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FAMS > Wound and Fracture Management > Flashcards

Wound and Fracture Management Flashcards

1
Q

What is the timeline on which skin heals?

A

Day 1-7 Inflammation
Day 4-14 Proliferation
Day 13-Months Maturation/Remodeling

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2
Q

What cell is essential for inflammation?

A

Neutrophil

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3
Q

What does inflammation do for a injured site?

A

Vascularizes it (vasoconstriction with platelet aggregation, vasodilation with clots, leukocyte eat bacteria)

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4
Q

What is another key part of wound healing related to inflammation?

A

Debridement of tissue (necrotic) - macrophage helps with this

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5
Q

What occurs during proliferation?

A

Fibroblast make extracellular matrix and collagen
Granulation tissue forms (capillaries and fibroblasts - protect wound and provide physical scaffolding

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6
Q

What occurs during remodeling?

A

Collagen continues to remodel and re-orient for months
-Scar has decreased strength, vascularity and cellularity

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7
Q

Describe the following types of wound:
-Clean:
-Clean Contaminated:
-Contaminated:
-Dirty:

A

-Clean: Non-traumatic, no break sterile tech (right flank pyloro-omntopexy abomasum)
-Clean Contaminated: Enter luminal organ without spillage (c-section)
-Contaminated: Enter luminal organ without spillage, fresh traumatic (Dehorn, castration, rumen cannulation, mam vein laceration)
-Dirty: Gross infected, old trauma, devitalized wound with necrotic tissue (wire injury, puncture, equipment wound)

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8
Q

What are some considerations for patient preparation?

A

Restrain, chemical, pain control

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9
Q

What does the intial wound assessment require?

A

Gloves, clip hair, clean would with mild soap clean gloves and cold pack to work on, lavage and debride

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10
Q

What fluid should you use for a lavage?

A

Isotonic - more with pressure

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11
Q

How should primary closure be performed?

A

Muscle and fascia - absorbable - chromic gut

Skin nonabsorbably - monofilament - polymamid or braunamid

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12
Q

Why are tension relieving sutures important?

A

Prevent pressure necrosis, prevent suture failure, interrupt circulation, inhibit wound healing

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13
Q

What are some tension relieving sutures?

A

Near far far near, Mattresses (verticle better for blood flow) - use simplex tubing to help make tension relieving stents

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14
Q

What is dead space and why do we not want it?

A

Space left in wound after procedure that fills with blood or serum and increases the risk of infection while preventing tissue apposition and healing

Prevent by tacking upper plane to lower, drain or pressure bandage

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15
Q

In FA rarely use drains but why would you use them?

A

Evacuation of accumulated fluid, prevent expected accumulation fluid, eliminate dead space
Not a fix for poor debridement and suturing

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16
Q

What is delayed primary closure?

A

swelling and moderate contamination or delayed response - suture before granulation but after a few days of lavage

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17
Q

What is secondary healing?

A

closed after granulation tissue often with skin flap and under tension

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18
Q

What is healing by second intention?

A

Very common in FA - excessive contamination, delayed response and in field
-Left to heal by granulation tissue formation, wound contraction and epithelization

19
Q

What is Myiasis?

A

Fly Strike (sheep often have moisture in wool and flies lay egg that damage tissue)
Signs: discolored wool, falling out, decreased activity/eating

20
Q

How do you treat fly strike?

A

Shear (cm around area), spray with catron, clean well, debride, antibiotic and pain med, spray with catron daily

21
Q

What topical product should not be used in food animal species?

A

Furazone

22
Q

What topical treatment is ok?

A

Aluspray, new skin, aloe vera, silver sulfadiazine

23
Q

The majority of food animal wounds are…

A

Iatrogenic - c-section, DA, exenteration, claw amputation

24
Q

What are the advantages of surgical dehorning?

A

Shorter healing time and elimination of open wound

25
Q

Describe disbudding?

A

Caustic paste (isolate) - 1-3 days, bloodless
Disbudding - <4weeks ideal, goat <2 weeks, local anesthesia cornual block and pain meds

26
Q

What are some tips for barns dehorning?

A

Cornual nerve block
Clip hair
blade at start of hair
stop bleeding pull small vessel
gauze cover if open to sinus

27
Q

Keys to castration?

A

Good drainage
younger better
anesthesia local
fly spray

28
Q

What are the most common bones fractured in ruminants?

A

Metacarpus, metatarsus, tibia, radius/ulna, humerus and femur

29
Q

What are some advantages of fracture repair in ruminants?

A

Lay down more
good potential bone healing
rarely have contralateral limb break down
dont mind orthopedic device

30
Q

What are some things that decrease the prognosis for any repair?

A

Sepsis, nerve damage and vascular trauma

31
Q

What are some considerations in fracture repair of ruminants?

A

Economics, genetics, cause of fracture, pets and after care

32
Q

What are the bad kinds of fractures?

A

Open, articular and proximal limb in adult

33
Q

Is internal fixation an option in ruminants?

A

Yes! - need confinement up to 9 months, infection possible

34
Q

Can you externally fix a skeletal fracture?

A

Yes (equipment tricky), cheaper than internal, need stall rest

35
Q

How should you apply a cast? (where in relation to the fracture?)

A

the joint above and below the injury

36
Q

What should you tell the farmer about the cast?

A

Keep the cow in small pen, out of rain, will need bandage 2 week after off and confinement 4-8 week after removal

37
Q

How many layers of casting material?

A

4-6 if <330lb
8-12 if adult

Change e3 week 0-6month
e 6 week 6-12 month
6-8 week if older than 12 month

38
Q

Walk me through placing a cast:

A
  1. Clean and dry the hoof well
  2. Cotton cast padding 2 layers , 3 over dewclaw and joint
  3. Vet wrap - firm
  4. Casting Material (glove)
  5. Duct tape over cast toe and sole
  6. Elasticon to skin
39
Q

Whats the prognosis for an open fracture?

A

Poor to grave (cast make it worse) - need external fixation and lavage wound

39
Q

What type of fracture is common in calves?

A

Physeal fracture - Salter 1 and 2
(Distal metatruss/metacarpus, distal femur and radius or proximal tibia

40
Q

What considerations should you have for calves?

A

Immune system decreased- risk postop infection and concurrent disease (pneumonia and navel ill) Angular limb deformities possible )

41
Q

What is an important consideration for the Thomas Schroeder Splint?

A

If splinted leg down then cant get up

42
Q

If fracture is in the foot what should be done?

A

Block good foot and wire other toe in flexion
Digit amputation?

43
Q

Why is coxofemoral joint luxation more common in dairy than beef?

A

Floors, less muscling

FAMS (13 decks)

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