Wounds

Question 1

What classifications of wounds are there?

Answer 1

Clean-surgical
Clean contaminated-surgical in GI tract
Contaminated-gi tract spillage
Dirty-necrotic/RTA

Question 2

What are the important considerations when managing a wound?

Answer 2

Will be hospitalised for long periods 
Patient nutrition (regular sedation's for bandage changes will require starving feeding tube?
long stay catheters 
Physio therapy 
soft bedding

Question 3

What type of dressing is used to promote wound healing in the early stages?

Answer 3

Wet to dry promotes granulation bed to form and debrides the wound

Question 4

Why is intracyte useful to apply to wounds?

Answer 4

osmotic properties gently debride the wound

Question 5

Why is honey useful to apply to wounds?

Answer 5

osmotic debridement

antibacterial

Question 6

Why are foam dressings useful in certain wounds?

Answer 6

Wounds with large amount of exudate
absorb 10 x there volume
semi permeable allow o2 to reach the wound

Question 7

What dressing would you apply to a wound that is being closed the following day?

Answer 7

wet to dry to allow debridement before surgery

Question 8

What is important to consider if a wound is open to the bone and contains an implant?

Answer 8

Implants allow for biofilms to occur
implant sound be removed
Bone should be foraged first before closure(Drilling holes in the bone to encourage granulation tissue)

Question 9

What are the indications for a free skin graft?

Answer 9

Not enough skin the cover the wound
Distal limbs effected
primary closure not possible
healthy granulating wounds/ acute surgical wounds

Question 10

What are the contra-indications for a free skin graft?

Answer 10

Necrotic tissue/ infection
Wounds on the head or trunk
incomplete granulation bed
Debris

Question 11

What is the technique for a free skin graft?

Answer 11

Donor site 
plan graft 
full thickness 
prepare graft-remove hypodermis 
mesh for drainage and conformity 
recipient bed 
(remove thick layer of fat as will prevent graft from obtaining nutrients)

Question 12

How should skin grafts be cared for?

Answer 12

Sedation for bandage changes
Aspetic technique
immobilisation
prevention of fluid accumulation

Question 13

What are the pros and cons of a skin graft?

Answer 13

Cover distal limb defects
labour intensive and time consuming
variable cosmetic and functional outcome
other reconstruction techniques prefered

Question 14

What is important to consider in dog bite wounds?

Answer 14

Underlying structures are more likely to be damaged more so than the superficial
contaminated wound
Crushing injury to underlying tissue

Question 15

How should a dog bite wound be managed?

Answer 15

Clip large area of fur 
Lavage the wound 
Explore the wound 
swab fro culture and sensitivity 
Broad spectrum antibiotics 
Closed (always use a drian) 
Manage as open
Check for underlying damage use of radiographs CT
Always explore bite wounds over the thorax, abdomen and neck

Question 16

What are the goals of wound management?

Answer 16

Prevent further contamination 
Remove foreign debris 
Debride dead and dying tissue
promote viable vascular bed 
patient considerations
select appropriate method of closure