Bandages/Wound Management

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bestes27
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168804
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Bandages/Wound Management
Updated:
2012-09-04 20:36:36
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Bandage Wound Management
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VT 2000 Small Animal Medicine II
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  1. What does bandages help protect from? What do they help prevent?
    • Further contamination, and further trauma.
    • Wound desication (drying out), hematoma formation a(pocket filled with blood), and sercoma formation (clear fluid).
  2. Minimize exuberant ______ tissue formation in open wounds in open wounds on lower limbs of horses.

    (Bandages)
    Granulation. See this in proudflesh.
  3. Absorb wound ____ and lift away foreign material or loose tissue adhering to bandage.

    (Bandages)
    Exudate.
  4. The bandages ____ the wound.
    Emobalize.
  5. It minimizes _____ ____ around incisions.

    (Bandages)
    Postoperative edema.
  6. Promote ___ environment, thereby increasing ____ availability in the wound.

    (Bandages)
    Acid. Oxygen.
  7. Bandages keeps the wound ____.
    Warm.
  8. What are the three layers to a bandage?
    • 1. Primary
    • 2. Secondary
    • 3. Tertiary
  9. The primary (contact) layer. Describe it!
    Direct contact with the wound. It is either adherent or nonadherent. It is either occlusive or semiocclusive.
  10. What does OCCLUSIVE mean?
    Moisture will not get through the bandage but oxygen will.
  11. What does SEMIOCCLUSIVE mean?
    Allows both air and moisture to get through.
  12. Secondary layer. Describe it!
    It is absorbent. Protects from outside trauma. Very padded (cast padding or rolled cotton). Covers primary layer. Supports the wound.
  13. Tertiary or holding layer. Describe it!
    The holding or protective layer. Gauze and elastic or adhesive tape. Semioclussive is preferred. Allows air and allows moisture to enter or exit. Strike through.
  14. What does STRIKE THROUGH mean?
    The protective barrier has been breached. Wet on the outside from the inside. Allows bacteria to get through.
  15. List the steps of applying a bandage.
    • Apply anchoring tapes (stirrups).
    • Apply primary (contact) layer on wound.
    • Apply secondary (padded) layer.
    • Apply tertiary (conforming) gauze layer.
    • Apply splint.
    • Reflect, twist, and adhere tape stirrups to gauze.
    • Apply tertiary (protective) tape.
  16. Stabilize fractures ____ to elbow.

    (Casts)
    Distal.
  17. ____ limbs to protect ligament or tendon repairs.

    (Casts)
    Emobolize.
  18. Extend one joint ___ and ___ any fracture or structure to be immobilized.

    (Casts)
    Above. Below.
  19. Cast material applied instead of ____ layer.
    Tertiary.
  20. Why do we leave the middle two toes of out of the bandage/cast?
    So we can check for warmth, color, and swelling.
  21. What is the Robert Jones Bandage?
    It is used for temporary emobolization. Used when we need stability for a fracture until we can do something about it.
  22. How long do we leave the chest or abdominal bandage on?
    No more then 4 hours.
  23. What does the Ehmer sling do?
    Rotates knee and hip inward. Keeps ball and socket in hip. Used to emobolize leg after fixing a dislocated hip.
  24. What does Cranial Dorsal Coxofemoral Luxation mean?
    Forward and above socket dislocation.
  25. 90-90 Flexion sling. What does it do?
    Put stifle and hock in 90 degrees. Used to prevent hyperextention.
  26. What bandage would we use for a fractured scapula?
    Velpeau's Sling. This is where we stick the limb to the chest so it does not move.
  27. What sling protects the front leg's tendons by preventing the dog from barring weight?
    Carpal Flexion Sling.
  28. ___ is used for Cranial Ventral Coxofemoral Luxation, which prevents excessive abduction (movement away from the body).
    Hobbles.
  29. What do we use ear badages for?
    Aural hematomas.
  30. When checking the bandage what do foul odors indicate?
    Tissue damage!
  31. What is the definition of a wound? When is a wound caused purposefully? When is a wound incidental?
    Normal integritity of tissue is desuptive. Surgery. Traumatic injury.
  32. What are the phases to woud healing?
    • 1. Inflammatory phase.
    • 2. Debridement.
    • 3. Repair.
    • 4. Maturation phase.
  33. The Lag Phase last __ to __ days.
    3 to 5.
  34. Repair phase shows significant ___ in wound strength.
    Increase.
  35. The ____ phase is when wound strength reaches its maximum.
    Maturation.
  36. What are the host factors that affect wound healing?
    Age, Malnourishment, Health, and Corticosteroids.
  37. What are some wound characteristics that affect wound healing?
    Foreign material in wound, soil particles, type of incisions, contaminated tissue, bacterial toxins and inflammation, blood supply and movement.
  38. What are the external factors that affect wound healing?
    Drugs (corticosteroids, anti-inflammatory drugs, prolonged aspirin therapy, chemotherapeutic drugs), Radiation therapy (kills rapid multiplying growing cells).
  39. The inflammatory phase starts ___ after injury.
    Immediately.
  40. ___ fills the wounds and cleans it.

    (Inflammatory Phase)
    Blood.
  41. ___ ___ will constricts to slow hemorrhage.

    (Inflammatory Phase)
    Blood Vessels.
  42. Vessels dilate after five to ten minutes to allow ___ ___ into wound.

    (Inflammatory Phase)
    Clotting Elements.
  43. Clotting elements + blood = ?
    Clots
  44. __ stablizes the wound edges and provides limited strength.
    Clot
  45. Scabs acts as ___ ___ to infections.
    Physical barriers.
  46. What do scabs do?
    • Prevent continued bleeding.
    • Allow the wound to heal.
  47. Once the scab is in place the ___ are leaked into the wound beginning the ___ phase.
    White Blood Cells. Debridement.
  48. Debridement phase starts __ hours after injury.
    6.
  49. Which cells appear during the debridement phase.
    Monocytes and Neutrophils.
  50. When does the repair phase start?
    3-5 days after injury.
  51. ___ arrives and produces collagen that turns into a scar.
    Fibroblasts.
  52. Fibroblast + capillaries + fibrous tissue = ?
    Granulation.
  53. When does granulation tissue appear?
    Should appear 3-5 days after wound.
  54. What color is the granulation if the number of capillaries is low?
    White/Pale.
  55. Granulation tissue provides a __ to infection, and lays down a ___ for epithelial cells.
    Barrier. Foundation.
  56. Granulation tissue contains ___ which are responisble for __ ___.
    Myofibroblast. Wound contraction.
  57. __ is the final phase.
    Maturation.
  58. In the maturation phase wound strength is achieved, collagen fibers cross link, and the number of capillaries ___.
    Decrease.
  59. Wound will only reach __% of orginal strength.
    80.
  60. List the immediate wound care techniques.
    • Put pressure on wound.
    • Cover with clean, dry bandage.
    • Water-soluble antibiotic ointments.
    • No anitbiotic creams and powders.
    • Sugar and honey.
    • Hair removal form around the wound.
  61. Water is the medical term for flushing of the wound?
    Lavage.
  62. Why do we lavage?
    • To remove debris and loose particles.
    • To reduce bacteria in the wound.
  63. What do we flush with?
    Large amounts/volume of water or sterile saline.
  64. We do not add ___, soaps, detergents, and ___.
    Antibiotics. Antiseptics.
  65. What should you do before you lavage?
    Take a sample for a culture.
  66. Wound ___ is where we use more physical effort to remove things from the wound.
    Debridement.
  67. Why do we do wound debridement?
    • To remove foreign material.
    • To remove contaminated devitalized or necrotic tisse. (Dead tissue).
  68. Surgical ___ of affected tissue.
    Excision. (We cut it away)
  69. We use ___ or ___ (chemical) debridement to remove necrotic tissue.
    Surgical or enzymatic.
  70. What are the 4 types of wound closure?
    • 1. Primary
    • 2. Delayed Primary
    • 3. Secondary (Second Intention)
    • 4. Tertiary (Third Intention)
  71. Which wound closure would we use for a fresh, clean, sharply incised wound with minimal trauma and minimal contamination?
    Primary Wound Closure.
  72. When is the best time to suture? (What is the golden period).
    6-8 hours.
  73. Which wound closure closes 1-3 days after injury.
    Delayed Primary Wound Closure.
  74. The delayed primary wound closure closes before ___ ___ appears.
    Granulation tissue.
  75. We use delayed primary wound closure for ___ contaminated wounds and ___ traumatized wounds.
    Mildly. Minimaly.
  76. In second intention healing (secondary wound closure) the wound is allowed to heal ___ surgical closure. So the wound closes as result of ___ and ___.
    Without. Contraction. Epithiliazation.
  77. We use second intention healing (secondary wound closure) is what kind of wounds? This means we will need to lavage and bandage.
    Dirty, contaminated, traumatized wounds.
  78. In the third intention healing (tertiary wound closure) we suture at least __ to __ days after the injury.
    three to five.
  79. In third intention healing the wound is ___ contaminated and ___ traumatized.
    Heavily. Severly.
  80. The epithlelialization and contraction will not __ the wound in the tertiary wound closure.
    Close.
  81. In wound closures what considerations should we look at?
    • Time lapse since injury.
    • Degree of contamination.
    • Amount of tissue damage.
    • Thoroughness of debridement.
    • Blood supply to the wound.
    • Animal's health.
    • Closure without tension or dead space.
    • Location of the wound.
  82. The partial thickness of the wound in the epidermus. We will need to change these bandages every three to four days.
    Abrasions.
  83. Abrasions develop minimal ___ and heal by ____.
    Exudate. Re-epithelialization.
  84. Sharply incised edges with minimal tissue trauma.
    Lacerations.
  85. Minimal debridement, lavage, and primary closer should have <__ hours after injury. En bloc debridement (remove whole edges and create a new wound) and primary closure should happen >__ hours after injury.
    8. 8.
  86. Define AVULSION.
    When tissue is torn away in a laceration.
  87. Name some examples on how animals can get burns.
    Chewing on an electrical cord, hair dryer, heating pads, house fires, and hot liquids.
  88. In first-degree burns only the ___ is involved. And no ___ form. Erythematous because of dermal ___.
    Epidermus. Blisters. Vasodilation.
  89. In first-degree burns pain subsides in 2-3 days and the damaged epidermus desquamates. What does DESQUAMATE mean?
    It means it falls off.
  90. In second-degree burns __ layers of the dermis are involved. Because of this ___ forms. Fluid collection forms at interface if epidermis and dermis.
    All. Blisters.
  91. In third-degree burns involve all layers of the dermis and its appearance is?
    White, or black and leather, firm, depressed, compared with surrounding skin. Maybe a little dip in the skin.
  92. What degree burn do animals normally get?
    Fourth-Degree Burn.
  93. If more than __% of the body is burned then survival is unlikely.
    50.
  94. What are some treatments of severe burns?
    • Intravenous crystalloid and colloid fluid administration.
    • Antibiotic administration.
    • Nutritional support. (metabolic requirements may increase 200%).
    • Intense wound management. (2nd intention open wound).
  95. When managing a burn, you should NOT apply ___ or ___.
    Lotions or salves.
  96. In wound management for burns the wound is kept moist. ___ as the primary bandage and padded ___ tertiary layer. You should change the bandage daily at the minimal.
    Hydrophillic. Nonocclusive.
  97. Puncture wounds have small ___ and deep ___ damage.
    Openings. Tissue.
  98. What are the treatments to puncture wounds?
    • Explore it.
    • Debride it.
    • Lavage it.
    • Maybe primary closure with drain.
  99. What injury is common in small animals?
    Degloving injuries.
  100. Define ANATOMIC DEGLOVING.
    Skin and some deep tissue get torn off limb.
  101. Define PHYSIOLOGICAL DEGLOVING.
    Skin surface is intact or appears to be, but doesnt fall off, but the muscle is damaged.
  102. What is the treatment of degloving injuries?
    • Debridement.
    • Lavage.
    • Management of open wound.
  103. What are the steps to treating a degloving injury?
    • Culture sample.
    • Lavage.
    • Debridement.
    • Bandage (modified robert jones).
  104. Define DECUBITAL ULCERS.
    Wound that results from compression of soft tissue and skin between a body promanance and what they are laying on. (BED SORES)
  105. What are the treatments of decubital ulcers?
    • PREVENTION is best.
    • Minimal debridement.
    • Skin flaps preferred.
    • These ulcers are very hard to heal.

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