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LAS > Wound Management > Flashcards

Wound Management Flashcards

1
Q

quittor

A

infection of lateral cartilage of pastern

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2
Q

a wound is near a synovial joint. what should you do?

A

collect synovial fluid sample

then distend joint with STERILE ISOTONIC SALINE

look for drainage from wound to determine if joint involved

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3
Q

epithelization starts….

A

immediately

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4
Q

polysporin

A

gentler antibiotic ointment than neomycin

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5
Q

secondary closure is used on what wounds

A

> 5 days old; after granulation tissue has set in

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6
Q

diagnostics for LA wounds (4)

A
  • PE
  • rads
  • US
  • always probe!!
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7
Q

true or false: lavaging with dilute antiseptics is NOT effective

A

true

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8
Q

nitrofurazone

A

yellow topical antibiotic agent used in horses

carcinogenic

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9
Q

scarlet oil

A

horse wound potion; stimulates granulation tissue so contraindicated on limbs

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10
Q

hydrogels are good for…

A

desiccated/dry wounds; leave in place for 4-7 days

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11
Q

what type of wound can damage navicular bone/bursa

A

punctures to sole/frog

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12
Q

you should always ______ when dealing with wounds (3)

A
  • debride well (#1 factor for successful healing)
  • wear gloves
  • bandage
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13
Q

how to prevent infections

A
  • debride/clean (may need to debride multiple times)
  • bandage
  • appropriate use of topical antimicrobials
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14
Q

vetricyn

A

contains bleach; should never be used on horse wound

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15
Q

_____ types of closures are used AFTER granulation tissue appears

A

secondary closure or second intention healing

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16
Q

what’s a concern with wounds near coronary band?

A

can affect future hoof growth

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17
Q

true or false: you should avoid putting anything on a wound that you don’t want in eyes or consumed

A

true

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18
Q

what’s a concern with punctures to the sole/frog

A

concern for navicular bone/bursa damage

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19
Q

a horse gets a wound; he’s already vaccinated for tetanus

A

booster him

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20
Q

hydrogen peroxide

A

cytotoxic; do NOT use on wounds

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21
Q

true or false: there isn’t really a golden period of wound healing in horses

A

true

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22
Q

always evaluate _____ before giving a horse analgesia

A

heart

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23
Q

phases of wound healing (3)

A
  • inflammatory: hemostasis + acute inflammation + fibrin deposit
  • proliferative: tissue formation + angiogenesis
  • remodeling: regains some strength via cross linking of collagen fibers + alignment along lines of tension
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24
Q

can use _____ syringe when lavaging LA wounds

A

35 cc

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25
Q

cause of proud flesh

A

horse limbs have:

  • increased motion
  • decreased vascularity
  • poor wound contraction
  • little muscular support
  • inefficient inflammatory phase in horses (neutrophils stay longer) -> profibrotic/chronic inflammatory state
  • some topical agents can contribute (scarlet oil)
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26
Q

true or false: full thickness lip lacerations MUST be repaired surgically

A

true

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27
Q

steroids on wounds?

A

NO

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28
Q

ointment can _______ when applied to wounds

A

inhibit epithelialization

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29
Q

contraction of wounds begins when?

A

week 2

occurs centripetally

fibroblasts -> myofibroblasts

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30
Q

tissue formation and angiogenesis occurs during which phase of wound healing?

A

proliferative

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31
Q

______ indicates infection

A

> 10^5 bacteria/gram of tissue

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32
Q

PRP

A

growth factors used on wounds

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33
Q

what’s a concern with heel bulb lacerations?

A

concern for coffin joint involvement

34
Q

what’s a concern with lacerations to the pastern (2)

A

concern for:

  • pastern joint involvement
  • DDF tendon sheath involvement
  • collateral cartilage damage/quittor if on lateral aspect
35
Q

panalog

A

antibiotic + steroid ointment; should NOT be used on horse wounds

36
Q

semiocclusive foam is good for what type of wounds?

A

healthy/not infected

37
Q

_____ types of closures are used BEFORE granulation tissue appears

A

primary or delayed primary closure

38
Q

how to deal with chronic wounds

A

no potions!!

remove excess granulation tissue SURGICALLY (don’t use chemical agents because kills epithelium)

39
Q

remodeling phase of wound healing: begins when and involves what

A

begins after 2 weeks and continues for years sometimes

wound regains some strength via alignment of collagen along lines of tension + crosslinking of collagen fibers

40
Q

white lotion

A

contains lead; should never be used on horse wound

41
Q

why are healed wounds weaker?

A

new epidermis lacks dermis

42
Q

primary closure is used for ______ wounds

A

clean and clean contaminated BEFORE granulation tissue

43
Q

UMF > ____ needed when using honey for wounds

A

UMF >10 for dogs

UMF > 15 for horses

44
Q

most repaired wounds fail due to…

A

improper preparation and assessment

45
Q

type of biological dressing used in horses

A

equine amnion

46
Q

hypertonic saline/wet-dry dressing is good for…

A

highly exudative/necrotic wounds;

change q 24-48 hours

47
Q

antiseptics on wounds?

A

no; cytotoxic

48
Q

analgesia options for horses

A
  • alpha 2 agonists (reversible; sedation + analgesia; xylazine is good short acting option)
  • NSAIDS
  • opioids: butorphanol can improve effect of alpha 2 agonists
49
Q

a tetanus naïve horse gets a wound

A

give BOTH toxoid and antitoxin

50
Q

1 factor for successful wound healing

A

debridement

51
Q

what’s a concern with axillary wounds?

A

SQ emphysema/pneumomediastinum

**strict stall rest

52
Q

calcium alginate is good for what type of wounds?

A

wounds in granulation phase or wounds over broken bones

53
Q

treatment options for excess granulation tissue (3)

A
  • resection + bandage (contact inhibition; no nerve block needed because no nerves in granulation tissue)
  • delayed secondary closure (often needs multiple debridements)
  • skin grafts
54
Q

why don’t you need local blocks when debriding granulation tissue?

A

no nerves in granulation tissue

55
Q

healthy granulation tissue appears…

A

pink; flat/even with skin; no fissures; no hematomas; no inflammation

56
Q

if granulation tissue isn’t healthy enough yet for a skin graft, what should you do?

A

debride; use TAO for a few days

57
Q

types of skin grafts

A
  • pedicle vs. free graft
  • full thickness (requires GA) vs. partial thickness (epidermis + part of dermis; uses watson know or dermatome)
  • auto vs. allograft vs. xenograft
58
Q

what tools are used to harvest partial thickness

A
  • watson knife or

- dermatome

59
Q

pros of full thickness skin graft

A
  • more cosmetic

- resists trauma better

60
Q

con of full thickness skin graft

A

not as readily accepted

61
Q

skin grafts adhere to recipient bed via…

A

fibrin

62
Q

how are skin grafts fed?

A

nourished by plasma like fluid via capillaries (serum imbibition)

63
Q

general steps for applying a skin graft

A
  1. create recipient holes FIRST to allow for hemostasis (6 mm apart; start distally because bleeds a lot; recipient holes must be SMALLER than graft)
  2. harvest graft from under mane or ventrlateral abdomen (excise SQ + fat to ensure adherance)
64
Q

reasons for graft failure

A
  • ** site prep most important for survival
  • hemorrhage
  • infection
  • motion -> stall rest
65
Q

graft survival is most dependent upon….

A

site prep

66
Q

______ ( a complication of skin grafting) prevents fibrin adherence and vessel growth

A

hemorrhage/fluid accumulation

67
Q

graft must ______ to prevent fluid accumulation

A

contact wound

68
Q

what must you pay attention to when applying sheet graphs?

A

direction of hair growth

69
Q

some bacteria can infect wounds with <10^5 bacteria/gram of tissu. which bacteria can do this? (2)

A
  • pseudomonas

- B hemolytic strep

70
Q

types of free skin grafts

A
  • island free grafts:
    • pinch/seed
    • punch
    • tunnel (rare)
  • sheet free grafts
    • split vs. full thickness
    • solid vs. meshed
71
Q

types of island free grafts (3)

A
  • pinch/seed
  • punch
  • tunnel
72
Q

types of sheet free grafts

A
  • split vs. full thickness

- solid vs. mesh

73
Q

pros of mesh grafts (3)

A
  • allows graft to cover larger area
  • prevents fluid accumulation
  • conforms to irregular surfaces
74
Q

survival rate of punch grafts

A

60-75%

75
Q

recovery following skin graft

A
  • bandage: sterile, non-adherent, use elastic gauze roll because don’t want tension
  • STALL REST
76
Q

____ scalpel blade is used for recipient bed prep for pinch grafts

A

15

77
Q

_____ scalpel blade is used for harvesting pinch graft

A

11

78
Q

size of pinch graft

A

3 mm

79
Q

how far apart should island skin grafts be?

A

6 mm

80
Q

how do you secure sheet graphs?

A

at margins

81
Q

pros of pinch and punch skin graphs (3)

A
  • no GA needed!!
  • minimal equipment/skill
  • complete failure rare (60-75% survival rate)
82
Q

cons of pinch and punch skin graphs (2)

A
  • poor cosmesis

- little hair growth

LAS (51 decks)

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