Veterinary Wound Management Basics
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Questions and Answers

What is one reason for considering secondary closure in open wound management?

  • To reduce the cost of treatment
  • To minimize the need for further surgeries
  • To prevent infection
  • To expedite the wound closure process (correct)

Primary closure of wounds is equally effective in both dogs and cats.

False (B)

List one factor that influences the decision to close a wound.

Degree of contamination.

Wounds in cats generally show significantly less _______ tissue than in dogs.

<p>granulation</p> Signup and view all the answers

Match the following animals with their healing characteristics:

<p>Cats = Slower healing and less granulation tissue Dogs = Faster healing and more granulation tissue</p> Signup and view all the answers

Which of the following is NOT a factor to consider in wound management?

<p>Cost of treatment (B)</p> Signup and view all the answers

Epithelialization at 21 days after wounding is higher in dogs than in cats.

<p>True (A)</p> Signup and view all the answers

What should be evaluated in animals with open wounds that are not healing properly?

<p>Factors that may delay or interfere with the healing process.</p> Signup and view all the answers

What type of wound is characterized by a small skin opening with deep tissue contamination and damage?

<p>Puncture wound (A)</p> Signup and view all the answers

A laceration is characterized by minimal peripheral trauma to the wound edges.

<p>True (A)</p> Signup and view all the answers

Name two common causes of thermal burns.

<p>Fire and hot liquids.</p> Signup and view all the answers

A ______ injury results in extensive loss of skin and underlying tissue.

<p>degloving</p> Signup and view all the answers

Match the type of wound or injury with its description:

<p>Puncture wound = Caused by penetration of an object Laceration = Characterized by sharply incised skin edges Thermal burn = Resulting from heat exposure Degloving injury = Extensive loss of skin and underlying tissue</p> Signup and view all the answers

Which of the following is NOT a type of thermal burn?

<p>Puncture injury (A)</p> Signup and view all the answers

The risk for infection is low in thermal burns.

<p>False (B)</p> Signup and view all the answers

What are the characteristics of a physiologic degloving injury?

<p>The skin surface is intact but separated from underlying tissue.</p> Signup and view all the answers

What is the first step in the wound healing process?

<p>Formation of a fibrin-platelet clot (B)</p> Signup and view all the answers

Wound healing consists of five distinct phases.

<p>False (B)</p> Signup and view all the answers

What type of injury is typically associated with an abrasion?

<p>Partial-thickness epithelial injury</p> Signup and view all the answers

The main cells that initially dominate the wound healing process are __________.

<p>polymorphonuclear cells</p> Signup and view all the answers

Which of the following is NOT a phase of wound healing?

<p>Inflammatory remodeling (D)</p> Signup and view all the answers

Match the following stages of the wound healing process with their descriptions:

<p>Inflammation = Initial response to injury Debridement = Removal of dead tissue and debris Repair = Formation of new tissue Maturation = Strengthening and remodeling of tissue</p> Signup and view all the answers

What is the role of myofibroblasts in wound healing?

<p>Contract wound size</p> Signup and view all the answers

During wound healing, __________ cells become predominant by day 5.

<p>mononuclear</p> Signup and view all the answers

What is a decubital ulcer primarily caused by?

<p>Compression of skin and soft tissues (B)</p> Signup and view all the answers

Colonization is defined as the presence of microbes on a surface without replication.

<p>False (B)</p> Signup and view all the answers

What is the main goal of wound management?

<p>Facilitate wound healing without development of infection</p> Signup and view all the answers

The threshold of ______ colony-forming units (CFUs) per gram of tissue is considered significant for developing an infection.

<p>105</p> Signup and view all the answers

Match the following terms with their definitions:

<p>Contamination = Presence of microbes on a surface Colonization = Replication of surface microorganisms Infection = Invasion and replication of microbes within tissue Primary Wound Closure = Healing achieved by apposing wound edges</p> Signup and view all the answers

Which of these sites are common for decubital ulcers?

<p>Greater trochanter (A)</p> Signup and view all the answers

Primary wound closure is indicated for wounds that are clean and sharply incised with minimal trauma.

<p>True (A)</p> Signup and view all the answers

What is the criteria for a burden of microorganisms to lead to infection within a certain timeframe?

<p>105 CFUs per gram of tissue within 6 hours or more</p> Signup and view all the answers

What is the primary goal of delayed primary wound closure?

<p>Manipulate the wound bed environment over several days (A)</p> Signup and view all the answers

Secondary wound closure occurs within 3 to 5 days after wounding.

<p>False (B)</p> Signup and view all the answers

What is left to heal by contraction and epithelialization in second intention healing?

<p>Wound</p> Signup and view all the answers

Secondary closure is indicated for _______ contaminated, traumatized wounds.

<p>severely</p> Signup and view all the answers

Match the type of wound closure with its description:

<p>Delayed Primary Closure = Closure within 3 to 5 days after wounding Secondary Closure = Closure after granulation tissue has formed Second Intention Healing = Healing by contraction and epithelialization En Bloc Debridement = Complete excision of the wound</p> Signup and view all the answers

What is a potential drawback of second intention healing?

<p>The process may be inefficient and lead to incomplete reepithelialization (B)</p> Signup and view all the answers

Granulation tissue provides a microbial-resistant substrate that facilitates healing.

<p>True (A)</p> Signup and view all the answers

Open wound management that relies on second intention healing is indicated for ______ contaminated, traumatized wounds.

<p>dirty</p> Signup and view all the answers

What is the primary aim of immediate wound management?

<p>To reduce microbial burden and prevent contamination (D)</p> Signup and view all the answers

Animals with normal blood volume do not require red cell transfusions.

<p>True (A)</p> Signup and view all the answers

What types of nutritional support may malnourished animals require until they can sustain a balanced diet?

<p>Supplemental nutritional support via feeding tubes</p> Signup and view all the answers

Chronic wounds should be biopsied for histologic and __________ evaluation.

<p>microbiologic</p> Signup and view all the answers

Which method can improve healing in wounds with poor vascularity?

<p>Omental or muscular flaps (A)</p> Signup and view all the answers

Match the wound conditions with their required interventions:

<p>Severe hypoproteinemia = Supplemental feeding tubes Chronic wounds = Biopsy for evaluation Indolent pocket wounds = Surgical intervention Necrotic tissue = Resection to stimulate healing</p> Signup and view all the answers

Surgical intervention is never required for wounds that are under tension.

<p>False (B)</p> Signup and view all the answers

In unstable animals, immediate wound management can include copious irrigation with __________.

<p>tap water</p> Signup and view all the answers

Flashcards

Wound

Loss of skin and underlying tissue integrity.

Wound Healing

The body's process of restoring continuity to tissues after injury, leading to a complete epithelial surface.

Inflammation Phase

The first stage of wound healing, characterized by inflammation, blood clotting, and white blood cell recruitment to fight infection.

Debridement Phase

The second stage of wound healing, where dead tissue is removed, and the wound is cleaned by white blood cells.

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Repair Phase

The third stage of wound healing, involving the formation of new blood vessels (neovascularization), growth of new tissue, and the formation of granulation tissue.

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Maturation Phase

The final stage of wound healing, where the wound is strengthened by collagen fibers and the scar matures.

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Abrasion

A partial-thickness injury to the skin, usually caused by friction or rubbing.

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Reepithelialization

The process of new skin cells covering a wound.

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Decubital Ulcer (Pressure Sore)

Tissue damage caused by sustained compression between a bony prominence and a hard surface, leading to skin and soft tissue loss over the bony protrusion.

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Wound Contamination

The presence of microbes on a surface. The first step in the process of wound infection.

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Wound Colonization

When microorganisms on a surface begin to replicate. It is a step toward infection.

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Wound Infection

Invasion and replication of microbes within tissue. Leads to inflammation and tissue damage.

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Primary Wound Closure

The process of closing a wound by bringing the edges together, promoting healing by first intention.

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First Intention Healing

Healing process where wound edges are directly apposed, minimizing gaps, and healing occurs quickly.

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When is Primary Closure Indicated?

Used for clean, sharply incised wounds with minimal trauma and contamination, treated early.

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Wound Infection Severity

The number of microorganisms, their virulence, and host resistance factors determine the severity of infection.

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Puncture Wound

Caused by an object penetrating the skin, creating a small opening with deeper tissue damage and contamination. Examples include bites, gunshot wounds, and injuries from foreign objects like sticks or wire.

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Laceration

Incision with sharply cut edges, potentially extending into deep tissue like muscles or tendons. Usually, there's minimal damage around the wound edges, but if the tissue is pulled or torn off, large areas can lose blood supply and become dead.

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Degloving Injury

Extensive loss of skin and underlying tissue, with immediate or delayed exposure of the wound bed. Most common on limbs due to roller/wringer injuries or scraping against hard surfaces.

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Degloving Injury Types

Two types: Anatomic degloving involves tearing off the skin and tissue layers from the body. Physiologic degloving leaves the skin intact but separated from underlying tissues and blood supply, leading to delayed tissue death.

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Thermal Burn

Caused by direct exposure to heat sources like fires, dryers, heating pads, or hot liquids. Severity varies, but deep burns can be life-threatening due to fluid, electrolyte, and protein loss, increasing risk of infection and sepsis.

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Burn Depth Classification

Describes burn depth: Superficial partial affects the outer layer of skin (epithelium), deep partial reaches deeper into the skin (epidermis and part of dermis), and full thickness burns destroy all layers of skin and underlying tissue.

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Delayed Vascular Damage in Burns

Burn depth can change over time due to delayed damage to small blood vessels. This makes accurate classification on initial assessment difficult, prompting a move away from strict classifications.

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Burn Management

Burn management involves a variety of treatment methods designed to address the burn's severity, potential infections, and support for the patient's overall health.

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Delayed Primary Closure

Wound closure performed within 3 to 5 days after injury, before granulation tissue forms. It's used for mildly contaminated wounds that need cleaning and debridement before closure.

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Secondary Closure

Wound closure performed more than 5 days after injury, after granulation tissue has formed. It's used for severely contaminated wounds that require extensive cleaning and potentially treatment of infection before closure.

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Healing by Second Intention

A type of wound healing where the edges are left to heal naturally by contraction and epithelialization, resulting in a scar. It's often used for heavily contaminated wounds where primary or delayed closure isn't possible.

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En bloc Debridement

The process of surgically removing all dead tissue, foreign material or debris from a wound. It's essential for proper wound healing and to facilitate closure.

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Debridement

The removal of dead or damaged tissue from a wound, usually done in stages. This allows for gradual healing and may be necessary for wounds that are heavily contaminated or infected.

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Neovascularization

The growth of new blood vessels into the wound bed, a critical part of wound healing, which brings oxygen and nutrients for repair.

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Granulation Tissue

A type of connective tissue that forms during wound healing, characterized by a reddish, granular appearance. It's essential for the healing process and provides a base for new skin formation.

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Wound Closure Decision

The decision to close a wound or leave it open for healing is a complex process involving multiple factors.

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Primary Closure

Closing a wound surgically is a faster way to heal and restore function, but it is not always possible.

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Open Wound Management

When primary closure is not feasible, managing the open wound can be a viable option.

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Goal of Open Wound Management

Open wound management should aim to create a clean, healthy wound bed that can eventually close on its own.

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Factors Affecting Wound Management

Factors like contamination, time since injury, and tissue damage can influence the decision to close or manage a wound open.

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Species Differences in Wound Healing

Cats tend to heal more slowly than dogs after open wounds, with less granulation tissue formation.

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Systemic Factors Affecting Healing

Systemic illnesses like uremia, diabetes, and hyperadrenocorticism can interfere with wound healing.

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Local Factors Affecting Healing

Local factors like poor blood supply, necrotic tissue, and repetitive trauma can delay wound healing.

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Supplementation in Malnourished Animals

Animals with severe protein deficiency, vitamin or mineral deficiencies may need feeding tubes to supplement their diet until they're able to eat normally.

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Normovolemia in Malnourished Animals

Maintaining normal blood volume is important for proper blood flow and oxygen delivery to tissues.

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Biopsy of Chronic Wounds

Chronic wounds should be investigated for deeper causes like infections or tumors to ensure proper treatment.

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Wound Tension and Cavitation

Tension and cavities in wounds slow down healing, so surgery might be needed to fix them.

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Debridement of Necrotic Tissue

Removing dead or scarred tissue helps healthy tissue to form.

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Healing Problematic Wounds

Poor blood flow prevents healthy tissue formation. Flaps of tissue can be used to improve blood supply in hard-to-heal wounds.

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Immediate Wound Care

The initial goal of wound management is to reduce bacteria and prevent further infection.

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Temporary Wound Protection

A bandage can be used to protect a wound until a stable animal can receive more specific treatment.

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Study Notes

Pathophysiology of Open Wounds

  • A wound represents a loss of skin and tissue integrity
  • Wound healing is a four-step process:
    • Formation of a fibrin-platelet clot at the injury site
    • Recruitment of white blood cells to fight infection
    • Neovascularization and cellular proliferation
    • Tissue remodeling
  • Wound healing phases overlap and are influenced by endogenous and exogenous factors
  • Initial response to injury: vasoconstriction (5-10 minutes), followed by vasodilation (30-60 minutes) with fluid and leukocytes migrating to the site
  • Within 3-5 days: fibroblasts and endothelial cells proliferate forming granulation tissue
  • Epithelialization begins when a sufficient granulation bed is present (usually 4-5 days after injury)
  • Collagen deposition, and wound remodeling occur over time to strengthen the healing wound

Types of Wounds

  • Abrasion: Partial-thickness epithelial injury from blunt trauma or shearing forces. Heals rapidly with re-epithelialization and minimal bleeding
  • Puncture Wound: Penetration of an object into tissue. Characterized by small skin opening and deep tissue contamination
  • Laceration: Sharp incision into deep tissue (muscle and tendons) with minimal peripheral trauma to wound edges. May result in devitalized tissue if the incised tissue is elevated or avulsed
  • Degloving Injury: Extensive loss of skin and underlying tissue, often occurring on distal limbs due to roller or wringer-type injuries or scraping across a hard surface. May be immediate or delayed exposure of the wound bed. Anatomic degloving injury involves tearing of the skin and underlying tissue; physiologic degloving involves separated skin from subcutaneous tissue and blood supply, leading to delayed tissue necrosis
  • Thermal Burn: Tissue damage from heat application. Classified by depth of injury: superficial partial (epithelial), deep partial (epithelial and partial dermal), and full thickness.

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Description

Test your knowledge on the principles of open wound management in veterinary practice. This quiz covers topics such as wound healing characteristics, factors influencing closure, and differences between dogs and cats. Enhance your understanding of effective strategies for managing wounds in animals.

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