Wound Healing Flashcards
(103 cards)
1
Q
What are 3 ways to stop a wound from bleeding?
A
- Pressure bandage
- Clamp
- Ligate
2
Q
What are the first three things to consider with wound management?
A
- Stabilize
- Preserve life
- Evaluate the wound
3
Q
If an animal has been previously vaccinated, what type of tetanus prophylaxis should be used?
A
Tetanus toxoid
4
Q
If an animal has not been previously vaccinated, what type of tetanus prophylaxis should be used?
A
- Tetanus toxoid
- Tetanus antitoxin
5
Q
Which type of bacteria is most commonly isolated from horses?
A
Streptococcus
6
Q
Which 2 types of bacteria are most commonly isolated from ruminants?
A
- E. coli
- Arcanobacterium/Trueperella pyogenes
7
Q
What are 3 examples of systemic antibiotics that can be used?
A
- Penicillin
- Penicillin/Aminoglycoside
- TMS
8
Q
If local antibiotics are used, they might inhibit what?
A
Wound healing
9
Q
Phenylbutazone (Bute) is only used in what large animal species?
A
Horses
10
Q
What NSAID can be used in cattle?
A
Flunixin meglumine (Banamine)
11
Q
What are 3 reasons to give NSAIDs with wound healing in large animals?
A
- Block prostaglandin synthesis
- Decrease inflammation
- Decrease pain
12
Q
What are 4 classifications of wounds?
A
- Clean
- Clean/contaminated
- Contaminated
- Infected
13
Q
A wound made sterilely under surgery is classified as what?
A
Clean
14
Q
If pus is present in a wound, the wound is considered what?
A
Infected
15
Q
The period of time after a wound has occurred during which the wound may be closed primarily is known as what?
A
Golden Period
16
Q
When is the golden period for wound healing?
A
4 - 6 hours
17
Q
If past the golden period, should the wound be sutured?
A
No
18
Q
What are 4 classifications of wound healing?
A
- Primary intention
- Delayed primary
- Second intention
- Tertiary intention
19
Q
Healing without fibroplasia is what type of wound healing?
A
Primary intention
20
Q
Primary intention healing can be done with what type of wound?
A
Clean wound
21
Q
What are 2 types of suture patterns that can be used to close the skin in large animals with primary wound healing?
A
- Simple interrupted
- Vertical mattress
22
Q
What is a suture pattern that is good for use on the line alba in the horse?
A
Near-far-far-near
23
Q
If a wound occurred more than 6 hours ago, how is it classified?
A
Contaminated
24
Q
If a wound has a large gap and necrotic looking muscles, should the wound be closed?
A
No
25
What are 3 aspects of cleaning a wound?
- Pack
- Clip
- Lavage
26
What should be done before clipping a wound?
The wound should be packed.
27
What should be used to lavage a wound?
| What can be used in the field?
- Fluid that is physiologic
| - Water
28
When does the body of the animal begin debridement?
6 hours after wound occurs
29
What are 2 types of cells involved in debridement?
- Neutrophils/PMNs
| - Monocytes
30
Delayed closure of a contaminated wound is known as what type of healing?
Delayed primary intention
31
Contaminated wounds are left open until what occurs?
Until the infection is under control.
32
Wounds should be closed before when?
| How long does this take?
- Before period of fibroplasia occurs
| - Less than 4 days
33
What are 3 steps involved in second intention healing?
- Fibroplasia
- Contraction
- Epithelialization
34
What is the goal of second intention wound healing?
To provide an optimal environment for wound healing.
35
What are 2 examples of stimulants for granulation tissue formation?
- Hydrotherapy
| - Moist & irritant dressings
36
What are 4 effects of cold hydrotherapy on a wound?
- Vasoconstriction
- Decreased metabolism
- Cutaneous anesthesia
- Cell death
37
What are 3 effects of heat hydrotherapy on a wound?
- Vasodilation
- Increased metabolism
- Decrease pain
38
What are 4 examples of inhibitors of granulation tissue?
- Pressure
- Dry dressing
- Corticosteroid cream
- Caustic agents
39
What are 2 ways to create pressure in order to inhibit granulation tissue?
- Bandage
| - Cast
40
When is the period of fibroplasia for wound healing?
Days 4 to 16
41
What takes place during the period of fibroplasia of wound healing?
Rapid collagen synthesis
42
What is the lag period for wound contraction (when does it begin)?
9 days
43
Complete closure of a wound is determined by what?
Amount of skin available.
44
What can wound contraction be inhibited by?
Exudate
45
What takes place under a scar?
Centripetal migration
46
What are 3 different components of epithelialization?
- Mobilization
- Migration
- Mitosis
47
After wound contraction ceases, closure is completed by what?
Epithelialization only
48
With large animals, exuberant granulation tissue can form where?
Distal limbs
49
Why does exuberant granulation tissue tend to form in distal limbs of large animals?
Slow healing time
50
Epithelialization of a truncal wound occurs at what rate?
| Of a distal limb wound?
- 0.2 mm/day
| - 0.09 mm/day
51
Wound contraction of a truncal wound occurs at what rate?
| Of a distal limb wound?
- 1 mm/day
| - 0.2 mm/day
52
What are 2 problems with exuberant granulation tissue?
- Cosmetically displeasing
| - Can impair function
53
What is another name for exuberant granulation tissue?
Proud flesh
54
What is a differential for proud flesh?
Sarcoid tumor
55
What is one way to decrease bleeding of a leg wound?
Hanging limb upside down and using a tourniquet.
56
Which 2 species are the only mammals to develop excessive granulation tissue during wound healing?
- Humans
| - Horses
57
Abnormal collagen production and organization can produce what?
Exuberant granulation tissue
58
What can exuberant granulation tissue delay?
Wound healing
59
Growth of exuberant granulation tissue is promoted by what type of treatments?
Ones that arrest wound contraction and epithelialization.
60
What is a common treatment option for exuberant granulation tissue?
Surgical resection
61
What is the number one reason for the use of skin grafting in large animals?
Exuberant granulation tissue
62
How often should a pressure bandage be changed?
Every couple of days.
63
What are heel bulb lacerations usually caused by?
Contact with wire or other metal objects.
64
Why is a thorough examination of heel bulb lacerations warranted?
Adjacent synovial structures may be affected.
65
With heel bulb lacerations it is important to check what?
Wound depth
66
With heel bulb lacerations it is important to check if what is involved?
Joint
67
Involvement of what joint in a heel bulb laceration is associated with a poor prognosis?
Distal interphalangeal joint
68
What is the difference between delayed primary healing and third intention healing?
No granulation tissue formed in delayed primary healing.
69
What is something that can be used to reduce movement to allow for wound healing?
Cast
70
Skin grafting is done on what type of surface?
Clean bed of granulation tissue or a clean wound.
71
What type of skin graft is between species?
Xenografts
72
What type of skin graft is between two different animals of the same species?
Allograft
73
What is the purpose of skin grafting?
To provide dermal coverage of a wound and to stimulate epithelial edges of a wound.
74
Which type of skin graft involves a portion of the dermis?
| Which type involves the epidermis plus the dermis?
- Split thickness
| - Full thickness
75
Which type of skin graft gives the fest cosmetic appearance and hair growth?
Full thickness
76
What is a disadvantage of skin grafting?
Limited amount of donor skin available.
77
Are free grafts used more in small animal or large animal surgery?
Large animal
78
What are 2 types of free grafts?
- Island/seed (pinch or punch)
| - Sheet (split or full)
79
What are 3 advantages of a pinch/punch graft?
- Harvested and placed without general anesthesia
- Equipment and technical requirements are minimal
- Complete graft failure is rare
80
What is a disadvantage of a pinch/punch graft?
Poor cosmetic result with scant hair growth
81
Use local anesthesia, form a skin tent with forceps, cut at a right angle and remove a 3mm disk of tissue is the harvesting process what type of graft?
Pinch graft
82
Insert graft into pocket, beginning distally, usually using a dull needle to push into the pockets is the process for placing what type of graft?
Pinch graft
83
What should be placed over a pinch skin graft?
Bandage
84
When should a pinch graft be checked?
After 5 days
85
What is used to harvest a graft punch?
6 mm biopsy punch
86
What is a punch graft placed on while waiting to insert it?
Blood soaked sponge
87
What are 3 good donor sites for pinch/punch grafts?
- Neck
- Ventral abdomen
- Pectoral region
88
What is placed to close the harvest site of a punch graft?
Simple interrupted suture
89
What size hole is punched into the recipient site?
4 mm
90
What type of graft is inexpensive and easy to do?
Punch graft
91
What is the percentage range of times that punch grafts will take?
60-95%
92
Where is a common location for punch grafts to be used?
Distal limb
93
Split thickness and full thickness grafts are examples of what type of grafts?
Sheet grafts
94
What type of sheet graft technique increases the number of edges for epithelialization?
Mesh technique
95
What is a good type of graft for covering awkward surfaces?
Mesh graft
96
Are mesh grafts easy or difficult to immobilize?
Easy to immobilize
97
Mesh grafts produce problems from what?
From serum/blood
98
What tool can be used to harvest a skin graft?
Dermatome
99
What is a benefit of using a mesh graft?
Excellent drainage
100
What are three was skin grafts are secured to the bed?
- Suture material
- Staples
- Glue
101
How long is the graft very fragile for?
The first week
102
When is the first bandage change done?
Day 5
103
How long do skin grafts take to heal?
A LONG TIME!
