Wounds Flashcards
History for bites
What time did it happen
How
Where
If it was a bite
What size dog? Wildlife?
Was there shaking?
Are either animal vaccinated for rabies?
If puncture wound, what was the object?
What first aid has been provided?
Physical exam
Anatomical location
Extent of trauma
Degree of contamination
Blood loss
Erosion
Into the basement membrane
Ulcer
Into the dermis
Laceration
Torn or deeply cut
No tissue lost
Can be repared fairly easily if not dirty/infected/ or old
Usually due to something sharp
Avulsion/degloving
Skin is completely torn off
Lose a lot of tissue
Amputate if possible
Very hard to treat
Puncture wound
A type of cut made with a sharp object penetrating the soft tissue
Can be tricky to see as they are hard to visually see
Blunt trauma
Massive underlying tissue damage
Large force
The greater the area, the lesser the degree of injury
Main worry is free fluid if on abdomen and chest
Bite wounds
Laceration + avulsion + puncture + blunt force
Contaminated
Normally come in pairs(have two canine wounds not just one)
Good idea to play with the wound to make sure underlying tissue is ok
When there is pulling of wound you worry about ischemic injury
Loss of blood supply to skin
Necrotic tissue
Shows after a couple days
Hard
Black
Sunken in
Will have to be removed
Types of burns
First degree
- Only affect the epidermis
Second degree
- Affects the epidermis and some of the dermis
Third degree
- Affects all layers of the skin
Clean wound
ex.Elective surgical wound
Risk of infections <2.5%
TX Close wound
No antibiotics
Clean-contaiminated wound
ex. Surgical wound near open viscous
risk of infections 2.5-5%
treatment Clean and close wound
Maybe antibiotics
Contaminated wound
ex. GI surgery
Risk of infection: 5-20%
TX: Clean; close when there is no infection or place drain
Yes antibiotics
Dirty wound
Ex.Containing foreign body, bites; ANY wound left over 4 hours
Risk of infection 20%+
TX: Clean; surgical debride; let heal on own
Yes antibiotics
Golden period for wounds
The first 8 hours after a wound occurs
If addressed within 8 hours, prognosis is significantly improved
Related to time required for bacterial colonization
Healing stages of wounds
Inflammatory phase
-Inflammation
Proliferation
-Epithelialization
-Cellular phase
-Granulation
-Horses can get proud flesh or excessive granulation
Remodeling phase
-Maturation
How to deal with wounds(steps)
Assess
Restrict movement
Stop bleeding
LAVAGE
Treat infection
Close wound (first intention or second intention)
Step 1 of wound treatment
Assessment
History
PE (including wound assessment)
SOAP
(triage)
Step 2 of wound treatment
Restrict movement
Prevents further injury/contamination
Step 3 of wound treatment
Stop bleeding
Step 4 of wound treatment
Lavage
wound cleaning
Clip+ wash
Saline or 1;40 CHX
Step 5 of wound treatment
Treat Infection
Antibiotics
Honey bandages
Laser therapy
Step 6 of wound treatment
Wound Closure
1st intention wound closure(aka primary closure)
2nd intention closure (aka Open wound healing)
Combination of both
1st intention wound closure
Surgical closure with suture/staples
Used for planned surgeries and some wounds
Requires
Clean cut
Clean edges
Aftercare for first intention wound care
Bandage usually applied- able to monitor lesion
Keep the lesion clean and dry
Instruct owner to not apply anything to the lesion
Suture or staple removal in 10-14 days(usually)
What should the owner monitor for?
Discharge/pus
Inflammation
Redness or irritation
Reopened stitches
2nd intention wound healing
Aka open wound healing
Infected wounds
Lack of skin (lots of tissue)
Cost issues or poor surgical candidate
Hydrotherapy is
Promotes wound healing
Steady stream of water (shower strength)
Tepid water
10 min over wound
Allow to dry completely
Pat dry (cotton)
Then air dry
