Wound Management/Granulation tissue Flashcards Preview

LA sx Q's shuffled > Wound Management/Granulation tissue > Flashcards

Flashcards in Wound Management/Granulation tissue Deck (70)
Loading flashcards...
1

What should you do if a horse has sustained a penetrating wound at its vaccination status is unknown?

Booster with tetanus toxoid

2

What should you do if a horse sustains a penetrating wound and is unvaccinated?

Give tetanus toxoid AND tetanus antitoxin

3

T/F: the golden period is the time in which there is less than 10^5 in a wound of a horse

False

There is NO golden period in equine wound management

4

What is primary closure? What type of wounds can this be used on?

Immediate closure

Clean and clean-contaminated wounds

5

What is delayed primary closure? What type of wounds would you do this in?

2-5days after injury (before granulation tissue production)

Contaminated wounds / questionable viability
Edema/tension

6

What is secondary closure and in what type of wounds is it used?

Closure after more than 5days (granulation tissue has formed)

Contaminated/infected wound

7

What is second intention healing?

Wound edges are not apposed. Granulation tissue, wound contracture, and epithelialization

8

What are the three phases of wound healing?

Inflammation/ lag (hemostasis and acute inflammation)

Proliferative (tissue formation)

Remodeling (regaining of strength)

9

What occurs in the inflammation/lag phase of healing?

Hemostasis
—> platelet aggregation
—> vasoconstriction followed by vasodilation
—> fibrin formation

Inflammation
—> activated platelets release wound repair mediators
—> PDGF, TGF-B
—> PMNs, macrophages and fibroblasts (remove damaged tissue, release chemoattractatns, PMNs decrease after 2days, macrophages persist for days to weeks)

10

What occurs during the proliferative phase of healing?

Macrophages release tissue growth factors and initiates proliferation

Angiogenesis
Fribroplasia and granulation tissue
Collagen deposition
Epithelialization
Wound contraction

11

What initiates angiogenesis in wound healing?

Decreased O2 tension
High lactate
Low pH in wound

12

What is the purpose of fibroblasts in wound healing?

Release collagen, GAGs, HA, and glycoproteins

Release proteases to digest fibrin clot

Help arrange collagen molecules into fibers then bundles aligned parallel to wound surface

13

What type of collagen is present initially in a wound and what type is present as the wound remodels?

Collagen type III — initial wound healing with dense blood vessel population

Collagen type I — remodeling

14

When does epithelialization begin?

Immediately after wounding

Rapid in superficial injuries

15

New epidermis lacks __________ resulting in less strength and elasticity

Dermis

16

Contraction of wounds begins how long after injury?

2weeks

17

Fibroblasts differentiate into __________ allowing for wound contraction

Myofibroblasts

18

Remodeling phase begins when and can last how long?

2weeks post injury and can last 1-2years

19

What are the steps for optimal wound care?

Adequate restraint

Analgesia

DEBRIDEMENT

Lavage

Closure

Bandage

20

What A2 agonists can be used for restraint/analgesia and what is their duration of action?

Xylazine IV: 15-20mins
Detomidine IV: 30-45mins (can last longer if combined with butorphanol)

21

What steps do you do prior to debridement to prep a wound?

Wear gloves!

Clip
Can put a water soluble gel in would to prevent hair from going into the wound
Evaluate

22

What is the most important factor in success of wound healing

Debridement
—> remove necrotic tissue, decease bacterial load and remove microscopic foreign

Sharp
Irrigation (hydraulic)
Direct contact

23

What solutions can be used for wound lavage?

Non toxic solutions — LRS, Normosol, or saline

DO NOT used antiseptics —> cytotoxic

24

Preventing bacterial infection of wounds can be done with what methods?

Effective wound cleaning/debridement

Appropriate use of dressings and procedures for bandage changes

Appropriate use of topical antimicrobials

25

T/F: scarlet oil is a good topical product to increase healing of distal limb wounds

false

Scarlet oil is used to stimulate granulation tissue

Distal limbs a prone to over granulation

Scarlet oil is appropriate for large areas that need to be filled in. Eg over the shoulder or over the abdomen

26

What is the use of white lotion in wounds?

No use! Has lead in it, very bad

27

What is Panalog?

Steroidal antibiotic/antifungals

Steroids reduce the rate of healing (epithelialization)

28

Why should nitrofurazone never be used in wound managment?

Carcinogenic — can cause ovarian cancer

29

What are the only appropriate topical agents for wound healing?

Silver sulfadiazine
Polysporin (

30

Wha type of wound dressing would you use on an exudative or necrotic wound?

Hypertonic saline dressing
— draws fluid out of wound

Change Q24-48hrs