Wound Management

Question 1

What is the “golden period” of a wound?

Answer 1

6-8 hours

Question 2

Where do nosocomial infections most commonly come from?

Answer 2

1. Fingers

2. Mouth

Question 3

How do you handle hemorrhage?

Answer 3

Compression

Question 4

What is the inoculum size for a wound infection to develop?

Answer 4

10^5 CFU per gram tissue

Question 5

Horses mount a less intense or more intense inflammatory response?

Answer 5

Less intense

Question 6

What is it called when you wait 2-3 days before closing a wound?

Answer 6

Delayed primary closure

Question 7

What is it called when you wait to close a wound until granulation tissue is present?

Answer 7

Secondary closure

Question 8

What is the MOST important aspect of wound closure?

Answer 8

Debridement

Question 9

When should antibiotics be included in wound therapy?

Answer 9

1. High risk wounds (bite wounds, penetrating wounds, wounds involving joints)
2. Wounds older than 6-8 hours
3. Obvious local or systemic signs of infection

Question 10

When should antibiotics be administered during the wound therapy process?

Answer 10

Prior to debridement

Question 11

Why don’t you use a razor when removing hair around a wound?

Answer 11

Razors damage hair follicles

Question 12

True or False: Detergents are irritating to wound tissues.

Answer 12

TRUE

Question 13

What are Betadine and Hibiclens?

Answer 13

Detergents

Question 14

Which is more active in the presence of organic debris, Betadine or Hibiclens?

Answer 14

Hibiclens (Chlorhexidine)

Question 15

It is okay to wash the skin with tap water, but ____ is preferred.

Answer 15

Saline

Question 16

What are your 2 options for wound anesthetization prior to lavage and debridement?

Answer 16

1. Lidocaine

2. Mepevicaine

Question 17

When anesthetizing a wound, avoid anesthetic agents with ____.

Answer 17

Epinephrine

Question 18

Why should you avoid anesthetic agents with epinephrine?

Answer 18

Cause vasoconstriction (the head is the only exception)

Question 19

How would you administer the anesthetic around the wound?

Answer 19

SQ

Question 20

When anesthetizing a wound, would you begin on its proximal side or distal side?

Answer 20

Proximal side

Question 21

True or False: Lavage is not considered debridement.

Answer 21

FALSE - lavage is a form of debridement

Question 22

How much pressure does a 35 cc syringe with an 18 gauge needle produce?

Answer 22

8 psi

Question 23

How much pressure does a 300 mm Hg pressure bag, 1 liter saline bag, and 18 gauge needle produce?

Answer 23

7-8 ps

Question 24

How much pressure does a spray bottle generate?

Answer 24

6-8 psi

Question 25

How much pressure is generated by a bulb syringe and basin?

Answer 25

0.5 psi

Question 26

For wound lavage, ____ is the gold standard. Others are reserved for heavily contaminated wounds.

Answer 26

Saline

Question 27

Current recommendations for lavage of wounds deemed suitable for primary closure...

Answer 27

Saline alone Gravity flow or bulb syringe At least 3-6 liters

Question 28

Current recommendations for lavage of heavily contaminated wounds NOT suitable for primary closure...

Answer 28

Saline + 0.5% chlorhexidine Low pressure lavage (6-8 psi) At least 6 liters

Question 29

What is the most important thing you can do to assist wound healing?

Answer 29

Debride the wound of devitalized tissue or foreign bodies

Question 30

Which is preferred in buried absorbable sutures, monofilament or multifilament?

Answer 30

Monofilament

Question 31

True or False: Suture closure of dead space in wounds will always reduce the deleterious effects of dead space.

Answer 31

FALSE - suture closure of dead space in wounds will NOT always reduce the deleterious effects of dead space

Question 32

When drainage is indicated, ___ closed suction is preferred over ___.

Answer 32

When drainage is indicated, ACTIVE closed suction is preferred over PASSIVE.

Question 33

For how long would you leave tension sutures in place?

Answer 33

5-7 days

Question 34

For tension sutures, what would you use in a horse?

Answer 34

No. 2 monofilament nylon or polypropylene

Question 35

For tension sutures, what would you use in a dog or cat?

Answer 35

No. 0 or 1 monofilament nylon or polypropylene

Question 36

What are your suture pattern options for tension sutures? (6)

Answer 36

1. Ventral mattress 2. Horizontal mattress 3. Simple interrupted 4. Far-far-near-near 5. Walking sutures 6. Stent sutures

Question 37

In which species is strength in sutured wounds obtained more quickly, cats or dogs?

Answer 37

Dogs

Question 38

In a cat, how many days after a procedure would you remove skin sutures?

Answer 38

10-14 days

Question 39

In a dog, how many days after a procedure would you remove skin sutures?

Answer 39

7-10 days

Question 40

In a horse, how many days after a procedure would you remove skin sutures?

Answer 40

10-14 days

Question 41

Sutured wounds can become contaminated with the first ____ hours, so protect with bandages if possible.

Answer 41

48 hours