Wound Management in Small Animals

Question 1

Therapeutic considerations when treating wounds depends on…

Answer 1

• the degree of bacterial contamination
• the extent of trauma to the surrounding tissues

Question 2

Wound closure may be done….

Answer 2

immediately or delayed until the risk of dehiscence & infection have been reduced

Question 3

Wounds are classified as either…

Answer 3

open or closed

Question 4

Examples of closed wounds include…

Answer 4

crushing injuries
contusions

Question 5

Open wounds are often classified by

Answer 5

etiology

Question 6

An abrasion is an ____ wound type and is caused by…

Answer 6

open; damage to the skin consisting of loss of the epidermis and parts of the dermis

Question 7

What are examples of open wounds?

Answer 7

abrasion
avulsion/degloving
incision
laceration
puncture/bite
ballistic
burns

Question 8

Explain the classification of burns and to what extent the damage is.

Answer 8

1st degree - superficial epidermis devitalized, dilation/congestion of intradermal vessels
2nd degree - some epidermal destruction w/ blistering. Some skin elements remain viable.
3rd degree - All skin elements destroyed. Coagulation of subdermal plexus.
4th degree burns - deep carbonization or charring

Question 9

What are some clinical appearances for each burn classification?

Answer 9

• 1st degree: erythema
• 2nd degree: erythematous, weeping blisters. Painful. Superficial skin layers can be easily removed.
• 3rd degree: dry, hard, inelastic tissue. Thrombosed veins may be visible
• 4th degree: carbonization or charring

Question 10

What are some causes of the different classifications of burns?

Answer 10

• 1st: sunburn, UV light
• 2nd: scalds, spills, hot water bottles
• 3rd: flame, immersion scald, chemical burn, electrical current
• 4th: large fire

Question 11

What are the different classifications of open wounds based on the degree of contamination? Explain.

Answer 11

• Clean: Sx wounds
• Clean-contaminated: recent wounds where contamination can be effectively removed
• Contaminated - gross contamination w/ foreign debris
• Dirty & infected - existing infection present

Question 12

What types of open wounds (based on degree of contamination) can be closed primarily after appropriate wound management?

Answer 12

Clean-contaminated and contaminated

Question 13

An infected wound should not be closed… unless complete excision of the wound can be achieved

Answer 13

primarily

Question 14

wound infections exists when…

Answer 14

established microorganisms multiply in the host tissues

Question 15

What are the signs of inflammation that are common with a wound infection?

Answer 15

heat, pain, redness, swelling, discharge

Question 16

What is wound contamination?

Answer 16

When microorganisms are present in contaminated wounds but are not multiplying within cells.

Question 17

What local factors affect infection?

Answer 17

• foreign bodies
• ischemic/necrotic tissue
• closure of wound under tension
• wound dead space
• haematoma formation
• excessive/inappropriate suture material

Question 18

if local factors that affect infection are present, how does this affect bacteria causing wound infection?

Answer 18

It lowers the numbers of bacteria required to cause a wound infection.

Question 19

What systemic factors affect infection?

Answer 19

Systemic dz
hypovolaemic shock
increasing age
malnutrition
steroids/cancer chemotherapeutic agents

Question 20

What are the 4 types of wound closure/healing?

Answer 20

• primary closure
• delayed primary closure
• secondary closure
• second intention healing

Question 21

Describe primary wound closure. What type of wound do you use it on?

Answer 21

Immediate closure w/ appositional sutures

Clean/ clean-contaminated
Viable tissue, no tension

Question 22

Describe delayed primary wound closure. What type of wound would you use it on?

Answer 22

Closure done 2-5 d post-wounding. Follow open wound management

Clean-contaminated wounds w/ questionable tissue viability. Dirty wounds

Question 23

Describe secondary wound closure. What type of wound is it used on?

Answer 23

Closure >5days post-wounding. Granulation tissue & epithelialized skin edges are excised.

Contaminated and dirty wounds

Question 24

Describe second intention healing

Answer 24

Healing occurs by granulation, wound contraction, & epithelialization

Large skin defects & extensive tissue devitalization

Question 25

What are the steps for acute wound management?

Answer 25

1. Check for life-threatening injuries to other body systems
2. Stop bleeding & replace lost fluids if necessary
3. Give appropriate analgesia
4. Manage the wound

Question 26

bacterial numbers in the wound can be reduced by:

Answer 26

• wound lavage
• Sx debridement
• antimicrobial therapy

Question 27

When clipping, how would one protect the wound?

Answer 27

applying sterile KY jelly or hydrogel

Question 28

Topical agents like harsh antiseptics, ointments, and wound powders can cause ____ ____ to the tissue & inhibit ____ ____.

Answer 28

chemical injury; wound healing

Question 29

While waiting for treatment to occur, how would one go about avoiding further contamination of a wound?

Answer 29

Protect wound w/ sterile non-adherent wound dressing

Question 30

What solutions can be used for wound lavage?

Answer 30

• sterile isotonic solutions
• Chlorhexidine solution
• Povodine iodine

Question 31

how does one achieve the ideal 8 psi for pressure irrigation of a wound?

Answer 31

with a 35 ml syringe and a 19 g needle

Question 32

What is wound debridement?

Answer 32

Removal of devitalized tissue from a wound to produce a clean wound w/ well-vitalized tissue

Question 33

What forms of debridement can be used?

Answer 33

surgical, enzymatic, mechanical

Question 34

What antibiotics are commonly used for wound management?

Answer 34

Cephalosporin
Amoxi-clav

Question 35

What organism commonly causes superficial infections?

Answer 35

Staph spp.

Question 36

bite wounds are commonly contaminated with

Answer 36

Pasteurella spp