Wound basic
Velpeau's sling
Holds flexed forelimb against chest
Casts
Stabilize fractures distal to elbow Immobilize to protect tendon and ligament repairs
2nd degree burn
Superficial, all layers of dermis. Forms blister--fluid accumulation at interface of dermis and epidermis.
Acute wounds
Surgical or traumatic wounds Blunt trauma, bite wounds, gun shots
First intention healing--primary
appositional healing sutured use primary closure
4th degree burns
All layers of skin, deep tissue. SubQ fat.
contraction/epithelization
Allowed to heal without surgical closure. From inside out. second intention healing.
Layered debridement
Begin at superficial, progress in depth. Large wounds, substantial tissue trauma. Hydrotherapy
Repair phase
Begins 3-5 days after injury Dependent on debridement phase. Fibroblasts produce collagen, elastin, and proteoglycans. Granulation tissue growth.
Lavage
Cleaning interior of wound, not water log. 7 PSI Isotonic sterile saline 35-mL syringe + 19 g needle Waterpik .05% Chlorhexidine solution No antibiotics .1% Providine-iodine solution
Primary closure
Closed with sutures. Fresh, clean wounds. EX surgical wounds 1st intention healing.
Secondary closure
Closure after 3-5 days. Closure after granulation tissue has formed. contaminated or traumatized wounds. third intention healing
Bandage: tertiary layer
Consolidates second layer. Holding/protective layer. Stretch gauze, elastic wrap.
Contamination vs. infection
Contamination implies the presence of microorganisms that do not necessarily colonize or reproduce in the host. Infection implies colonization and reproduction of the organisms within the host. Disease only occurs when the infection impairs the health of the host.
Third intention healing
Delayed primary closure Sutured after granulation tissue has formed.
Disinfectant
Disinfectants are used on other surfaces, ranging from operating room surfaces to kitchen counters, in order to destroy potentially dangerous microbes.
En bloc debridement
Excision of entire wound Small wounds in areas of loose skin Primary closure
Maturation phase
Final and longest phase. 17-20 days post injury, up to years. Scar fades, wound strengthens. Gains ~80% original strength
3rd degree burns
Full thickness burns, all layers of skin. White--black--leathery Firm, decompressed.
Dirty wounds
Grossly contaminated or infected. At least 4 hrs old. necrotic tissue, abscess, foreign material, perforated vicera
Inflammatory phase
Immediately after injury. Fibrinogen + clotting gluing of edges
Ehmer sling
Immobilize hind limb
Infected wounds
Microorganisms invading tissues and producing toxins. And wound greater than 12 hrs. old.
Primary non-adherent
Minimal disruption of granulation tissue. Occlusive--used when no exudate present. Semiocclusive--prevents tissue dehydration but allows fluid absorption.
Contaminated wounds
Moderate contamination evident. Fresh traumatic injuries, open fractures, penetrating wounds. Surgery with organ spillage, Presence of bile or urine.
Bandage: secondary layer
Padded conforming layer: exudate absorption and wound protection
Modified Robert Jones Bandage
Post-op bandage simple, minimal padding
Bandage: primary adherent
Protect wound and promote debridement
Exuberant granulation tissue
Proud flesh
Drains
Relieve build-up of air and fluid. Prevention of: seroma, hematoma tissue pockets, dead space treatment of abscess foreign material can't be removed, necrotic tissue not excised
Abrasions
Shearing btwn two compressive surfaces. Partial thickness wounds of the epidermis. Heal by reepithelialization. Keep moist.
Avulsion
Tearing of tissue from attachment site. Creation skin types, degloving injury.
Distal limb splints
Temp. immobilization distal to radius and ulna carpus, tarsus, metacarpals, metatarsals, phalanges support of traumatized distal limb
Enzymatic debridement
Use of Trypsin to remove necrotic tissue. wounds that cannot be surgically debrided. May damage normal tissue.
Dry-dry
absorbs exudate and allows debris to adhere to bandage. gauze pads, cling gauze, baby diapers.
Debridement phase
begins about 6 hrs post injury. Up to 5 days Phagocytosis--neutrophils, monocytes/macrophages
Clean wounds
elective incisions surgical wounds Tissues not predisposed to infection.
Clean-contaminated wound
minor contamination event: Surgical wounds with minor breaks in aseptic technique. Elective surgery in tissues with normal resident bacterial flora: GIT, RT, GUT
Carpal flexion sling
non-weight bearing forelimb sling
Wet-dry
primary gauze soaked in saline. loosens dried exudate/debris by rehydration of wound
Lacerations/incisions
sharply incised edges. Min. tissue trauma. Primary closure.
Puncture wounds
small skin opening, deep tissue damage. gun shot, bites, insect stings. Foreign material and bacterial. large wounds=drainage
90-90 flexion sling
stifle and hock placed in a 90 degree flexion
Robert Jones bandage
temporary immobilization distal to elbow or stifle extend one joint above and below fracture thick padding
Antiseptic
used on exposed portions of the body, often at the site of a wound or surgical incision, in order to prevent infection
1st degree burn
very superficial, does not blister. Erythematous--skin reddening Vasodilation--vessel swelling Damaged epidermis desquamates--comes off in scales and flakes.
Second intention healing
wounds left open to heal. non-closure