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20 Cards in this Set
- Front
- Back
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Wound Healing - wound created when an insult disrupts the normal integrity of the tissue
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4 Phases
Inflammatory ebridment Repair Maturation |
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Platelet initiates wound healing process - releases growth factors
Process amplified and sustained by macrophages, endothelial cells, and fibroblasts |
Inflammatory phase begins immediately -
Blood fills wound and cleans surface Vasoconstriction occurs (5-10min) Vasodialation occurs (clotting elements released) clot formed- fibrin is wound strength Scab formed - doesn't provide wound strength |
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Debridement phase - 6 hrs after injury
WBC's appear - neutrophils and monocytes Phagocytes remove necrotic tissue, bacteria and foreigh material 1st 3-5 days ia lag phase-wound strength is minimal |
Repair phase- 3-5 days after injury- fibroblasts produce collagen that will mature into scar tissue
wound strength increased capillaries appear - red Granulation tissue appears after 3-5 days fills tissue defect protects wound provides a barrier to infection provides a surface for new epithelial cells to form across procides a source of myofibroblasts- responsible for wound contraction Epithelium for mation 4-5 days faster if sutured or edges held close together (1st intention) wound contraction reduces the size of the wound no new skin formed during contraction occurs 5-9 days after injury Infection stops after the repair phase |
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Maturation phase- wound strength increases
Remodeling of collagen fibers in fibrous tissue(cross linking) phase befins once collagen has been adequately deposited in wound - wound never regains strenght of normal tissue |
Factors affecting wound healing-
Age Malnourishment(protein) Disease-liver,kidney,cushings, diabetes |
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Factors aggecting wound healing-
Drugs steroids NSAIDS(aspirin) Radiation Chemotherapeutic drugs |
Wound Management
stabilize patieng cover with a clean dry bandate asap water-soluble antibiotic ointment pack wound with sterile gauze or lubricatn or close with sutures towel clamps or michel clips clip hair scissors dipped in mineral oil |
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Wound Management
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stabilize patient
cover/clean dry bandage asap h20 soluble antibiotic ointment pack - temporarily close clip hair/mineral oil |
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Wound Lavage
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removes debris and loose particles reduces bacteria large volumes of warm sterile electrolyte solution w/o antibiotics soaps detergents and antiseptic solutions
mechanical action most important |
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Wound Debridement
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remove all contaminated devitalized or necrotic tissue
surgically or en bloc enzymatic devridment for those not suitable for surgical debridement |
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Wound Closure
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1. Primary - 1st intention or appositional healing- suturing or grafting a wound soon after injury - golden period - 6hrs
2. Delayed Primary closure - 1-3 days after injury used for mildly contaminated minimally traumatized - some debridement and cleaning 3. Healing by contraction and epitheliazation - dirty contaminated traumatized wounds - must have loose skin 4. Secondary closure - 3rd intention - sutured 3-5 days after injury - granulation tissue present - contraction will not completely close |
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Factors in Wound Management decision making
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Time since injury
degree of wound contractionn degree of tissue trama initial debridement blood supply animal physical status wound tension location of wound |
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Wound bandaging
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bandages protect wound from more trama and contamination
prevents dessication, hematoma/seroma, dead space, immobilizes, minimizes edema granulation tissue, absorbs wound exudate, lifts foreign material loose tissue provides acidic env promoting healing, keeps warm |
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Bandage Layers
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1. Primary - direct contact - nonadherent, keeps wound moist, enhances epitheliazation, reduces inflammation, reduces disruption
2ndary - absorbent,padded, conforming layer of cast padding or cotton 3. Tertiary layer p holding and protective layer- gauze, elastic, tape wonce wet must change bandage - should be nonocclusive(breathable) |
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standard procedure for application
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anchoring tape strips
primary bandage layer tertiary bandage layer-gauze application of the spling reflect and twist tape strips tertiary bandage layer - tape middle 2 toes exposed to assess color, warmth & swelling |
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Casts
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fiberglass
fractures distal to elbow or stifle/immobilization cast must extend 1 joint above and below not much padding monitor weekly |
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Bandages and splints
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Robert Jones Bandage
temporary immobilization not used for femur or humerus bulky rigid Modified RJB simple padded bandage - used to help reduce postoperative swelling of the limbs- little or no splinting |
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Ehmer Sling
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Immobilize a hind limb after reduction of craniodorsal coxofemoral luxation or after pelvic surgery
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90-90 Flexion sling
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Stifle and hock placed in a 90 degree flexion
non weight bearing sling |
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Velppeau sling
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Holds flexed forlimb against the chest and prevents movement in all joints - non weight bearing sling
scapulohumeral joint |
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Carpal flexion sling
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non weight bearing sling forelimb sling
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Hobbles
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Hind limbs to prevent excessive abjuctions of the limbs
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