What are the 4 classifications of operative wounds?
You perform surgery in the abdomen and penetrate an organ in the GIT, what would would differentiate a clean-contaminated wound from a contaminated wound? What would make it a dirty wound?
Clean-contaminated: Spillage of the GIT contents
Dirty: If the punctured organ contained pus
As a rule of thumb, with every hour of surgery the risk of infection increases by ___%
100 (it doubles)
T/F: Classifying a wound as "dirty" implies infection.
What is the most common cause of peritonitis in small animals?
T/F: Hypothermia intra-operatively does not increase nor decrease the risk of infection.
What is the most common source of operative wound infections?
The patient's endogenous flora (GIT, skin)
If prophylactic antibiotics are indicated, how long prior to the incision of the skin should it be administered? How long should administration be continued?
30-60 minutes (best while patient is awake)
Continue for no longer than 24 hours
How does healing of superficial wounds differ in dogs and cats?
In cats, the SQ tissue is important for wound healing and needs to be preserved whenever possible. If it does need to be removed, expect it to take longer to heal.
In dogs we can be more aggressive in debriding away the SQ tissue.
T/F Prophylactic or preventative antibiotics are given before the animal is induced.
False, preventative is given intra-operatively.
What is the difference between an anatomic and a physiologic degloving?
In an anatomic the skin is avulsed
In a physiologic the skin is devitalized but still in place (an eschar)
What is one risk of leaving devitalized skin in place on a degloving wound?
What is a benefit of leaving it in place?
Risk: Bacteria can collect underneath it
Benefit: Acts as a short-lived bandage, minimizes amount of open wound
Using the rule of 9s, what is the extent of burn when the entire forelimb is affected?
What are 2 topical treatment options for initial burn management?
Usually used together
T/F: Hydrotherapy is a good option for early burn wound management if it is a full thickness burn.
False, partial thickness
Burns >___% TBSA are often associated with significant complications and prolonged treatment.
What virus predisposes animals, especially cats, to non-healing wounds?
Retrovirus (causes immunodeficiency e.g. FIV, FeLV)
T/F: A piece of glass or a tooth pick are examples of foreign bodies that are well-tolerated and do not necessarily need to be removed.
False, organic materials are poorly tolerated so the tooth pick must be removed (glass is ok)
A ____ is a communication between a mesothelial surface and the skin, while a ____ is a communication between two epithelial surfaces that is lined by epithelium.
Sinus (mesothelial Surface to Skin)
Fistula (Latin for FLUTE/tube, open on both ends)
In an altered female dog with a draining tract in the caudal abdomen, what differential other than a foreign body must you consider?
Granulation tissue/infection caused by a suture reaction from the spay
Given that prophylactic antibiotics are indicated for your patient, what antibiotic would you give if the most likely source of contamination is the skin? What is it is the GIT?
GIT- Cefoxitin (2nd generation cephalosporin)
Using the rule of 9s, what is the extent of burn when the entire hindlimb is affected?
What is the "Golden Period"?
The 6-8 hours after injury before bacteria invades and begins to replicate
What do you call negatively charged particles with a large surface area that may worsen an infection? How do they work?
Infection Potentiating Factors (IPFs)
MOA: Inactivate neutrophils
T/F: Up to 90% of bacteria can be removed with proper wound lavage.
Why are bulb syringes not effective in removing bacteria and foreign bodies from wounds?
Not enough pressure
What dilution of Povidone-Iodine should be used for wound lavage? How long is the residual activity?
1:10 or less
Which has longer residual activity, Povoidone-iodine or chlorhexidine?
Chlorhexidine (residual activity = 8-12 hours, also increases with repeated applications)
What is the most common method of surgical debridement, Layered or En Bloc?
What is Granulex?
Enzymatic (chemical) debridement solution or spray containing trypsin, castor oil and Balsam of Peru.