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