Flashcards in Wound Management/Granulation tissue Deck (70)
What should you do if a horse has sustained a penetrating wound at its vaccination status is unknown?
Booster with tetanus toxoid
What should you do if a horse sustains a penetrating wound and is unvaccinated?
Give tetanus toxoid AND tetanus antitoxin
T/F: the golden period is the time in which there is less than 10^5 in a wound of a horse
There is NO golden period in equine wound management
What is primary closure? What type of wounds can this be used on?
Clean and clean-contaminated wounds
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
What is secondary closure and in what type of wounds is it used?
Closure after more than 5days (granulation tissue has formed)
What is second intention healing?
Wound edges are not apposed. Granulation tissue, wound contracture, and epithelialization
What are the three phases of wound healing?
Inflammation/ lag (hemostasis and acute inflammation)
Proliferative (tissue formation)
Remodeling (regaining of strength)
What occurs in the inflammation/lag phase of healing?
—> platelet aggregation
—> vasoconstriction followed by vasodilation
—> fibrin formation
—> 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)
What occurs during the proliferative phase of healing?
Macrophages release tissue growth factors and initiates proliferation
Fribroplasia and granulation tissue
What initiates angiogenesis in wound healing?
Decreased O2 tension
Low pH in wound
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
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
When does epithelialization begin?
Immediately after wounding
Rapid in superficial injuries
New epidermis lacks __________ resulting in less strength and elasticity
Contraction of wounds begins how long after injury?
Fibroblasts differentiate into __________ allowing for wound contraction
Remodeling phase begins when and can last how long?
2weeks post injury and can last 1-2years
What are the steps for optimal wound care?
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)
What steps do you do prior to debridement to prep a wound?
Can put a water soluble gel in would to prevent hair from going into the wound
What is the most important factor in success of wound healing
—> remove necrotic tissue, decease bacterial load and remove microscopic foreign
What solutions can be used for wound lavage?
Non toxic solutions — LRS, Normosol, or saline
DO NOT used antiseptics —> cytotoxic
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
T/F: scarlet oil is a good topical product to increase healing of distal limb wounds
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
What is the use of white lotion in wounds?
No use! Has lead in it, very bad
What is Panalog?
Steroids reduce the rate of healing (epithelialization)
Why should nitrofurazone never be used in wound managment?
Carcinogenic — can cause ovarian cancer
What are the only appropriate topical agents for wound healing?