Wounds Flashcards
what is a wound?
an injury which there is a forcible break in the continuity of the soft tissues
wound classifications?
open - broken skin surface
closed - internal wound
others
examples of open wounds?
incised puncture laceration abrasion/graze avulsion/degloving
examples of closed wounds?
contusion/bruise
haematoma
injury to organ
examples of other wounds?
burn/scalds
crush injury
complicated
wound considerations
presence of haemorrhage - control - think about FBs and fractures size and shape of wound - will change when healing - use photographs to monitor position of wound - other structures that may be affected - eg thorax and lungs appearance - necrotic or infected? wound status patient temperament - tolerate checks - sedation? GA? animal condition - underlying issues - pain and shock
wound status?
clean
- no break in sterility
- most surgical wounds
clean-contaminaed
- surgery into a contaminated area (eg GI tract)
- but no obvious spillage
contaminated
- surgery into contaminated area (eg bladder) will spillage of contents
- or open wound with no obvious contaminates
dirty
- wounds with discharge/infection
- or open wound with foreign body or environmental contamination
wound management?
control haemorrhage if suspected infection take swab for culture and sensitivity decontaminate wound debridement of necrotic tissues consider methods of wound closure consider factors that ay delay wound healing apply dressing if appropriate monitor progress
how to decontaminate wound?
place sterile water-soluble jelly in woound
- to stop contamination of hair when clipping
clip and clean around edges of wound
- allows access to see extent of damage and skin health
lavage and gently clean wound
- sterile saline
- sterile water
- providone-iodine
- chlorhexidine
use a 30ml syringe and 19G needle
- creates pressure of 8psi
debridement?
removal of foreign matter or necrotic/contaminated tissue
- won’t stitch together
surgical debridement
- using scalpal in sterile conditions
debridement dressings
ways to achieve healing?
primary or first intention `healinh - suture wound surgically secondary or second intention healing - leave to heal on own - not enough skin to close wound - no choice and takes longer delayed primary or third intention healing - leave open for some time - eg support removal of infection as sutures can cause spread - then close later on
stages of wound healing?
hamostasis
- immediate
- blood vessels constricts
- platelet plug forms
- 60 seconds
inflammatory
- immediate
- healing cells move to injury site
- clotting factors, WBCs and RBCs
- 2-5 days after injury
proliferative
- granulation/repair phase
- wound and tissue rebuilt
- now healthy and fresh tissue
- epithelium starting to grow
- 3-7 days after injury
remodeling
- fully closed wound
- scar tissue forms
- 9-12 months before strength regained
factors that delay healing?
all likely to cause breakdown
movement infection tension interference of blood supply persistent irritation and self-trauma tumour cells invading wound presence of foreign body
can cause proud flesh
infection classifications?
systemic infections
- widespread throughout body
exogenous infection
- caused by organisms
- from the environment, not normally in body
nosocomial infection
- acquired in hospital
Iatrogenic infection
- from action of the vet
- eg non-sterile equipment or didn’t wash hands properly
VN role with wounds?
TLC - stressed and depressed bandage observations repeat dressing changes grooming feeding puzzles/games out of cade/stable time - cant run - may have to carry if small client information - wound care - photos to show how healing
