Use LEFT and RIGHT arrow keys to navigate between flashcards;
Use UP and DOWN arrow keys to flip the card;
H to show hint;
A reads text to speech;
27 Cards in this Set
- Front
- Back
|
What are the three stages of wound healing? |
Inflammatory phase Proliferation phase Maturation phase |
|
|
What takes place during the inflammation phase? |
Vasoconstriction, platelet aggregation Lasts 3-5 days after wound (or longer, if the wound is more severe) |
|
|
What takes place during the proliferation phase? |
Seen 2 weeks after injury Epithelization- basal epithelium breaks off and produces more epithelium *no hair brough Angiogenesis Fibroplasia- ECM, collagen, elastin formation (granulation tissue placed, 7-10 days) |
|
|
What happens during the maturation phase? |
Contraction of the wound, happens 7-9 days after wound Scar is formed, but will always be 15-20% weaker than the original skin |
|
|
What are some management factors that interfere with healing? |
*Tension, motion, pressure, inadequate debridement, devitalized tissue (eschar), dessication, maceration (dessication- gets too dry, masseration- too wet) |
|
|
Define eschar |
Dead skin, often associated with burns Ideal medium for bacterial growth and impedes wound healing |
|
|
What host factors can interfere with wound management? |
Protein deficiency, anemia, uremia, cushing's, addison's, diabetes, vitamine A,C, and E deficiency, corticosteroid medication, chemotherapy, sepsis and old age |
|
|
What local wound factors can interfere with wound healing? |
Oxygen tension, temperature, radiation, neoplasia, infection, foreign body, devitalized tissue, eschar |
|
|
What are the stages of wound management? |
Cleanse Debride Lavage- with 0.05% chlorhexidine, 0.1-1.0% povodine-iodine (Inactivated with organic materials), hyperchlorous solutions Bandage *don't use hydrogen peroxide for open wound |
|
|
What are the different options for the contact layer of a bandage? |
Wet to dry bandage- causes debridement when removed Negative pressure- provides suction and faster granulation Alignates- made from seaweed, forms a gel and then is removed in 3 days |
|
|
When a wound is in it's proliferation phase, what can you use to as a contact layer in a bandage? |
Hydrogels- moist wound environment for granulation Hydrocolloids- insoluble gel that retains fluid and promotes epithelization. Used for superficial burns Petroleum impregnated- provides contraction, reduces epithelization |
|
|
What situations are antibiotics indicated in wound management? |
For extensively deep trauma For contaminated wounds that had to be closed (with a drain) |
|
|
What situations would make an equine case an emergency? |
Airway/breathing obstructed, severe hemorrhage, any clinical signs associated with a surgical lesion (sepsis, dystocia, pain, trauma), urinary obstruction |
|
|
What is the definition of celiotomy? What are the categories of? |
Surgical incision into the abdominal wall (usually the same as laparotomy) Treatment- to remove foreign debris Diagnostic- mass biopsy Anaphylactic- spay Elective |
|
|
What is different about the linea alba in cats? |
The linea alba is wider caudally and it is separate from the subcutaneous tissues so you can move around the subcutaneous tissues to find the linea alba (this is not the same case in dogs) *linea alba is always widest at the umbilicus |
|
|
What extra precautions need to be taken when making an abdominal incision in the preputial area of a male dog? |
Curve the incision laterally around the prepuce *will have to ligate the preputial vein |
|
|
What type of suture and suture pattern would you use to close a celiotomy? |
Prolonged absorbable/non-absorbable suture simple interrupted or continuous *with 6-8 extra throws at the end if you do the continuous pattern |
|
|
What are the holding layers that you want to incorporate when you close a celiotomy? What layers don't you want to include? |
Yes- the external rectus sheath and linea alba No- the viscera/omentum or any subcutaneous tissue |
|
|
How do you want to close the subcutaneous layers after you have a holding layer established? The skin? |
SQ- use 3 or 4-0 absorbable suture and a simple cutaneous or buried interrupted pattern Skin- Subcuticular, use 3 or 4-0 absorbable Subcutaneous or cruciate suture, use a 4-0 nonabsorbable suture *lg. animals are usually closed with ford-interlocking, horizontal mattress or staples |
|
|
Define gossybipoma. how can you prevent it? |
Gossybipoma- a retained surgical sponge Count them in/out, don't leave in abdomen (always in hand/with forceps), use radio-opaque gauze |
|
|
When bacteria is present in the abdomen, what is the immune reaction? What types of things in the stomach make the inflammation worse? |
Vasodilation, fibrin formation in order to try to wall off the infection, ileus and rigidity of the intestines Bile salts, gastric mucous, hemoglobin, barium, increased fluid all make the inflammation worse |
|
|
What are the ways you classify peritonitis? |
primary- from microbes outside the abdomen, usually monomicrobial Secondary- perforation in intestinal wall , usually polymicrobial - 25% mortality due to not seen until clinical signs already seen Aseptic- mechanical, foreign body, chemical, parasitic |
|
|
In chemical peritonitis, what fluids are most irritating? Less irritating? |
Most- gastric fluids and pancreatic enzymes Least irritating- sterile urine and bile |
|
|
How do you diagnose a case of peritonitis? |
PE, imaging, fluid analysis (cytology, lactate, glucose) *fluid analysis after abdominocentesis is the best tool- do both an aerobic and anaerobic culture |
|
|
How do you use blood-fluid and peritoneal lactate to diagnose a case of septic peritonitis? |
Can only be used in dogs* Blood-fluid lactate indicator with >2.0mmol/L Peritoneal lactate indicator with >2.5mmol/L |
|
|
How do you diagnose uroperitoneum? |
Fluid analysis reveals: Fluid:serum creatinine >2.4:1, potassium >1.4:1 Culture Contrast imaging |
|
|
How do you initially start treating a case of septic peritonitis? |
Source control, damage control, fluid therapy, drainage, antibiotics Antibiotics- start emperically then culture-based. Use cephalosporin/ampicillin, aminoglycoside, fluoroquinolone (if no resistance) or metronidazole |
