Wounds Flashcards
open wound - define
break in the skin surface
wounds: 2 x clasifications
open & Closed
open - 7 types
avulsion, abraisions, deegloving, incised, lacerations, shear, puncture
possible causes of: avulsions
dog fights, falls, RTA
possible causes of: abrasions
Friction, RTA
possible causes of: Degloving
RTA or animal trap
possible causes of: incised
knife/scalpel, glass, metal
possible causes of: laceration
dog fights, barbed wire, RTA
possible causes of: shear
dog fight, animal trap
possible causes of: puncute
bites, shootings, nails, thorns, teeth
appearance of: avulsions
skin is torn from your body during an accident or other injury
appearance of: abraisions
shallow scrape on the skin surface
appearance of: degloving
extensive section of skin is completely torn off the underlying tissue
appearance of: incised
clean cut through the tissues
appearance of: laceration
produced by the tearing of soft body tissue
appearance of: shear
downward pressure AND friction.
appearance of: puncture
pointed object that pierces or penetrates the skin.
Closed - 3 types
haematoma, contusion, injuries to internal organs
possible causes of: haematoma
head shaking, blunt trauma
possible causes of: contusion
blunt force trauma, blood sampling, surgery
possible causes of: internal injuries
blunt force trauma, dog fights, rta, kick injuries
appearance of: haematoma
abnormal collection of blood outside of a blood vessel
appearance of: contusion
blood vessels are damaged or broken as the result of a blow to the skin
appearance of: internal injury
Disturbance of the different regulating systems in the body
wound healing phases
inflamatory phase, proliferative phase, remodelling phase.
signs of inflammation
PRISH Pain, Redness, Irittation, Swelling, Heat
Define: Acute inflammation
immediate and rapid response to an injury
define: chronic inflammation
inflammatory response which has occured for longer than expected (weeks/months)
3 x outcomes of wound healing
resolutiom, regeneration, organisation
define: resolution
no tissue distruction, inflammatory process is mild, tissue returns to its orginal state before the injury
three examples of why chronic inflammation might occur
persistant infections, prolonged exposure to foreign body, autoimmune disease
define: regeneration
damaged tissue is replaced by proliferation of remaining cells.
when can regeneration occur
when vasculature is still intact to allow blood supply
what types of cells are unable to regenerate
cardiac cells and nuerons
define: organisation (wound outcome)
cells cannot be repaire by regeneration, tissues heals by formation of scar tissue
What is 2 problems with scar tissue
loss of function, more susceptible to recurrent damage
most tissues heal by a combination of the three outcomes. True or False
TRUE
define: wound contamination
a wound with bacteria in
what is the only wound that can be classed as truly clean
surgical wound
optimal time to treat a wound
within 6 hours
wound contamination - 0-6 hours
golden period, contaiminated but not infected, little bacteria multiplication
wound contamination - 6-12 hours
bacteria begining to divide. early stages of infection,
wound contamination - over 12 hours
infection established
descibe a clean wound
surgical wound, no break in sterility, surgically prepaired, no contaminated body systems entered
describe a clean-contaminated wound
surgical wound that enters a contaminated body system, no spillage or spread of contaminate
list the contaminated body systems RE: wounds
respiratoty system, gastrointestinal system
descibe a contaminated wound
wounds with spillage from contaminated system. severe inflammation but without infection. Fresh open wounds are also contaminated
descibe a dirty wound
wound with leaking from pus filled organ. pus present in wound due to infection. traumatic wound with debris or foriegn body
defeine: colonisation
the presence of multiplying micro-organisms on wound surface.
does colinisation illict an immune response?
no, no clinical signs or symptoms from the animal
define: infection (re: wounds)
presence of multiplying micro-organisms which over whelm body’s immune system
list signs of infection
pus, cellulitis, wound dehiscence (breakdown)
factors affecting wound healing: 7 x wound related
movement, infection, tension, poor perfusion, self trauma, tumours, foreign bodies
factors affecting wound healing: 4 x patient related
age, malnutrition, drugs, other concurrent diseases
aims of lavage x 3
wash debris from wound, dilute bacteria in wound, not cause further damage
what is the recommended amount and pressure of lavage?
100ml per cm2. pressure of 7-15psi
how would the correct lavage pressure be achieved
20ml syringes with 19g needle
three points to remember when lavaging
more fluid = more dilute bacteria. more contaminated = more lavage needed. early lavage = less bacteria given the opportunity to multiply
lavage solutions x 6
tap water, sterile saline, hartmans, chlorohexidine, povodine-iodine, hydrogen peroxide
tap water - pros + cons
pro - cheap, readily avaliable. con - no antimicrobial properties
tap water - indications
external wounds that do not enter a body cavity or joinjt
sterile saline - pros + cons
pro - relivelty inexpensive. isotonic, no tissue damage. cons - more acidic than hartmans. no antibacterial action
sterile saline - indications
any wound
hartmans - pros + cons
pro - relivelty inexpensive. physiologically similar to plasma, no tissue damage. cons - no antibacterial action
hartmans - indications
any wound
chorhexidine - pros and cons
pro - not inactiviated by organic matter, wide antimicrobial spectrum. cons - high concentrations can cause cell damange and slow granulation tissue formation
chorhexidine - indications
contaminated or infected wounds
povodine-iodine pros and cons
pro - wide spectrum antimicrobial. cons - poor risidual activity, can cause thyroid disorders, inactivated by debris, pus or organic matter
hydrogen peroxide - pros and cons
NOT RECOMMENDED
hydrogen peroxide - indications
NOT RECOMMENDED
define: debridement
removal of necrotic tissues from the wound, until fresh bleeding edges are exposed.
2 x methods of debridment
surgical and debridement dressings
3 x main debridement dressings
adherant dressings, hydrogels, hydrocolloids.
wound closure: x 4
primary closure (first intention) delayed primary closure, secondary closure, second intention healing
define: primary closure
surgical closure of a wound immediatley after presentation
deinfe: delayed primary closure
surgical closure of a wound 3 - 5 days after initial injury
define: secondary closure
surgical closure of a wound 5 - 7 days after initial injury
define: secondary intention
heals by granulationm epithilisation and contraction - regular bandage changes. not healing with surgical intervention.
Surgical drains: when might they be used?
when surgery or trauma disrupts the hypoderm. skin no longer attached to fascia. may create a dead space which will fill with fluid and can increase infection rates.
functions of wound dressings x 5
absorb exudates. analgesia, protection of wound, prevention of infection, promotion of wound healing
3 x classifications of wound dressings
passive, interactive, bioactive.
define: passive wound dressing
having no action on the wound
define: interactive wound dressing
responding to the wound environment in some way
define: bioactive wound dressing
having a biological effect ont he wound
management specific to skin grafts
robort jones bandage, v.careful bandage changes, aspective wound mangaement, non-adherant primary dressing layer.
define: direct contact
grooming, biting, close body contact
define: indirect contact
coming into contact that an infected animal has also been in contact with (bedding, food bowls, fomites)
define: contagious
patient can infect another through direct or indirect contact
define: non contagious
patient cannot infect another via indirect or direct contact]
define: isolation
eliminates possibility of contact by isolating animal - used in conjuction with barrier nursing
Define: quarrenteen
compulsary isolation of animals with, or exposed to contagious infectious deisease
define: barrier nursing
reduces indirect contact with infectious agents. gloves, gowns, seperate equipment
define: protective isolation
isolation of susceptible animals in an attempt to protect them from potential infection