Fichas
Wounds
Fichas del conjunto (43)
- 1What are the three main classification of a woundOpen
closed
burned - 2What are the sub classifications of and open wounds?incisions
lacerations
punctures - 3what are the sub classifications of closed wounds?abrasions
contusions - 4what is primary healing?The healing without granulation tissue
- 5What are the 4 phases of wound healing?1.Inflammatory phase
2.Debridement phase
3.Repair phase
4.Maturation phase - 6what are the inflammatory and debridement phases of healing more commonly known as?The lag phase
- 7what are the requirements for a wound to be able to heal under primary intention?-fresh
-clean
-adequate vascularisation
-minimal tension - 8what is the golden period?The period in which bacteria haven't yet multiplied 10^5, usually taken to be 6-8 hours (note different tissues have different periods, the head for example can last 24 hours)
- 9What are the signs of the inflammatory stage?red
hot
swollen
painful - 10What are the choices of lavage material?-tap water
-saline
-lactated ringers
-povidone iodine at 0.1%
-chlorhexidine at 0.05% - 11How should a wound be prepared for primary closure?-remove gross contaminants
-remove any hair entering the wound
-the surrounding hair should be soaked with water or K-Y jelly
-'high' pressure lavage (8ppsi- 19g needle and 35ml syringe or a low setting on a water pik) - 12how should pain relief be applied to the wound?local or regional anaesthesia, a perineural anaesthesia may be practical to anesthetize the wound if it is in the extrematies
(note that local anesthetics prevent adherence of leukeocytes to the endotheleum which slows healing down, adding adrenalin to the LA may counteract this?) - 13what are worries about a deep wound?-nerves
-vessels
-bones
-joints
-body cavity (throax/ab) - 14how and for how long can grafts be stored?3-4 days if refrigerated in McCoys 5A medium with 10% horse serum.
- 15how should a new graft be protected?with a non adherent dressing which isn't lifted for 4 days, the minimum dressing is a tie over one
- 16how should exuberant granulation tissue be treated in a skin graft?chemical cautery (caustic powder) or steroids
- 17what should you do if you see epithelium sloughing after a skin graft?dont panic new will form
- 18What is better about split thickness grafting?It is often better accepted although harder to do and requires specialist equipment. It is less cosmetic than full thickness grafts, the hair often grows to an excessive length. The donor sites often scar (i.e. develop hyper pigmentation).
- 19How is skin harvested for a split thickness skin graft?power or hand dermatomes
- 20where can a full thickness skin graft be harvested from?cranial pectoral area
- 21what are the pros and cons of a full thickness skin graft?only small areas can be grafted due to the donor site, they are cosmetic however and easy to do
- 22what are the pros and cons of island graftingIslands grafts are good as little expertise are required, no specialist equipment is required and a GA is unnecessary. They are however tedious, not cosmetic and requires a granulation bed so cannot graft a new wound with these.
- 23how are pinch grafts done and where are the sites?they are done with a scaple blade and donor sites are; pectoral, perineum and neck beneath the main.
- 24For a punch graft where can skin be harvested from?neck beneath the main and ventral pectoral areas only.
- 25What about the underlying structures can damage a skin graft?bone beneith it which hasn’t got periosteum, tendon with no paratenon and cartilage without perichondrium will prevent a graft from up taking
- 26what are the most common bacteria on a horses graft bed?streptococci, pseudomonas and proteus
- 27what fluid accumulations can stop a graft binding and why?seromas, haematomas or exudate. It stops the graft binding with fibrin.
- 28what are the most common reasons for a graft failing?-fluid accumulation
-movement
-infection - 29what are the stages to a graft up taking?The grafts start out by imbibition, then after 4 days they gain blood vessels, odema starts to reduce down a bit although they are still fragile, at day 10 they are firmly united. About 7-8 weeks later the nerves re innervate, they may need buster collars or bandages to prevent self mutilation.
- 30whats the difference between a free and a pedicle graft?A free graft contains no blood vessels whilst pedicle grafts do
- 31What the most common type of skin graft used in a horse?a pedicle graft
- 32what are the three types of island graft?tunnel, punch and pinch grafts
- 33how are island grafts classified?they're pedicle grafts
- 34what are the indications of a skin graft?Insufficient skin to increase healing speed by contraction or epithelisation. It can be cheaper than frequent rebandaging.
- 35when should a wound be referred?open joint/synovial cavity, sever lameness, tendon damage, foreign body, deep penetration, fractures and if the if the owner requests it.
- 36what are the malignant things that granulation tissue may turn into?sarcoids, pythiosis and fibrosarcomas.
- 37what things are used in treating exuberant granulation tissue?pressure bandages, immobilization, topical anti microbials, cryosurgery, topical agents such as Cu sulphate or white lotion, biological dressings, skin grafting and surgical excision (doesnt contain nerves remove back to skin level). Honey can be useful as it sucks water out and is an anti microbial.
- 38why is granulation tissue required?epethelial cells to migrate, is resistant to infection and induces contraction
- 39how may wound tension be relieved?stenting, drains and tension relieving incisions.
- 40how long can it take for a sequestrum to form?3-6 weeks
- 41why are scabs bad?they prevent epithelisation as they are dry, they should there fore be removed and the wound kept moist
- 42what are the 10 things which may prevent wound healing?-infection
-foreign body
-necrotic tissue
-movement
-loss of blood supply
-poor tissue O2
-tissue deficit
-continued trauma
-local factors
-health status issues
-tumor transformation
-iatrogenic factors - 43if a wound has granulation tissue how old must it be and how old is it to have epithelisation?granulation tissue- 4 days
epithelisation- 10-14 days
Información
- Descripción
- El usuario ha eliminado su información de asignaturas Fichas sobre Wounds, creado por Usuario eliminado el 18/10/2016.
- Creado por
- Usuario eliminado · oct 2016
- Actualizado
- 19 oct 2016
- Visitas
- 51
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- Historial
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- Creado por buzzybea1 · 27 feb 2014
- Copiado por Hoya Suzuki · 18 oct 2016
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