Wound Management and Bandaging Flashcards
What are the 4 phases of wound healing?
Hemostasis-wound is being closed by clotting
Inflammation- lasts 3-5 days- wound strength is lowest
Proliferation- rebuilding of tissue
Maturation- begins approx 3 wks after injury and can continue for years
What is another term for the inflammatory phase of wound healing?
lag phase- wound strength is lowest
When does the proliferation phase begin?
2-3 days after injury- partially happening at the same time as the inflammatory phase- can continue for several weeks
What are 4 wound classifications?
Clean
Clean- contaminated
Contaminated
Dirty and infected
Name 5 types of wound debridement
Staged surgical debridement, en bloc excision, enzymatic, mechanical, biological
Describe what en bloc excision is
If wound is small enough- cut around the entirety of wound and excise small wound and close
Describe mechanical wound debridement
An adherent primary bandage layer is used to non selectively debride heavily contaminated wounds- only used in inflammatory phase
Describe enzymatic wound debridement
enzymes are used to slowly digest necrotic tissue, only sue for small contaminated wounds- not substitute for surgical debridement
Name the 4 methods of wound closure
Primary closure with primary intention wound healing
Delayed primary closure
Secondary closure
Second intention wound healing
Describe delayed primary closure
For wounds older than 6-8 hours with some contamination and questionable ability to heal with primary closure. Treat as open wound for 2-3 days then surgically closed before granulation tissue is seen
Describe secondary closure (third intention wound healing)
For wounds older than 6-8 hours, for infected necrotic wounds, and for failed primary wound closure. Wounds granulation tissue is closed by apposition of granulation surfaces
Describe second intention wound healing
For wounds older than 6-8 hours, for infected, necrotic wounds. Wound is allowed to heal by granulation tissue formation and epithelialization
How are burns classified?
How deep into the tissue the injury reaches and how large the affected area is
Describe 1st degree burns
Superficial and involve only the epidermis. Affected skin is reddened and painful, recovers in a few days w/o tx
Describe 2nd degree burns
Partial-thickness, may form fluid-filled blisters or show discoloration of part of the dermis. (Full extent of injury may not be knows until several days after injury). Often heal with second INTENTION with re-epithelialization
Describe 3rd degree burns
Full-thickness, thick, leathery, often black layer of dead dermis (eschar). TX- remove eschar and debride
Describe 4th degree burns
Involve deeper tissues apart from the dermis and require surgical reconstruction. Critically ill and require extensive care to survive
Give 2 main reasons bandages are applied
Management of soft tissue wounds and stabilization of bone and joint injuries. (also applied after SX- helps decrease hemorrhage and edema, protect wound..)
How many layers in most bandages??
3 layers, 1st primary- indirect contact w/ wound
2nd- absorbs and holds exudate
3rd- protects inner layers and determines appropriate amount of pressure and support
What was the Schroeder-Thomas splint for?
Used to immobilize distal femoral fx- suspends limb in a rigid metal frame (shaped like the leg)- NOT rec to tx fx as it causes muscle contracture with permanent loss of limb function
What is a spica splint used for?
Maintains the forelimb or pelvic limb in extension with soft padded bandage and addition of a strong lateral support splint that curves over the shoulder or pelvis
When is a spica splint used
Commonly used in forelimb after elbow luxation reduction when the elbow must be kept in extension and mobility must be reduced
What is an Ehmer sling and when is it used?
non-weight bearing sling applied to pelvic limb to protect hip after injury (leg taped with figure 8 pattern)
What is the appropriate length of time a p should wear a non-weight bearing sling?
No longer than 2-3 weeks, to prevent muscle and joint contracture
When is a 90/90 sling used (non-weight bearing)
Use in puppies after repair of distal femoral fx- prevents contracture by keeping affected muscles stretched- Stifle and hock taped while both joints held at 90 degrees
When would a Velpeau sling be used (non-weight bearing)
Mainly used after reduction of medial shoulder joint luxation- Entire forelimb is flexed and brought up against thoracic wall and a soft-padded bandage applied
Why are hobbles used?
Prevent abduction of pelvic limbs and are used after reduction of ventral hip luxation
Equine wounds on the distal aspect of limb are notorious for developing what?
Exuberant granulation tissue “proud flesh”
What is a lower limb support bandage used for?
Provide support for soft tissues( ligaments, tendongs) of the limb contralateral to the injured limb as it is carrying excessive weight due to the injured leg
What is a claw block used for?
Used in bovine- (they have 2 weight-bearing digits)- when one digit is affected the block is applied to the good digit to elevate the other digit off the ground and give it some relief
Indications for modified Thomas splints
Tibial fx, radial fx or ligamentous injuries of the stifle
What is a modified Thomas splint used for
Often used in farm animals for external support to provide traction and maintain alignment of the limb (can be combined with a cast for max support)
