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20 Cards in this Set

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Wound Healing - wound created when an insult disrupts the normal integrity of the tissue
4 Phases
Inflammatory
ebridment
Repair
Maturation
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
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
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
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
Wound Management
stabilize patient
cover/clean dry bandage asap
h20 soluble antibiotic ointment
pack - temporarily close
clip hair/mineral oil
Wound Lavage
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
Wound Debridement
remove all contaminated devitalized or necrotic tissue
surgically or en bloc
enzymatic devridment for those not suitable for surgical debridement
Wound Closure
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
Factors in Wound Management decision making
Time since injury
degree of wound contractionn
degree of tissue trama
initial debridement
blood supply
animal physical status
wound tension
location of wound
Wound bandaging
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
Bandage Layers
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)
standard procedure for application
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
Casts
fiberglass
fractures distal to elbow or stifle/immobilization
cast must extend 1 joint above and below
not much padding
monitor weekly
Bandages and splints
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
Ehmer Sling
Immobilize a hind limb after reduction of craniodorsal coxofemoral luxation or after pelvic surgery
90-90 Flexion sling
Stifle and hock placed in a 90 degree flexion
non weight bearing sling
Velppeau sling
Holds flexed forlimb against the chest and prevents movement in all joints - non weight bearing sling
scapulohumeral joint
Carpal flexion sling
non weight bearing sling forelimb sling
Hobbles
Hind limbs to prevent excessive abjuctions of the limbs