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LA Sx scs RUSVM > Wounds, Bandaging, Casting > Flashcards

Wounds, Bandaging, Casting Flashcards

1
Q

If the vaccine status of a horse presenting with a wound is unknown, what needs to be done? What if you know the horse is unvaccinated?

A

Unknown: Booster with tetanus toxoid

Unvax’d: Tetanus toxoid + Tetanus antitoxin

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2
Q

How much blood (%) does a horse have?

A

8-10% BW

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3
Q

When is the golden period of wounds in horses?

A

Does not exist in horses

In other animals = period of time before there is less then 10^5 bacteria/g of tissue

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4
Q

What type of closure/healing is it if it occurs 2-5 days after the injury before granulation tissue is formed?

A

Delayed primary closure

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5
Q

What do you do if you anticipate complications due to dead space?

A

Place drain

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6
Q

If you anticipate flap necrosis upon closure of a large non-penetrating thoracic wound, what can you do?

A

Use flap as ‘natural band-aid’, debride and close

Wait 3-5 days for tissue to declare itself

Manage client expectations

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7
Q

What are the 3 phases of wound healing?

A

Inflammation/Lag

Proliferative

Remodeling

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8
Q

What initiates (3 things) angiogenesis during wound healing?

A

Decreased O2 tension

Low pH (in wound)

High lactate

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9
Q

What type of collagen is layed down during wound healing?

A

Type III (40%) which shifts to type I as wound remodels

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10
Q

What is the single most important factor for successful wound healing? What are the 3 types of this?

A

Debridement

Sharp, Irrigation (hydraulic), Direct contact

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11
Q

When lavaging a wound it is important to use the appropriate ______ and appropriate _______.

A

Volume

Pressure

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12
Q

T/F: Ointments are likely to slow the epithelialization of a wound.

A

True

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13
Q

Which antimicrobial dressing contains the active agent PHMB to which microbes are unable to become resistant?

A

Kerlix AMD

Dr. Little’s fav

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14
Q

Name these 5 joints

A

Tibiotarsal

Intertarsal

Fetlock

Pastern

Coffin

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15
Q

Which structure is indicated by the blue scribbles?

A

Collateral cartilage

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16
Q

What 2 structures are you concerned about with a pastern laceration?

A

Tendon sheath (of digital flexor)

Pastern joint

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17
Q

What structure are you concerned about with a puncture wound to the sole/frog?

A

Navicular bursa

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18
Q

What structure are you concerned about with a heel bulb laceration?

A

Coffin joint

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19
Q

What type of wound closure would you choose?

A

Second intention (debride and bandage)

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20
Q

What type of wound closure would you choose given this occured a few hours ago?

A

Delayed primary

(debride, lavage, banadage q24-48 hrs, then close)

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21
Q

Why do eyelid lacterations have to be repaired surgically?

A

Globe must stay protected (function of lid maintained)

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22
Q

What must you ensure when closing an eyelid laceration?

A

Must align eyelid margin

Protect eye from trauma during suturing

Keep suture from irritating eye when repair is complete

Close in 2 layers (conjunctiva and skin)

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23
Q

Why would you use stent sutures when closing a lip laceration?

A

To minimize risk of pull through during healing

Also remember at least 2-layer closure

24
Q

What is proud flesh? How is it treated?

A

Excessive granulation tssue

Tx: Resection and bandage, delayed secondary closure, skin grafts

25
Q

Excessive granulation tissue is most likely to occu in which of the following locations?

a. Metacarpus
b. Pectoral region
c. Thorax
d. Head and neck

A

a. Metacarpus

26
Q

What is the single most important factor for a successful skin graft?

A

Recipient bed preparation

27
Q

Which type of graft, full thickness or split thickness, will look better? Which has better survivability?

A

Full looks better

Split has beeter survivability

28
Q

T/F: When preparing a punch graft, the recipient holes are made with a smaller punch biopsy.

A

True

29
Q

What are the 3 main reasons for graft failure?

A

Infection

Hemorrhage (fluid accumulation)

Motion

30
Q

What can you do to conform a split thickness sheet graft to an irregular surface?

A

Meshing

31
Q

How is the sheet graft secured?

A

Along the wound margin with glue, sutures, or staples

32
Q

What is the most common reason for skin graft failure in horses?

a. Motion
b. Fluid accumulation
c. Bandaging
d. Infection

A

d. Infection

33
Q

You place a bandage. On days 1 and 2 there is no lameness and the bandage looks great. On day 3 the patient is lame. What should you do?

a. Patient is sore from surgery, as expected, continue monitoring
b. Patient likely kicked the wall and is now sore, recheck tomorrow
c. Give Bute toda and recheck tomorrow if not better
d. Remove bandage and reevaluate wound/incision site immediately

A

d. Remove bandage and reevaluate wound/incision site immediately

34
Q

In which direction must you roll bandaging material on a limb?

A

Inwards- pullign flexor tendons medially

35
Q

What is used to secure primary and secondary bandage layers?

A

Conforming roll gauze (Kling or brown)

36
Q

How much should each of the bandage layers overlap?

a. 25%
b. 50%
c. 75%
d. 100%

A

b. 50%

37
Q

In order to protect the ________ distally and soft tissue structures proximally, ______ should extend from the tertiary layer on either side. Distally, the _____ ______ should be covered by the secondary bandaging material.

A

Coronary band

Cotton

Heel bulb

38
Q

When creating a stack bandage, which bandage is placed first?

A

Distal

39
Q

What can you do to cover a wound that cannot be bandaged, for example near the hip?

A

Stent bandage

40
Q

How often must a sweat bandage be changed and the limb washed?

a. Every 6 hours
b. Daily
c. Every 48 hours
d. When it is dry

A

b. Daily

At least daily - tell clients q 12 hours

41
Q

What type of PVC can you use for splinting?

A

Schedule 40

42
Q

What’s this?

A

Kimzey Leg Saver splint

43
Q

If you are placing a bandage and splint for a radial fracture, Where will you place the palmar and lateral splints? Which side of the limb is most likely to open up due to the fracture becoming open?

A

Palmar: Heel to elbow

Lateral: Hoof to withers

Medial

44
Q

Fracture to which limb structure is the exception to the immobilization rule? Why?

A

Olecranon

The shoulder cannot be stabilized

Would make a stack bandage with a palmar splint to fix limb in extension

45
Q

What can be used to stabilize radial and tibial fractures, as well as ruptured gastrocnemius, in farm animals?

A

Thomas-Schroeder Splint

  • Plus cast*
  • NOT FOR EQUINE!!!*
46
Q

Which material is preferred for casting?

a. Plaster of Paris
b. Fiberglass casting tape
c. Clay

A

b. Fiberglass casting tape

47
Q

What are the 3 main complications of immbolization (e.g. through casting)?

A

Articular cartilage degeneration

Loss of bone density

Decreased muscle strength

48
Q

How long should the stockinette be in relation to the cast?

A

2.5x longer

49
Q

Where do you drill a hole when placing a distal limb cast?

A

Toe of the hoof wall

Then place Gigli wire through hole

50
Q

Where do you start placing casting tape for a distal limb cast?

A

Proximally

Down then up

51
Q

Why is it important to incorporate the hoof into the cast for large animals?

A

To ensure maximal diversion of weight from the limb and ground forces away from the limb to the cast

52
Q

What landmark do you use for the top of a distal limb cast?

A

Top of splint bones

53
Q

Where is extra padding required on a distal limb cast? What are you protecting?

A

Top of the cast to protect sesamoid bones

Back of cast to protect flexor tendons

Bottom of the cast to protect the coronary band/beel bulbs

54
Q

Why must you use a cast saw in perpendicular fashion?

A

It is an oscillating saw which will cut the skin if dragged down the limb

55
Q

Why should a bandage be placed after cast removal?

A

Protect any wounds

Protect skin which is sensitive now

Provide some support

56
Q

What is the most common reason for cast failure?

A

Poor placement

57
Q

What is the most common clinical sign indicating cast failure?

A

Lameness

LA Sx scs RUSVM (4 decks)

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