary in ability to absorb exudate
- some suitable only for lightly to moderately exuding wounds, others have greater fluid-handing capacity & are suitable for heavily exuding wounds
How much fluid can foam dressings absorb
normally 1:1 ratio for volume of dressing & volume to fluid it will absorb
If used under compression bandaging, fluid-handling capacity of foam dressing may be reduced
What are the consequences of incorrectly used foam dressings
Saturated foam dressings can cause maceration of healthy skin if left in contact with wound
Describe hydrogel dressings
made up of primarily water in polymer to maintain moist wound base
available in amorphous or sheet formulations
can take up shape of wound
secondary, non-absorbent (foam) dressing needed
used to donate liquid to dry wounds
avoid in presence of infection
unsuitable for heavily exuding wounds
Why is cling film not generally used as a dressing
water vapour impermeable so causes maceration if not changed frequently enough
Describe the applications and actions of these types of silver
Describe tie-over dressing
