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54 Cards in this Set

  • Front
  • Back
wound contamination
bacteria not replicating within the wound
wound colonization
replicating bacteria without trauma to animal. May be beneficial by reducing adherence of pathogenic bacteria to wound bed
wound infection
bacteria replicating and causing trauma to animal
10^5 bacteria/ gram of tissue
wound infection development is dependent on:
1.dose of bacteria
2.virulence of the bacteria resistance
4.amount of necrotic tissue(debride necrotic tissue)
chronic wound infection
fragile granulation tissue
weak collagen in diorganized patterns
reduced wound contraction
What should be considered in any wound that fails to heal despite providing the best possible wound healing environment
foreign body
covert wound infection
-loss of granulation tissue
-change in the character of granulation tissue
-pale gray or deep maroon in color
-tissue that is more friable
Foreign material in a wound reduces the volume of bacteria necessary for infection to what
10^4/g tissue
what concentration of chlorexidine is ok for cleaning wounds
generally less than .05%. general rule is to use the lowest possible concentration to reduce celluar toxicity
Hydrogen peroxide
only use to remove necrotic tissue
acetic acid (vinegar)
-poss.action against pseudomonas sp. and other aerobic gram negative bac.
-rec. 15min/day soak or compress
-may help with odor
-should be stopped once infection is under control
Dakin's solution
.5% bleach solution
-only use for chemical debridement of necrotic tissue
summary of cleaning agents
antispetics are useful to clean the very surface of a wound or the area surrounding a wound
-becuase of celluar toxicity, they are probably not the best choice for wound cleaning and should not be used in clean wounds
topical antibiotics
effective in reducing bacterail numbers in burn patients
-avoid commonly used systemic antibiotics
-use for 2 weeks or less
-use an approapriate anitbiotc culture/sensitivity
.5% silver nitrate
-burn patients
-cream needs to removed and replaced daily
-study:collagenase better than silver
-study:silver in horses less garanulation tissue
study showed that it sig. reduces healing rate
-not recommended
triple antibiotic
synergistic action
-more recent studies have shown that a moist wound-healing environment may be as beneficial as triple antibiotic in reducing bacterial numbers and more beneficial in stimulating wound healing
constant clens
wound cleanser
-non toxic
-contains polysorbate 20
-isotonic and pH-balanced
-risen off with saline
methods of debridement
autolytic debridement
breakdown of nectroic tissue by WBC
-achieved under occlusive dressing
-won't work well in dirty wounds or dry wounds
enzymatic debridement
topical application of proteolytic substances
-like amped up autolytic debridement
mechanical debridement
physical force
-wet to dry dressing
-wound irrigation
-gauze manipulation
sharp debridment
dead space
it is important to minimize the dead space by suturing, using passive drains, or active drains
moist wound healing
occlusion provides constant thermal regulation
fine balance bt drying out and maceration of peri-wound tissue
wet gauze dressing
tends to dry out
-amount of moisture retention dependent upon many factors: secondary dressing, amount of solution, type of gauze, freq. of dressing change, and must be moistend up to 6 times a day
hypertonic saline dressing-curasalt
pre moistened
-designed for infected or heavily exudating wounds only
-works by non selective debridement
-must change dressing at least every 3 days to prevent dilution of saline
antimicrobial dressing:
kerlix, AMD
polyhexamethylene biguanide (PHMB)(similar to chlorhexidine)
PHMB dressing changes
-surgical incisions every 5 days
-in necrotic wounds at least every 3 days to prevent dilution of the PHMB
-premoisten in dry wounds/cover
Hydregel wound dressings (curafil)
medical grade gel that is intended to promote moist wound healing
-composed of water, glycerin,polymer
-use on dry to moist wounds with cavities
-first and second-degree burns
-minor irriations of the skin
hydregel dressing changes
up to 5 days
calcium alginate dressing (curasorb)
-soft, nonwoven fabric pads composed of sodium and calcium alginate, a derivative of seaweed
-interacts with sodium in wound
-absorb up 20 times its weight in exudate
-used for moderate to heavily draining wounds
calcium alginate dressing applications
-wounds where granulation tissue needs to be stimulated
-dehisced surgical wound
-skin tears
-pressure ulcers
-other external wounds with moderate to heavy exudate
calcium alginate dressing changes
up to 5-7 days
-cover with plastic in dry wounds
topical dressing:collagen
-final wound strenght determined by the character and quality of collagen
-hydropilic moist wound environment
-powders, gels, and sponges
topical dressing:maltrodextrans
--polysaccharide powders from plant starches
-inhibit growth of some bacteria
-provide nutrition
-granulation stage of wound healing
replacement tissue dressing
-provide a framework over which other cells migrate
-stimulate to form the tissue that is desired
-procine smeall intestinal sub-mucosa
acell extracellular matrix scaffold
-porcine bladder
-provides structural and functional proteins
-influence how cells attach, express their genes, and eventulally differentiate
-studies:affect the type of cells recruited
-not rejected by the host unlike other xenographic transplants,
-tissue types invading: urinary tract, dura matter, esophagus, musculotendinous tissues, and blood vessels
-possible antimicrobial activity
Equine amnion dressing
-studies: reduces wound retraction and granulation tissue formation, and improves epithelializtion
-used in skin grafting as a non adherent dressing
-drawback is the availability and the amount of time necessary for preparation
cytokines in wounds
chemotactic effects, mitogenic effects, and activating effects, which simulate production of the extracellular matrix components
platelet derived growth factor
decreasing wound-healing times by acting as a chemotactic agent and mitogen for fibroblasts, smooth muscle cells and inflammatory cells
transforming growth factor beta
chemotactic agent for fibroblasts and macrophages, smooth muscle cells and osteoblasts
-inhibitory effect on endothelial cells, various epithelial cell types and lymphocytes
transforming growth factor alpha
potent angiogensis factor
growth factor summary
growth factor soup vs purified growth factors
-present in wound exudate during moist wound healing
-greatest benefit in the granulating and epithelialization stages of wound healing and will be used with other synthetic dressings
platelet rich plasma in wound healing
growth factors
fibrin scaffold
hyperbaric oxygen TX
wound healing: granulation tissue formation, epitheliaization, wound infection
-mixed reports
semi occulsive foam dressing hydrasorb
semi occlusive
use on mildly exudative wounds
-minimized exuberant granulation tissue
ventral midline surgical approach
linea alba - holding layer
paramedian surgical approach
external rectus sheath: holding layer
-rectus abdominus muscle
-internal rectus sheath
-used in cattle for abomasum pexy
flank surgical approach
-external abdomimal olique fascia and muscle:holding layer
-internal abdominal oblique muscle
-transverse abdominus muscle
-most common in food animals: r for exploration
l for c section
ventral lateral surgical approach
-external abdominal oblique fascia and muscle/ external rectus sheath: holding layer
-internal abdominal oblique muscle/recuts abdominus muscle
-transverse abdominus muscle/interna rectus sheath
-good acess to uterus in cattle
paracostal surgical approach
-externalabdominal oblique fascia and muscle:holding layer
-internalabdominal obique muscle
transverse abdominus muscle
in body wall closure where should your largest sutures go
holding layer
small in subcutaneous to close dead space
big enough in skin to hold, small enough to be cosmetic
bowel healing stages
initially edges are sealed by a serofibrinous coagulum
granulation tissue is laid down begining at 24-48 hours
by 14 days replaced by fibrous tissue
new vessels emerge by 72 hours, originating from the arterial plexi form all layers except the mucosa
hypervasculation by 7 days
vascular response diminishes after 14 days in the aligned layers