Wound Healing

Question 1

What are the 3 phases of wound healing?

Answer 1

Acute inflammatory phase, proliferative/repair phase, remodeling phase

Question 2

What occurs in the acute inflammatory phase of wound healing?

Answer 2

vasoconstriction and clot formation, followed by vasodilation and diapedesis (movement of neutrophils infiltrating) of cells, fluids, and protein in ECM

Question 3

What occurs in the proliferative/repair phase?

Answer 3

Granulation tissue “proud flesh” present at 3-4 days, visible at 5-7 days

Question 4

When does the greatest rate of connective tissue accumulation occur? (in days)

Answer 4

7-14 days

Question 5

What occurs during the remodeling phase?

Answer 5

Collagen reorganization, increased tensile strength, scar, continues up to 2 years

Question 6

When does wound contraction stop???

Answer 6

Wound margins meet = contact inhibition
Tension is greater than contractile forces of myofibroblasts
Low myofibroblast count in chronic wounds

Question 7

What sedative do we usually opt for when examination of a wound on a horse?

Answer 7

Xylazine, detomidine
or
Butorphanol 
or
Ace

Question 8

What psi do we lavage wounds with?

Answer 8

Sterile saline 7-15 psi

can also combine the sterile saline with betadine or chlorhexidine

Question 9

Do extensors or flexors have poor prognosis?

Answer 9

Flexor lacerations have poor prognosis

Extensor lacerations have good prognosis with splinting

Question 10

In the ____ phase, ECM replaces ___ ___

Answer 10

proliferative phase; fibrin clot

Question 11

If you see granulation tissue over the whole wound, should you cold turkey take the p off abx?

Answer 11

Yup, granulation tissue is super protective against infection and abx are no longer needed and risk colitis anywayyyy

Question 12

Greatest rate of conn tissue (in 7-14 d) occurs in what phase?

Answer 12

Proliferative phase

Question 13

Is exuberent granulation tissue aka proud flesh good or bad???

Answer 13

kinda bad because we have to trim it because it will grow over the area- so trim it to make it flat to the epithelial margin thickness to stimulate wound contraction and remove bacterial contamination bc proud fresh has lots of crevices for bacteria to hide

proud flesh is largely blood vessels and will bleed a ton

Question 14

Failure to recognize synovial involvement in a timely manner can be a death sentence for the horse because…..

Answer 14

uncontrolled joint sepsis leads to cartilage damage and debilitating and irreversible arthritis

Question 15

How to determine if a wound involves a synovial structure:

Answer 15

anatomical location, wound fluid cytology, pressurize the joint and see what fluid comes out, NEVER put a needle through it unless its clean or you can go to a non-wound nearby structure and be sure to insert abx at that time too

Question 16

What is the golden window of wound care to prevent contamination of becoming an inf?

Answer 16

4-6 hours

Question 17

Vascular and cellular response after injury= what phase?

Answer 17

Acute inflammatory phase

Question 18

in what phase of wound repair does fibroblasts synthesizing matrix causing contraction?

Answer 18

Proliferative/Repair Phase

Question 19

Collagen reorganization occurs in what phase of wound healing and tensile strength increases???

Answer 19

Remodeling Phase

Question 20

How long dose the acute inflammatory phase last? What about the proliferative/repair phase???

Answer 20

under a week; like 7-14 days

Question 21

What can be used to estimate age of a wound?

Answer 21

Granulation tissue- seen at 5-7 days

Question 22

Scar tissue has ___% strength of original tissue

Answer 22

80%

Question 23

When do we explore the wounds with probes?

Answer 23

AFTERRRR a lot of thorough cleansing