Wound infections

Question 1

The importance of the infection

Answer 1

The importance of the infection is the delaying of the wound healing

Question 2

cause of infections

Answer 2

• Mechanically (reducing the vascular supply)
• Increases cellular response
• Bacterial collagenolysis

Question 3

signs of infection

Answer 3

General signs and local signs

Question 4

General signs:

Answer 4

• High fever
• Depression
• Decreased appetite

Question 5

Local signs:

Answer 5

Painful, reddish, heat, swelling, functional limitation

Question 6

Factors effecting the infections

Answer 6

• Quantity and virulence of the germ

- Patient resistance

Question 7

Bacterium

Answer 7

Aerob bacterium

Anaerob bacterium

Question 8

Aerob bacterium

Answer 8

• Staphylococcus
• Streptococcus
• Enterobacterium
• Pseudomonas

Question 9

Anaerob bacterium

Answer 9

-Clostridium

Question 10

Types of infections

Answer 10

Bacteriological, clinical, mixed, parasitic, fungal

Question 11

Clinical infections:

Answer 11

• Presence with local and general signs

- Infected wounds heal slower than uninfected ones

Question 12

Mixed infections:

Answer 12

-Relatively common, and tissue bacteria numbers above 1 million organisms delays healing

Question 13

When is fungal infection common?

Answer 13

This infection of superficial wounds is relatively common

-Phythius spp. infection can be catastrophic complications of relatively triviale wounds

Question 14

Which complications can we have in an infection?

Answer 14

Foreign body, necrotic tissue, blooding, burns, Loss of blood supply

Question 15

Other factors making the infection worse:

Answer 15

• High concentration desinfitiation – stop the healing
• Bone sequester – bigger infection
• Sutures material
• Talcum
• Metal implants

Question 16

Antiseptics:

Answer 16

• Povidone-iodine (0.1 – 0.2%)
• Chlorhexidine (0.05%)
• Hydrogen peroxide (3%)
• Acetic acid solution (0.25 – 0.5% not recommended)

Question 17

Infections:

Answer 17

• Primary infection
• Secondary infection
• Exogen (contact, aerogenic) – most common
• Endogen (haematogen)

Question 18

View of the infection:

Answer 18

• Primary infection
• Secondary infection
• Exogen (contact, aerogenic) – most common
• Endogen (haematogen)

Question 19

Clean infection:

Answer 19

• Non traumatic surgical wounds
• Hollow viscus is not entered
• Incision does not pass through infected or nonviable tissue

Question 20

Clean - contaminated:

Answer 20

-Surgical wounds in which the lumen of the alimentary, urogenital or respiratory tract may be entered but with minimal invasiveness and contamination

Question 21

Contaminated infection:

Answer 21

• Traumatic wounds
• Relatively clean source of wounding
• Commonly accompanied by inflammation
• Include surgical wounds that contain “spill” from another organ and traumatic wounds older than 4 to 6 hours

Question 22

Infected wounds

Answer 22

• Old traumatic wounds
• Pus and/or abscess is present
• Preoperative entry into viscera may have occurred
• Infected wound

Question 23

Which calassification can we put the wounds into after bacterium?

Answer 23

• Pyogenic
• Putrid
• Aerogenic
• Mono- or polyinfection

Question 24

Pyogenic wound infection:

Answer 24

• Staphylococcus
• Streptococcus, Rhodococcus
• Corynebacterium
• Pseudomonas
• E. coli
• 6 – 8 hours after wounding we will have the pyogenic infection
• Endo- and exotoxins will be produced, signs:
• Thrombotisation of vessels
• Necrosis and neutrophils
• Leukocytosis

Question 25

Signs of pyogenic wound infections:

Answer 25

Local:Painful, reddish, heat, swelling, functional limitation, lymphadenitis general: Fever, decreased appetite,

Question 26

Local signs of pyogenic sutured wound:

Answer 26

- Swelling, tension of the material and tissue, fluctuation, discharge of pus - Painful, redish, functional limitation - We do the opening of the edges and demarcation, second intention - Bacto test to check resistance - Ther.: AB, opening when fluctuate drainage and bandage

Question 27

Local signs of pyogenic fresh wound:

Answer 27

- Discharge of pus, swlling - Painful, reddish, functional limitation - Demarcation - Ther.: AB, helping in the cleansing (?)

Question 28

Special clinical forms of pyogenic wound infections:

Answer 28

- Erysipelas - Phlegmone - Abscess

Question 29

Erysipellas:

Answer 29

- Pyogenic germs specially streptococci in the skin - Fastly progrediated and demarcated - Horse, cow, pig and dog - Pustule, phlegmone and gangrene -Thr.: AB, sulfonamides (recidivate)

Question 30

Phelgmone

Answer 30

- Septic or aseptic inflammation of the connective tissue - It can be subcutan, subfascial, intermuscular, - Special form I horse: Einschuss-phlegmone in horse - Localized or diffuse

Question 31

Subcutan signs of phlegmone:

Answer 31

- Painful - Swelling is sharply described and daughy - Functional limitation - Fever

Question 32

Subfascial and intermuscular signs of phlegmone:

Answer 32

``` Most painful (skin over the swelling is moveable) -Swelling is smooth and tight -Strong functional limitation -Fever ``` Therapy: AB, rest, hyperaemisa bandage , ointment, NSAIDs

Question 33

Phlegmones can become:

Answer 33

- Sanatio - Abscess - Elephanthiasis

Question 34

Abscess:

Answer 34

- Cavity in the tissue filled with pus - Empyema: pus in a natural body cavity - Sequester: abscess in the bone - Result of haematoma, seroma, phlegmone or foreign body infection - Demarcated inflammation and necrotic tissue

Question 35

Injury of the eye:

Answer 35

Septic endothalmitis

Question 36

Cause of the abscess:

Answer 36

- Wrong deinfitiation of the skin - Non sterile needle, instruments - High concentration of antiseptic fluids - Phlegmone - Necrotic tissues - Foreign body

Question 37

Signs of abcess:

Answer 37

- Well focused, fluctuating, painful, swelling | - Centhesis

Question 38

what can happen to the abscess?

Answer 38

-Absoption -Opened -Fistulation Thr.: open it, curettage

Question 39

What is pus?

Answer 39

-Serum and necrotic tissue part with dead leucocytes and bacteria

Question 40

Results of pyogenic infections:

Answer 40

- Toxaemis - Septicaemia - Pyemia - Local result - Fistulation (bursitis)

Question 41

Gasphlegmone

Answer 41

-Clostridium -Manifestation of signs (1 – 4 hours) -Toxins -Emphysematous gas production -Severe signs Thr.: surgical approuche

Question 42

tetanus:

Answer 42

- Clostridium tetani toxins in punctured deep wound or after surgical procedures (castration 10 – 14 days) - Mainly in horse, cow or in pig

Question 43

Signs of tetanus:

Answer 43

Muscle rigidity, as max opened nostrils, prolapse of the membrane nicitans, trismus, rigid posture and moving and ear holding, dyspnoe, defense of the abdominal