Wounds & Bandaging

About how many gallons of blood are in a 1,000 lb horse?

about 10 gallons

Signs of distress or shock will appear at about ________ gals of acute blood loss.

2 gals

When the spleen contracts, how many gallons of blood does it slowly release?

3 gallons

How does hemorrhaging occur with blood loss?

Spleen cannot release blood fast enough to replace blood loss → rapid hemorrhage

Describe the difference between arterial hemorrhage, venous hemorrhage, and capillary bleeding.

• Arterial hemorrhage: bright red blood spurting, jumping, or pulsating out of wound, with no signs of slowing

• Venous hemorrhage: darker red blood flowing down the wound

• Capillary bleeding: blood oozing from just under the skin surface that is easily controlled & stopped with short-term pressure

If a major vessel is involved or in the area of the wound, what steps should be taken?

• watch for signs of shock

• apply pressure to wound

• call veterinarian

What are things to consider when dealing with an open wound?

1. How old is the wound?

2. Is it bleeding?

3. Is there a foreign body present?

4. What is the location?

Wounds should be sutured within _________ of occurrence.

12 hours

True or False: If there is a foreign body present in a bleeding wound, you should immediately remove it.

False: Removing a foreign body from a bleeding wound can cause more damage. Wait for veterinarian to asses.

What locations are at high risk of developing ‘proud flesh’?

• carpus (knee)

• tarsus (hock)

What is ‘proud flesh’?

exuberant granulation tissue

Explain how wounds heal?

1. Inflammation: 0-6 hrs

   • minimizes blood loss & infection

   • hemagglutination

2. Debridement: 6-18 hrs

   • prevents further infection

3. Repair: 12 hrs

   • granulating within wound defect

   • contracture

   • re-epithelialization (1mm/day)

4. Maturation

   • toughening of scare to full strength

   • fully covered w/ skin

List the methods of wound closure.

• Primary surgical closure

• Secondary surgical closure

• secondary intention/healing

What does primary surgical closure provide?

shortest healing time

• closure at discovery

• better cosmetic results

What does secondary surgical closure provide?

allows infection to be cleared → allows dying or damaged tissue to be identified & removed

• surgical closure after wound bed is healthy

• less cosmetic results

What method of wound closure has the least cosmetic result?

secondary intention/healing

Provide wound lavage techniques.

• Saline

• Water → cheap & easy

• Povidone Iodine → only on intact skin

• Chlorhexidine → can cause necrosis & bacteria regrowth

• Distilled Vinegar → great for Pseudomonas infection

• Hydrogen Peroxide → will kill healthy cells too

What should you do if blood will not stop bleeding through the applied bandaging?

apply a tourniquet

What are the options for topical antibiotics?

• Silver → SSD cream, antimicrobial agent, less proud flesh formation

• Nitrofurazone → popular, not positive study on this product

• Triple Antibiotic Ointment → antibacterial

• Manuka Honey → antibacterial effect

What is exuberant granulation tissue?

‘proud flesh’ → seen below carpus or tarsus where there is no muscle

Why do wounds below the knee and carpus areas require bandaging?

skin tension is tighter → more granulation than epithelization → control granulation tissue rate

What are all the layers for bandaging a lower leg wound?

1. wound dressing

2. Telfa pad → hold wound dressing

3. rolled gauze → hold pad in place

4. padding

5. brown cling gauze

6. vetrap

7. elastikon

Leave a minimum of _____ of padding exposed at proximal & distal ends.

½ inch

What is the purpose of compression when bandaging?

Compression is used to limit or reduce swelling.

List factors that may delay healing of a wound.

• infection

• movement

• foreign body

• necrotic tissue

• altered pH of wound

• poor O2 supply

• poor nutritional & health status

When applying the vet wrap part of bandaging, what % of wrinkles are we trying to eliminate?

75%

True or False: A leg should be wrapped from back to front.

False: A leg should be wrapped from FRONT to BACK → counterclockwise on Left legs & clockwise on Right legs.

True or False: Applying vet wrap to a horse’s leg is okay, even when there is no padding beneath.

False: Vet wrap should NEVER be applied to a horse’s bare leg!