Wound Management

Question 1

Name four inhibitors of granulation tissue formation:

Answer 1

1. Pressure
2. Dry dressing
3. Corticosteroid cream
4. Caustic agents

Question 2

T/F: Phenylbutazone may be used in equine and bovine species

Answer 2

False

Phenylbutazone​ should not be used in cattle (long residual effect)

Question 3

If a horse has a wound and a previous tetanus vaccination history, what should be given?

Answer 3

tetanus toxoid

Question 4

A skin graft from the same individual is termed __________

Answer 4

autograft

Question 5

What is the correct order of wound management?

Answer 5

Pack –> Clip –> Lavage

Question 6

What systemic antibiotics are often used in equines for wound management?

Answer 6

penicillin, penicillin/aminoglycoside, TMS

(local antibiotics may inhibit wound healing)

Question 7

T/F: Treatments that arrest wound contraction and epitheliazation promote the formation of proud flesh

Answer 7

True

Question 8

In general, how much of the small intestine can be safely resected?

Answer 8

~50%

Question 9

A portion of skin consisting of all the epidermis and 75% of the dermis is harvested from the ventral pectoral area with a dermatome and expanded on stage of staggered razor blades before being sutured to a wound on the same horse’s cannon bone.

This type of skin graft is best described as a:

Answer 9

split-thickness mesh autograft

Question 10

Aside from cosmetic appearance, what is the #1 problem with proud flesh?

Answer 10

delays wound healing

Question 11

What is the rate of truncal wound epithelial migration?

Answer 11

0.2 mm/day

Question 12

T/F: Penrose drains are used for active drainage of a wound

Answer 12

False

Penrose drains are used for passive drainage of a wound

Question 13

Shown below is a ________ graft

Answer 13

mesh graft

Question 14

The period in which the wound becomes larger before contraction is known as the __________

Answer 14

lag period

Question 15

Horses that sustain a heel bulb laceration can successfully return to their intended use. Involvement of the ____________ joint is associated with a poor prognosis

Answer 15

distal interphalangeal joint

Question 16

What is the rate of distal limb wound contraction?

Answer 16

0.2 mm/day

Question 17

What is the ‘golden period’ in which a wound may be closed primarily?

Answer 17

4 to 6 hours

If there is <10⁶ bacteria/gram of tissue= likely to heal without complication​

Question 18

The #1 reason for using skin grafts in equine patients is for treatment of __________

Answer 18

proud flesh

Question 19

What is the rate of distal limb wound epithelial migration?

Answer 19

0.09 mm/day​

Question 20

What is a full thickness graft?

Answer 20

all of the epidermis and dermis

full thickness grafts give the best cosmetic appearance and hair growth

Question 21

What organism is most commonly isolated from traumatic wounds in equines?

Answer 21

Streptococcus

Question 22

__________ and __________ are the only mammals that develop excessive granulation tissue during wound healing

Answer 22

humans and equines

Question 23

A skin graft from another species is termed __________

Answer 23

xenograft

Question 24

Seabiscuit’s cousin, Oceanroll, had a contaminated wound that was left open, but closed before the period of fibroplasia began (<4 days). What type of wound healing is this?

Answer 24

Delayed primary intention healing

Question 25

Name three benefits of NSAIDs:

Answer 25

1. **Block prostaglandin synthesis** 2. **Decrease inflammation** 3. **Decrease pain**

Question 26

What are the two types of **free grafts**?

Answer 26

* **Island grafts**: pinch, punch, seed, or tunnel grafts * **Sheet grafts**: split of full thickness, solid or meshed grafts

Question 27

The graft type that is used in large animals is known as a **free graft**. What does that mean?

Answer 27

**a graft with no blood supply**

Question 28

T/F: **Flunixin Meglumine (Banamine®)** may be used in equine and bovine species

Answer 28

**True**

Question 29

What are the three major components of **second intention wound healing**?

Answer 29

**fibroplasia, contraction, epithelialization**

Question 30

What are the main advantages of **pinch grafting**?

Answer 30

* **Advantages:** * **General anesthesia not required** * **Minimal equipment necessary** * **Graft failure is rare** * Disadvantages * ​Poor cosmetic appearance * Scant hair growth

Question 31

Debridement begins ____ hours after wounding

Answer 31

**~6 hours**

Question 32

What surgical technique is being shown on this horse?

Answer 32

**punch grafting**

Question 33

If a horse has a wound and no previous tetanus vaccination history, what should be given?

Answer 33

**tetanus toxoid and tetanus antitoxin**

Question 34

What procedure is being performed on this skin?

Answer 34

**meshing**

Question 35

What is a **split thickness** graft?

Answer 35

**all of the epidermis and a portion of the dermis**

Question 36

What is the rate of truncal wound contraction?

Answer 36

**1 mm/day**

Question 37

What component of second intention wound healing is observed here?

Answer 37

**epithelialization**

Question 38

A skin graft from another member of the same species is termed \_\_\_\_\_\_\_\_\_\_

Answer 38

**allograft**

Question 39

In basic terms, what is **primary intention healing**?

Answer 39

**healing without fibroplasia**

Question 40

Where is exuberant granulation tissue most commonly seen?

Answer 40

**distal limbs**

Question 41

This substance is commonly found associated with wounds on the distal limbs of horses, preventing or delaying wound healing:

Answer 41

**granulation tissue**

Question 42

Three three main reasons for skin graft failure:

Answer 42

**motion, infection, hemorrha​ge**

Question 43

During this type of wound healing the wound is allowed to heal without suture placement:

Answer 43

**2nd intention**

Question 44

This type of wound healing provides the best functional and cosmetic outcome for the patient:

Answer 44

**primary**

Question 45

This fracture extends across a growth plate and through the metaphysis:

Answer 45

**Salter Harris Type II**

Question 46

PDS takes approximately this long to absorb in the body:

Answer 46

**180 days**

Question 47

A wound in this location often leads to significant SQ emphysema, and in severe cases pneumomediastinum:

Answer 47

**axillary region**

Question 48

While these types of skin grafts are not very cosmetic, they are functional and easy to perform:

Answer 48

**punch and pinch skin grafts**