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Large Animal Surgery > Wound Healing > Flashcards

Wound Healing Flashcards

1
Q

What are 3 ways to stop a wound from bleeding?

A
  • Pressure bandage
  • Clamp
  • Ligate
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2
Q

What are the first three things to consider with wound management?

A
  • Stabilize
  • Preserve life
  • Evaluate the wound
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3
Q

If an animal has been previously vaccinated, what type of tetanus prophylaxis should be used?

A

Tetanus toxoid

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4
Q

If an animal has not been previously vaccinated, what type of tetanus prophylaxis should be used?

A
  • Tetanus toxoid

- Tetanus antitoxin

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5
Q

Which type of bacteria is most commonly isolated from horses?

A

Streptococcus

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6
Q

Which 2 types of bacteria are most commonly isolated from ruminants?

A
  • E. coli

- Arcanobacterium/Trueperella pyogenes

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7
Q

What are 3 examples of systemic antibiotics that can be used?

A
  • Penicillin
  • Penicillin/Aminoglycoside
  • TMS
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8
Q

If local antibiotics are used, they might inhibit what?

A

Wound healing

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9
Q

Phenylbutazone (Bute) is only used in what large animal species?

A

Horses

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10
Q

What NSAID can be used in cattle?

A

Flunixin meglumine (Banamine)

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11
Q

What are 3 reasons to give NSAIDs with wound healing in large animals?

A
  • Block prostaglandin synthesis
  • Decrease inflammation
  • Decrease pain
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12
Q

What are 4 classifications of wounds?

A
  • Clean
  • Clean/contaminated
  • Contaminated
  • Infected
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13
Q

A wound made sterilely under surgery is classified as what?

A

Clean

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14
Q

If pus is present in a wound, the wound is considered what?

A

Infected

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15
Q

The period of time after a wound has occurred during which the wound may be closed primarily is known as what?

A

Golden Period

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16
Q

When is the golden period for wound healing?

A

4 - 6 hours

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17
Q

If past the golden period, should the wound be sutured?

A

No

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18
Q

What are 4 classifications of wound healing?

A
  • Primary intention
  • Delayed primary
  • Second intention
  • Tertiary intention
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19
Q

Healing without fibroplasia is what type of wound healing?

A

Primary intention

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20
Q

Primary intention healing can be done with what type of wound?

A

Clean wound

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21
Q

What are 2 types of suture patterns that can be used to close the skin in large animals with primary wound healing?

A
  • Simple interrupted

- Vertical mattress

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22
Q

What is a suture pattern that is good for use on the line alba in the horse?

A

Near-far-far-near

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23
Q

If a wound occurred more than 6 hours ago, how is it classified?

A

Contaminated

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24
Q

If a wound has a large gap and necrotic looking muscles, should the wound be closed?

A

No

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25
Q

What are 3 aspects of cleaning a wound?

A
  • Pack
  • Clip
  • Lavage
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26
Q

What should be done before clipping a wound?

A

The wound should be packed.

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27
Q

What should be used to lavage a wound?

What can be used in the field?

A
  • Fluid that is physiologic

- Water

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28
Q

When does the body of the animal begin debridement?

A

6 hours after wound occurs

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29
Q

What are 2 types of cells involved in debridement?

A
  • Neutrophils/PMNs

- Monocytes

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30
Q

Delayed closure of a contaminated wound is known as what type of healing?

A

Delayed primary intention

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31
Q

Contaminated wounds are left open until what occurs?

A

Until the infection is under control.

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32
Q

Wounds should be closed before when?

How long does this take?

A
  • Before period of fibroplasia occurs

- Less than 4 days

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33
Q

What are 3 steps involved in second intention healing?

A
  • Fibroplasia
  • Contraction
  • Epithelialization
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34
Q

What is the goal of second intention wound healing?

A

To provide an optimal environment for wound healing.

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35
Q

What are 2 examples of stimulants for granulation tissue formation?

A
  • Hydrotherapy

- Moist & irritant dressings

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36
Q

What are 4 effects of cold hydrotherapy on a wound?

A
  • Vasoconstriction
  • Decreased metabolism
  • Cutaneous anesthesia
  • Cell death
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37
Q

What are 3 effects of heat hydrotherapy on a wound?

A
  • Vasodilation
  • Increased metabolism
  • Decrease pain
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38
Q

What are 4 examples of inhibitors of granulation tissue?

A
  • Pressure
  • Dry dressing
  • Corticosteroid cream
  • Caustic agents
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39
Q

What are 2 ways to create pressure in order to inhibit granulation tissue?

A
  • Bandage

- Cast

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40
Q

When is the period of fibroplasia for wound healing?

A

Days 4 to 16

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41
Q

What takes place during the period of fibroplasia of wound healing?

A

Rapid collagen synthesis

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42
Q

What is the lag period for wound contraction (when does it begin)?

A

9 days

43
Q

Complete closure of a wound is determined by what?

A

Amount of skin available.

44
Q

What can wound contraction be inhibited by?

A

Exudate

45
Q

What takes place under a scar?

A

Centripetal migration

46
Q

What are 3 different components of epithelialization?

A
  • Mobilization
  • Migration
  • Mitosis
47
Q

After wound contraction ceases, closure is completed by what?

A

Epithelialization only

48
Q

With large animals, exuberant granulation tissue can form where?

A

Distal limbs

49
Q

Why does exuberant granulation tissue tend to form in distal limbs of large animals?

A

Slow healing time

50
Q

Epithelialization of a truncal wound occurs at what rate?

Of a distal limb wound?

A
  • 0.2 mm/day

- 0.09 mm/day

51
Q

Wound contraction of a truncal wound occurs at what rate?

Of a distal limb wound?

A
  • 1 mm/day

- 0.2 mm/day

52
Q

What are 2 problems with exuberant granulation tissue?

A
  • Cosmetically displeasing

- Can impair function

53
Q

What is another name for exuberant granulation tissue?

A

Proud flesh

54
Q

What is a differential for proud flesh?

A

Sarcoid tumor

55
Q

What is one way to decrease bleeding of a leg wound?

A

Hanging limb upside down and using a tourniquet.

56
Q

Which 2 species are the only mammals to develop excessive granulation tissue during wound healing?

A
  • Humans

- Horses

57
Q

Abnormal collagen production and organization can produce what?

A

Exuberant granulation tissue

58
Q

What can exuberant granulation tissue delay?

A

Wound healing

59
Q

Growth of exuberant granulation tissue is promoted by what type of treatments?

A

Ones that arrest wound contraction and epithelialization.

60
Q

What is a common treatment option for exuberant granulation tissue?

A

Surgical resection

61
Q

What is the number one reason for the use of skin grafting in large animals?

A

Exuberant granulation tissue

62
Q

How often should a pressure bandage be changed?

A

Every couple of days.

63
Q

What are heel bulb lacerations usually caused by?

A

Contact with wire or other metal objects.

64
Q

Why is a thorough examination of heel bulb lacerations warranted?

A

Adjacent synovial structures may be affected.

65
Q

With heel bulb lacerations it is important to check what?

A

Wound depth

66
Q

With heel bulb lacerations it is important to check if what is involved?

A

Joint

67
Q

Involvement of what joint in a heel bulb laceration is associated with a poor prognosis?

A

Distal interphalangeal joint

68
Q

What is the difference between delayed primary healing and third intention healing?

A

No granulation tissue formed in delayed primary healing.

69
Q

What is something that can be used to reduce movement to allow for wound healing?

A

Cast

70
Q

Skin grafting is done on what type of surface?

A

Clean bed of granulation tissue or a clean wound.

71
Q

What type of skin graft is between species?

A

Xenografts

72
Q

What type of skin graft is between two different animals of the same species?

A

Allograft

73
Q

What is the purpose of skin grafting?

A

To provide dermal coverage of a wound and to stimulate epithelial edges of a wound.

74
Q

Which type of skin graft involves a portion of the dermis?

Which type involves the epidermis plus the dermis?

A
  • Split thickness

- Full thickness

75
Q

Which type of skin graft gives the fest cosmetic appearance and hair growth?

A

Full thickness

76
Q

What is a disadvantage of skin grafting?

A

Limited amount of donor skin available.

77
Q

Are free grafts used more in small animal or large animal surgery?

A

Large animal

78
Q

What are 2 types of free grafts?

A
  • Island/seed (pinch or punch)

- Sheet (split or full)

79
Q

What are 3 advantages of a pinch/punch graft?

A
  • Harvested and placed without general anesthesia
  • Equipment and technical requirements are minimal
  • Complete graft failure is rare
80
Q

What is a disadvantage of a pinch/punch graft?

A

Poor cosmetic result with scant hair growth

81
Q

Use local anesthesia, form a skin tent with forceps, cut at a right angle and remove a 3mm disk of tissue is the harvesting process what type of graft?

A

Pinch graft

82
Q

Insert graft into pocket, beginning distally, usually using a dull needle to push into the pockets is the process for placing what type of graft?

A

Pinch graft

83
Q

What should be placed over a pinch skin graft?

A

Bandage

84
Q

When should a pinch graft be checked?

A

After 5 days

85
Q

What is used to harvest a graft punch?

A

6 mm biopsy punch

86
Q

What is a punch graft placed on while waiting to insert it?

A

Blood soaked sponge

87
Q

What are 3 good donor sites for pinch/punch grafts?

A
  • Neck
  • Ventral abdomen
  • Pectoral region
88
Q

What is placed to close the harvest site of a punch graft?

A

Simple interrupted suture

89
Q

What size hole is punched into the recipient site?

A

4 mm

90
Q

What type of graft is inexpensive and easy to do?

A

Punch graft

91
Q

What is the percentage range of times that punch grafts will take?

A

60-95%

92
Q

Where is a common location for punch grafts to be used?

A

Distal limb

93
Q

Split thickness and full thickness grafts are examples of what type of grafts?

A

Sheet grafts

94
Q

What type of sheet graft technique increases the number of edges for epithelialization?

A

Mesh technique

95
Q

What is a good type of graft for covering awkward surfaces?

A

Mesh graft

96
Q

Are mesh grafts easy or difficult to immobilize?

A

Easy to immobilize

97
Q

Mesh grafts produce problems from what?

A

From serum/blood

98
Q

What tool can be used to harvest a skin graft?

A

Dermatome

99
Q

What is a benefit of using a mesh graft?

A

Excellent drainage

100
Q

What are three was skin grafts are secured to the bed?

A
  • Suture material
  • Staples
  • Glue
101
Q

How long is the graft very fragile for?

A

The first week

102
Q

When is the first bandage change done?

A

Day 5

103
Q

How long do skin grafts take to heal?

A

A LONG TIME!

Large Animal Surgery (3 decks)

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