wound management large animals Flashcards
When first assessing a wound what do you look for?
How & why has this happened?
What structures are involved?
Is it traumatic? Surgical? Thermal? Chemical?
How much contamination is present?
Classifications range from clean to contaminated
Location is key to determine healing potential & if underlying structures could implicate healing
Healing rate is determined by location
Trunk heals quicker than distal limb
Why can blood loss change whether sedation should be used?
High blood loss could be a contraindication with sedative hypertension
Why is lameness an important part of wound evaluation?
High levels of mobility needed for welfare & for animal purpose
Is level of lameness catastrophic for future work?
Gait assessment can help evaluate associated structures
What is going on here?
Severe
Assumptions are bracialplexus damage & penetration of thoracic cavity
Horse likely to recover ok
What is going on here?
Small
Specific synovial structure implications (calcaneal bursa)
This injury will have poor outcome if inappropriately treated
- Synovial sepsis = level of lameness not compatible with animal welfare
What are methods for assessing synovial structures?
Synovial fluid samples
- cellularity
- total solids
- inflammation or infection
Contrast medium/sterile solution injected into bursa
Diagnostic techniques
- Radiographs
- ultrasounds
Can primary closure be done in these cases?
How can tension in large animal wounds be combatted in primary closure?
Mattress suture patterns +- stent/quill to distribute tension
How can we promote healing in these wounds
Don’t attempt to fix immediately
Secondary intension healing & debridement to accelerate process
Describe delayed primary closure
intermediate process
natural debridement process followed by primary closure
Describe the use of drains in large animal wound healing
Drains allow a portal for fluid & inflammatory exudate
Usually passive drains
- latex penrose drain
- 2 incisions not related to wound
- located in most dependent part
- fluid moves by capillary action into bandage material
What is “proud flesh” and why is it a problem?
Exuberant granulation tissue preventing epithelial tissue from growing across the wound
Granulation tissue has no nerve supply so proud flesh can be resected back to skin surface so epithelial cells can migrate over wound bend
Use scalpel blade to trim
What is being done in these images?
Skin grafting
A = Punch grafts
B&C = Pinch grafting
Provides epithelial cells to centre of wound
Pinch & Punch grafts easy to perform in standing horse
Cost effective means for wound management
Moderation sedation required
Wound bed free of infection & devitalized tissue, with good vascular supply is critical for success
