Wounds

Question 1

History for bites

Answer 1

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?

Question 2

Physical exam

Answer 2

Anatomical location
Extent of trauma
Degree of contamination
Blood loss

Question 3

Erosion

Answer 3

Into the basement membrane

Question 4

Ulcer

Answer 4

Into the dermis

Question 5

Laceration

Answer 5

Torn or deeply cut
No tissue lost
Can be repared fairly easily if not dirty/infected/ or old
Usually due to something sharp

Question 6

Avulsion/degloving

Answer 6

Skin is completely torn off
Lose a lot of tissue
Amputate if possible
Very hard to treat

Question 7

Puncture wound

Answer 7

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

Question 8

Blunt trauma

Answer 8

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

Question 9

Bite wounds

Answer 9

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

Question 10

Necrotic tissue

Answer 10

Shows after a couple days
Hard
Black
Sunken in
Will have to be removed

Question 11

Types of burns

Answer 11

First degree
- Only affect the epidermis
Second degree
- Affects the epidermis and some of the dermis
Third degree
- Affects all layers of the skin

Question 12

Clean wound

Answer 12

ex.Elective surgical wound
Risk of infections <2.5%
TX Close wound
No antibiotics

Question 13

Clean-contaiminated wound

Answer 13

ex. Surgical wound near open viscous
risk of infections 2.5-5%
treatment Clean and close wound
Maybe antibiotics

Question 14

Contaminated wound

Answer 14

ex. GI surgery
Risk of infection: 5-20%
TX: Clean; close when there is no infection or place drain
Yes antibiotics

Question 15

Dirty wound

Answer 15

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

Question 16

Golden period for wounds

Answer 16

The first 8 hours after a wound occurs
If addressed within 8 hours, prognosis is significantly improved
Related to time required for bacterial colonization

Question 17

Healing stages of wounds

Answer 17

Inflammatory phase
-Inflammation
Proliferation
-Epithelialization
-Cellular phase
-Granulation
-Horses can get proud flesh or excessive granulation
Remodeling phase
-Maturation

Question 18

How to deal with wounds(steps)

Answer 18

Assess
Restrict movement
Stop bleeding
LAVAGE
Treat infection
Close wound (first intention or second intention)

Question 19

Step 1 of wound treatment

Answer 19

Assessment
History
PE (including wound assessment)
SOAP
(triage)

Question 20

Step 2 of wound treatment

Answer 20

Restrict movement
Prevents further injury/contamination

Question 21

Step 3 of wound treatment

Answer 21

Stop bleeding

Question 22

Step 4 of wound treatment

Answer 22

Lavage
wound cleaning
Clip+ wash
Saline or 1;40 CHX

Question 23

Step 5 of wound treatment

Answer 23

Treat Infection
Antibiotics
Honey bandages
Laser therapy

Question 24

Step 6 of wound treatment

Answer 24

Wound Closure
1st intention wound closure(aka primary closure)
2nd intention closure (aka Open wound healing)
Combination of both

Question 25

1st intention wound closure

Answer 25

Surgical closure with suture/staples
Used for planned surgeries and some wounds
Requires
Clean cut
Clean edges

Question 26

Aftercare for first intention wound care

Answer 26

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

Question 27

2nd intention wound healing

Answer 27

Aka open wound healing
Infected wounds
Lack of skin (lots of tissue)
Cost issues or poor surgical candidate

Question 28

Hydrotherapy is

Answer 28

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