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What is a tearing wound without alot of tissue loss? with alot of tisue loss?
- w/o tissue loss= laceration
- w/ tissue loss = avulsion
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What is a puncture wound?
penetrating wound with small external opening, so poor drainage
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what is the first step in wound management?
- hemmorrhage control
- (tell owner to do this!)
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What can you do to prevent wound contamination during the initial wound cleaning?
Apply sterile KY jelly or pack with a sterile dressing
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T or F: You must inform the owner that the wound will usually look worse before it looks better
True
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In a horse with unknown vaccination history what tetanus prophylaxis should be used?
antitoxin and toxoid
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In an open wound why do we give parenteral antibiotics for 3-4 days?
to control cellulitis
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Do i have to apply topical medications to upper leg and body wounds?
no- most respond well with just cleaning frequently
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Should I use topical meds on a lower leg open wound? What are some commonly used meds?
- yes- lower leg wounds respond well to topicals
- Furacin, Silvadene, meds for granulation tissue prevention
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Should I bandage a upper leg or body wound? When is it appropriate to?
- no- bandages not usually helpful because hard to keep on
- exceptions= bones, nerves, vessels exposed
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Should I bandage a lower leg open wound?
yes- respond better
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Why is surgical wound closure helpful?
reduces healing time markedly
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When can i close a wound with primary surgical closure?
- less than 10 hours old
- exception= head and perineum (can be older wounds)
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When do we used delayed primary closure?
- -heavily contaminated
- - >10 hrs old
- -lower leg of horse
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In delayed primary wound closure how many days do i keep the sterile bandage on before I debride the wound and close it surgically?
appox 3 days
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I have a horse with a triangle shaped wound on its head with the apex dorsal, what am I most concerned with?
blood supply! (gotta have it!)
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If there is not enough tissue to close the wound what type of wound closure should I use?
facilitated wound contraction
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What area of the horse is skin grafting best used on?
- lower leg wounds
- - esp where healing by wound contraction is minimal and we cant close it by suturing
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Do thinner or thicker grafts take better? which look better
- thinner = better take
- thicker= look better
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a healthy non-infected bed of granulation tissue is required for what types of grafts?
mesh, full thickness, split thickness
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What grafts can I use with some degree of infection present?
pinch, punch, tunnel grafts
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What are the 2 donor sites for grafts on a horse?
pectoral region, ventral abdomen
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What 2 grafts can be done on a standing animal?
- pinch, punch
- (the rest under GA)
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How long does it take to see if the grafts have taken?
2-3 weeks
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What special equipment do we need to harvest a split thickness graft?
dermatome
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I have an area that I need to graft with alot of motion- what graft is best?
tunnel and strip grafts
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What is pre-suturing?
- technique used to close defect/blemish
- skin is tretched 2-3 hours before closure
- minimizes tension on skin edges
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Does increase in motion of joint wounds increase or decrease healing time?
increase
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How do I diagnose if a wound involves the joint?
flush the joint and look for leaking
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If i have a negative culture of joint fluid can the joint still be infected?
yes- a negative cultures DOESNT mean the wound is NOT infected
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What culture medium is best for joint synovial fluid?
Blood culture medium
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if I perform CYTOLOGY on synovial fluid from a wound- what would indicate it is infected?
- >50,000 WBC/uL
- >90% neutrophils
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A joint would that is >8 hours old should be closed how?
- delayed primary closure
- - use parenteral antibiotics and regional limb perfusion of antibiotics as well
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When do joint wounds become very painful?
when joint capsule closes the animal is leg carrying lame
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Do we need regional anesthesia to remove pround flesh?
no- no nerve endings present
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Where is it most common on the horse to see pround flesh?
below hock and below carpus
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What are some caustic agents we can use to reduce proud flesh?
- -podophyllin in tincture of benzoin (genital wart tx)
- -copper sulfate
- -antimony chloride
- -HCl acid
- -Lime
- -Meat tenderizer
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What is Pythiosis also called?
- "leeches"
- "swamp cancer"
- cause by Hyphomyces destruens
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Where is pythiosis found? Conidiobolomycosis?
- Pythiosis- lower legs
- Conidiobolomycosis- nasal passages
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What clinical sign do both pythiosus and conidiobolomycosis have in common?
marked pruritis
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Can I delay treatment of a phycomycosis?
NO!- delaying treatment makes the difference between success and euthanasia
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What is the treatment of choice for pythiosis?
immunotherapy/ vaccine- 75% cure rate
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What is the treatment of choice for conidiobolomycosis?
- Iodine therapy- IV or PO
- (KI not given IV)
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Will deworming a horse with summer sores cure him?
NO- deworming helps but larvae in wound causing granulation tissue are still a problem
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Should I immediatley debride a wound at the coronary band?
NO- wait several days to more accuratley removie devitalized tissue
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How much coronary band can I remove and it will still regenerate without permanent hoof-forming problems for life?
<1 inch
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What is the prognosis for an established infection in a closed tendon sheath?
BAD- only pasture sound maybe
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What can I infuse into a wound where I suspect a wooden foreign body to help locate it?
sterile methylene blue- stains the wood so helpful because you know to just remove all the stained tissue you see
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With an abcess - what species should I use a caustic to help destroy it?
cattle only- not recommended in our other species
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Do we have to culture the exudate from an abcess?
no- if the abcess is mature and we have ventral drainage we most likely dont need antibiotics
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What can cause an Indolent wound?
- -poor nutrition
- -epithelial fatigue
- -chronic infection
- -applying too many drugs that prevent healing (proud flesh treatments)
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What is a product we can use to stimulate epithelialization?
Scarlet red oil (a mild irritant)
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What 3 things can cause SQ air?
- - wounds that pump air (axilla area)
- -trachea wounds/resp tract
- -Clotridial spp.that form gas
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What is the prognosis for a wound with SQ air due to clostridial infection?
Poor- death likely
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what is the most common skin tumor on a horse? what age do we see these?
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What breeds of horses are more likely to get sarcoids?
- Arabians
- Appaloosas
- Quarter horses
- Donkeys- esp males
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What is the best treatment for Sarcoids?
cryosurgery- freezing with liquid Nitrogen
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Where are we most likely to see SCC on a horse?
- muco cutaneous junctions
- eye and adnexa most common
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what color horses are more likely to get melanomas? what color is more likely to have metastatic melanomas?
- grey and chestnutt
- non- grey horses are more likely to have mets
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What are 4 terms for verrucous dermatitis? and where are these found?
- 1. canker- frog and sole
- 2. grease heel- heel
- 3. scratches- pastern
- 4. grapes- pastern and fetlock
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What layer of skin is invovled with verrucous dermatitis?
epithelium ONLY
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Keloids form most commonly why?
improperly managed wound or secondary to prolonged irritation
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What is the most common underlying cause of pressure sores?
chonic laminitis- horse spends too much time laying down
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What is the problem with pine shavings a bedding?
contain turpentine- causes furthur irritation especially to pressure sores
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What is the most common MO found in burns?
Pseudomonas
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Where are dentigerous cysts most commonly seen on the horse?
base of the ears, can be on other areas of the head too
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Do I have to removie a dentigerous cyst?
NO- blemish only
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