large animal wound assessment Flashcards Preview

Surgery and Anesthesia test 1 > large animal wound assessment > Flashcards

Flashcards in large animal wound assessment Deck (14)
Loading flashcards...
1

basic principles of assess a wound

thorough hx

adequate restraint-physical and chemical

local/regional anesthesia

clipping-water soluble gel in wound

cleaning

assessment-depth, structures involved

2

wounds of head and neck

extensive blood supply and good soft tissue support

lots of imprtant structures may be involved in wound

heavy sedation often necessary

thorough evaluation

dx imaging

3

wounds over bony surfaces

blood supply becomes an issue when there is not adequate soft tissue to cover a wound

esp if periosteum has been lost

must debride edges

find alternative blood supply

injuries over cannon bone with loss of overlying tissue-difficult!

prone to development of proud flesh

sequestrum make form

4

Wounds of thorax and abdomen

penetrating wounds may involve the pleural or peritoneal cavities

multiple layers to abdominal wall may shift, obscuring the path of penetration

axillary wounds can result in pneumomediastinum and/or pneumothorax

5

wounds of extremities

proximal limb has better blood supply and soft tissue support than the distal limb

involvement of deeper structure major concern

movement impairs healing

often highly contaminated

6

structures to evaluate in distal limb: synovial

metacarpo/tarsophalangeal joint (fetlock)

proximal interphalangeal joint (pastern)

distal interphalangeal joint (coffin)

flexor tendon sheath

navicular bursa

decreases px

7

structures to evaluate in distal limb: tendons and ligaments

extensor tendons

superficial digital flexor tendon

deep digital flexor tendon

suspensory ligaments

collateral ligaments

ligaments associated wtih navicular bone

px depends on depth of laceration

8

What is the best way to determine if a synoial structure communicates with a wound?

put a needle into joing distant from wound and pressurize the joint with sterile saline

 

9

granulation tissue

should fill in wound until even with edge edge of surrounding skin

epithelialization around the edges

10

exuberant graulation tissue

proud flesh

particular problem for leg wounds in horses but not ponies

deficient but protracted infl phase

persistent hypoxia from occlusion of microvessels within granulation tissue

rapid and prolonged proliferation of fibroblasts

deficient epithelialization and contraction

debridement

bandaging

11

penetrating wounds of the foot

street nail

depend on length and orientation of penetrating object, can involve many diff structures: coffin join, navicular bursa, navicular bone, third phalanx, digital cushion, DDFT, ligaments of navicular bone

12

what would prevent a wound from healing?

ongiong movement at wound site

presence of exuberant granulation tissue

chronically infected granulation tissue

osteomyelitis of underlying bone

presence of sequestrum or foreign body

persistent drainage from a synovial structure

13

sequestrum

most frequently develops secondary to trauma of canon bone or fx

days to weeks to develop

dx on rad

exploration of wound/draining track, removal of sequestrum and all ofther infeced/abn tissue surrounding it

 

14

synovial fistula

persistant draining from a synovial structure

debrie, close the hole in synovial structure, close the skin wound-difficult