Wound Management and Bandaging

Question 1

What are the 4 phases of wound healing?

Answer 1

Hemostasis-wound is being closed by clotting
Inflammation- lasts 3-5 days- wound strength is lowest
Proliferation- rebuilding of tissue
Maturation- begins approx 3 wks after injury and can continue for years

Question 2

What is another term for the inflammatory phase of wound healing?

Answer 2

lag phase- wound strength is lowest

Question 3

When does the proliferation phase begin?

Answer 3

2-3 days after injury- partially happening at the same time as the inflammatory phase- can continue for several weeks

Question 4

What are 4 wound classifications?

Answer 4

Clean
Clean- contaminated
Contaminated
Dirty and infected

Question 5

Name 5 types of wound debridement

Answer 5

Staged surgical debridement, en bloc excision, enzymatic, mechanical, biological

Question 6

Describe what en bloc excision is

Answer 6

If wound is small enough- cut around the entirety of wound and excise small wound and close

Question 7

Describe mechanical wound debridement

Answer 7

An adherent primary bandage layer is used to non selectively debride heavily contaminated wounds- only used in inflammatory phase

Question 8

Describe enzymatic wound debridement

Answer 8

enzymes are used to slowly digest necrotic tissue, only sue for small contaminated wounds- not substitute for surgical debridement

Question 9

Name the 4 methods of wound closure

Answer 9

Primary closure with primary intention wound healing
Delayed primary closure
Secondary closure
Second intention wound healing

Question 10

Describe delayed primary closure

Answer 10

For wounds older than 6-8 hours with some contamination and questionable ability to heal with primary closure. Treat as open wound for 2-3 days then surgically closed before granulation tissue is seen

Question 11

Describe secondary closure (third intention wound healing)

Answer 11

For wounds older than 6-8 hours, for infected necrotic wounds, and for failed primary wound closure. Wounds granulation tissue is closed by apposition of granulation surfaces

Question 12

Describe second intention wound healing

Answer 12

For wounds older than 6-8 hours, for infected, necrotic wounds. Wound is allowed to heal by granulation tissue formation and epithelialization

Question 13

How are burns classified?

Answer 13

How deep into the tissue the injury reaches and how large the affected area is

Question 14

Describe 1st degree burns

Answer 14

Superficial and involve only the epidermis. Affected skin is reddened and painful, recovers in a few days w/o tx

Question 15

Describe 2nd degree burns

Answer 15

Partial-thickness, may form fluid-filled blisters or show discoloration of part of the dermis. (Full extent of injury may not be knows until several days after injury). Often heal with second INTENTION with re-epithelialization

Question 16

Describe 3rd degree burns

Answer 16

Full-thickness, thick, leathery, often black layer of dead dermis (eschar). TX- remove eschar and debride

Question 17

Describe 4th degree burns

Answer 17

Involve deeper tissues apart from the dermis and require surgical reconstruction. Critically ill and require extensive care to survive

Question 18

Give 2 main reasons bandages are applied

Answer 18

Management of soft tissue wounds and stabilization of bone and joint injuries. (also applied after SX- helps decrease hemorrhage and edema, protect wound..)

Question 19

How many layers in most bandages??

Answer 19

3 layers, 1st primary- indirect contact w/ wound
2nd- absorbs and holds exudate
3rd- protects inner layers and determines appropriate amount of pressure and support

Question 20

What was the Schroeder-Thomas splint for?

Answer 20

Used to immobilize distal femoral fx- suspends limb in a rigid metal frame (shaped like the leg)- NOT rec to tx fx as it causes muscle contracture with permanent loss of limb function

Question 21

What is a spica splint used for?

Answer 21

Maintains the forelimb or pelvic limb in extension with soft padded bandage and addition of a strong lateral support splint that curves over the shoulder or pelvis

Question 22

When is a spica splint used

Answer 22

Commonly used in forelimb after elbow luxation reduction when the elbow must be kept in extension and mobility must be reduced

Question 23

What is an Ehmer sling and when is it used?

Answer 23

non-weight bearing sling applied to pelvic limb to protect hip after injury (leg taped with figure 8 pattern)

Question 24

What is the appropriate length of time a p should wear a non-weight bearing sling?

Answer 24

No longer than 2-3 weeks, to prevent muscle and joint contracture

Question 25

When is a 90/90 sling used (non-weight bearing)

Answer 25

Use in puppies after repair of distal femoral fx- prevents contracture by keeping affected muscles stretched- Stifle and hock taped while both joints held at 90 degrees

Question 26

When would a Velpeau sling be used (non-weight bearing)

Answer 26

Mainly used after reduction of medial shoulder joint luxation- Entire forelimb is flexed and brought up against thoracic wall and a soft-padded bandage applied

Question 27

Why are hobbles used?

Answer 27

Prevent abduction of pelvic limbs and are used after reduction of ventral hip luxation

Question 28

Equine wounds on the distal aspect of limb are notorious for developing what?

Answer 28

Exuberant granulation tissue "proud flesh"

Question 29

What is a lower limb support bandage used for?

Answer 29

Provide support for soft tissues( ligaments, tendongs) of the limb contralateral to the injured limb as it is carrying excessive weight due to the injured leg

Question 30

What is a claw block used for?

Answer 30

Used in bovine- (they have 2 weight-bearing digits)- when one digit is affected the block is applied to the good digit to elevate the other digit off the ground and give it some relief

Question 31

Indications for modified Thomas splints

Answer 31

Tibial fx, radial fx or ligamentous injuries of the stifle

Question 32

What is a modified Thomas splint used for

Answer 32

Often used in farm animals for external support to provide traction and maintain alignment of the limb (can be combined with a cast for max support)