SA wound management

What is a major consideration when closing a wound to maximize healing success?

Tension on the edges of the wound.

What technique involves releasing the skin from its underlying attachments to reduce tension in wound closure?

Undermining.

Why is it important not to over-tension the edges of a wound during closure?

It can result in dehiscence due to poor perfusion and necrosis.

What is the preferred type of suture for deep layers of wound closure?

Monofilament absorbable synthetic material.

When should drains be used during wound closure?

When the wound is healthy and to reduce dead space after adequate debridement.

What is a key difference between open passive drains and closed suction drains?

Open passive drains like Penrose act by gravity, while closed suction drains actively remove fluid.

What should be done with the drain exit site and tubing for a Jackson Pratt drain?

It should be tied in with a purse string and finger trap to create a seal.

What type of suture is preferred for skin layer closure and why?

Nonabsorbable, monofilament sutures due to lower tissue reactivity.

What can excessive tension on wound edges lead to during healing?

Dehiscence and delayed healing.

Why is it important to educate owners about the use of e-collars post-surgery?

To prevent the animal from disturbing the wound as it begins to heal.

What are the main purposes of using bandages in veterinary medicine?

To protect and coapt injured areas, minimize contamination, absorb discharge, wick moisture away, reduce edema or seroma formation.

What are the three layers of a bandage?

Primary or contact layer, intermediate layer, and outer layer.

What should the primary or contact layer of a bandage do?

It should be in direct contact with the wound and promote healing.

What is the purpose of the intermediate layer in a bandage?

To hold the primary layer in place, provide protection, and have absorptive capacity.

What is the function of the outer layer of a bandage?

To protect the wound, provide sturdiness, and allow the animal to move.

How does honey promote wound healing?

It has antibacterial properties, pulls edema from surrounding tissues, and promotes granulation tissue formation.

What is a wet to dry bandage primarily used for?

To provide nonselective manual debridement of a wound.

Why might a veterinary professional stop using wet to dry bandages after a couple of days?

To prevent damaging budding granulation tissues that start to develop.

What key feature should a hydrocolloid dressing have?

It should help maintain moisture at the surface of the wound.

What signs might indicate distal limb vascular compromise in an animal with a bandage?

Swelling of the toes and spread of the nails apart.

What is a tie over bandage used for?

To secure bandaging material over a wound in awkward locations where traditional bandages are difficult to apply.

What is the benefit of using calcium alginate products on wounds?

They help promote granulation tissue formation.

What can happen if a bandage is too tight on a limb?

It can lead to necrosis of the limb distally due to compromised blood flow.

What is important to do during bandage changes for chronic wearers?

Inspect for rub sores and dermatitis.

How should you remove a wet to dry bandage?

It often requires heavy sedation or anesthesia due to causing pain when removing.

What should be monitored for in a patient with a Robert Jones bandage?

Monitor the toes to ensure they remain together and do not become swollen.

What is the significance of granulation tissue in wound healing?

It indicates that the wound is progressing towards healing after infection has been managed.

What does the acronym K stand for in the context of the lecture notes?

It is used as an informal acknowledgment or prompt to move forward in discussion.

What are the risks of closing a wound too soon?

The wound may contain non-viable tissue or be contaminated, leading to dehiscence or abscess formation.

What color indicates viable tissue in wound management?

Viable tissue typically appears as a dark red color and should bleed when cut.

What signs should be present for a wound to be considered ready for closure?

There should be signs of viable tissue, no signs of infection (like pus), and no gross contaminants.

What is the 'golden period' for wound management?

The 'golden period' is the first six hours post-injury, during which wounds are ideal for primary closure.

What type of wound management involves a delayed primary closure?

Delayed primary closure is performed generally within three to five days of wounding when the wound shows improvement.

What are the downsides of open wound management?

It is labor-intensive, expensive, can be uncomfortable for the animal, and has an increased risk of hospital-acquired infections.

What are the benefits of second intention healing?

It allows wounds to heal without closure and can be more financially manageable for owners.

What is a significant risk associated with second intention healing for distal limb wounds?

The risk of developing a physiologic tourniquet due to wound contraction.

What is the first step in primary closure management?

Performing a single definitive debridement before closing the wound.

What does granulation tissue refer to in wound healing?

Granulation tissue is fibrovascular tissue that forms and fills in defects during wound healing.

What is crucial to do before starting wound debridement?

Gather all necessary supplies ahead of time.

Why is the golden period for wound debridement important?

Intervention during this period reduces the risk of infection.

What should be used for wound lavage?

A balanced ionic solution like LRS, saline, or even tap water in some cases.

What is a key reason for providing adequate sedation during wound management?

To minimize stress and pain for the patient.

What should be done immediately after stabilizing a patient to address wounds?

Start wound assessment and gather supplies for debridement.

Which tissue type can be aggressively removed during debridement?

Fat, as it doesn't provide functional benefit and has tenuous blood supply.

What is a recommended pressure for wound lavage?

7 to 8 PSI.

How should you handle questionable muscle tissue during debridement?

Be more conservative, as muscle has a robust blood supply.

What are the signs of necrotic tissue?

Grey, green, or black appearance.

What is the protocol for culturing wounds?

Culture only after thorough lavage to reflect actual contamination.

What does 'dilution is the solution for pollution' refer to?

It emphasizes the importance of volume during wound lavage.

What is the main goal of wound debridement?

To leave only healthy, minimally contaminated tissue behind.

Why is it important to clip hair around the wound?

To prevent hair from getting trapped in the tissue and causing infection.

What is a common method for maintaining aseptic technique during irrigation?

Using sterile saline or balanced solutions while keeping them out of the wound bed.

What should you use on clean intact skin before addressing a wound?

Standard prep solutions like chlorhexidine or betadine, but avoid the wound bed.

When dealing with bite wounds, why is it important to explore deeper tissues?

Because teeth can cause significant trauma and contamination below the skin surface.

What tissue types should be preserved during debridement?

Skin, tendon, and ligament, as they are essential for recovery.

What is the reason for using sterile lubricant before clipping a wound?

To catch hair and debris and prevent it from entering the wound during clipping.

What should be done with visibly necrotic tissue?

It must be debrided and removed to promote healing.

How can you determine the extent of a wound from puncture wounds?

By palpating around the puncture to assess for cavities or pockets.

Why might general anesthesia be necessary for wound debridement?

To provide better control and minimize the animal's stress during the procedure.

What is an important consideration while performing a lavage?

Ensure copious volume to effectively dislodge debris.

What happens if you neglect surgical debridement in a wound management scenario?

Risk of infection increases due to contaminated and devitalized tissues being left in the wound.

What is a key initial step in wound management when an animal presents with severe trauma?

A full systematic evaluation of the animal from nose to tail, focusing on Airway, Breathing, and Circulation (ABCs) before addressing the wound.

What is the primary concern when an animal has multiple puncture wounds, such as from a dog attack?

The potential for a pneumothorax or other significant internal injuries that may threaten the animal's life.

Why is analgesic treatment important in cases of major wounds?

Major wounds are painful, and effective analgesia is crucial for the comfort and stability of the animal.

What type of antibiotic is typically used for minor, minimally contaminated wounds?

A first-generation cephalosporin, primarily targeting gram-positive aerobes.

What is a common mistake when treating wound pain in animals?

Using buprenorphine as the primary analgesic for acute, painful wounds instead of a full mu agonist like fentanyl.

Why should wounds be covered immediately after assessment?

To prevent contamination with hospital bacteria, tamponade bleeding, and protect the wound from further injury.

What is the first action to take for a severely dyspneic cat following a car accident with multiple wounds?

Assess for the presence of a pneumothorax and prepare to perform a thoracocentesis.

What is the rationale for avoiding NSAIDs in shocky animals with wounds?

NSAIDs can exacerbate risks of acute kidney injury and gastrointestinal issues in unstable animals.

What makes local anesthesia an ideal choice in wound pain management?

Local blocks eliminate pain perception completely in the targeted area.

In managing wounds, what should be prioritized over wound cleaning if the animal presents with life-threatening injuries?

Addressing any major life-threatening issues such as significant internal injuries.