LA Sx, Q2, I
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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
What is a puncture wound?
penetrating wound with small external opening, so poor drainage
what is the first step in wound management?
- hemmorrhage control
- (tell owner to do this!)
What can you do to prevent wound contamination during the initial wound cleaning?
Apply sterile KY jelly or pack with a sterile dressing
T or F: You must inform the owner that the wound will usually look worse before it looks better
In a horse with unknown vaccination history what tetanus prophylaxis should be used?
antitoxin and toxoid
In an open wound why do we give parenteral antibiotics for 3-4 days?
to control cellulitis
Do i have to apply topical medications to upper leg and body wounds?
no- most respond well with just cleaning frequently
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
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
Should I bandage a lower leg open wound?
yes- respond better
Why is surgical wound closure helpful?
reduces healing time markedly
When can i close a wound with primary surgical closure?
- less than 10 hours old
- exception= head and perineum (can be older wounds)
When do we used delayed primary closure?
- -heavily contaminated
- - >10 hrs old
- -lower leg of horse
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
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!)
If there is not enough tissue to close the wound what type of wound closure should I use?
facilitated wound contraction
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
Do thinner or thicker grafts take better? which look better
- thinner = better take
- thicker= look better
a healthy non-infected bed of granulation tissue is required for what types of grafts?
mesh, full thickness, split thickness
What grafts can I use with some degree of infection present?
pinch, punch, tunnel grafts
What are the 2 donor sites for grafts on a horse?
pectoral region, ventral abdomen
What 2 grafts can be done on a standing animal?
- pinch, punch
- (the rest under GA)
How long does it take to see if the grafts have taken?
What special equipment do we need to harvest a split thickness graft?
I have an area that I need to graft with alot of motion- what graft is best?
tunnel and strip grafts
What is pre-suturing?
- technique used to close defect/blemish
- skin is tretched 2-3 hours before closure
- minimizes tension on skin edges
Does increase in motion of joint wounds increase or decrease healing time?
How do I diagnose if a wound involves the joint?
flush the joint and look for leaking
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
What culture medium is best for joint synovial fluid?
Blood culture medium
if I perform CYTOLOGY on synovial fluid from a wound- what would indicate it is infected?
- >50,000 WBC/uL
- >90% neutrophils
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
When do joint wounds become very painful?
when joint capsule closes the animal is leg carrying lame
Do we need regional anesthesia to remove pround flesh?
no- no nerve endings present
Where is it most common on the horse to see pround flesh?
below hock and below carpus
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
- -Meat tenderizer
What is Pythiosis also called?
- "swamp cancer"
- cause by Hyphomyces destruens
Where is pythiosis found? Conidiobolomycosis?
- Pythiosis- lower legs
- Conidiobolomycosis- nasal passages
What clinical sign do both pythiosus and conidiobolomycosis have in common?
Can I delay treatment of a phycomycosis?
NO!- delaying treatment makes the difference between success and euthanasia
What is the treatment of choice for pythiosis?
immunotherapy/ vaccine- 75% cure rate
What is the treatment of choice for conidiobolomycosis?
- Iodine therapy- IV or PO
- (KI not given IV)
Will deworming a horse with summer sores cure him?
NO- deworming helps but larvae in wound causing granulation tissue are still a problem
Should I immediatley debride a wound at the coronary band?
NO- wait several days to more accuratley removie devitalized tissue
How much coronary band can I remove and it will still regenerate without permanent hoof-forming problems for life?
What is the prognosis for an established infection in a closed tendon sheath?
BAD- only pasture sound maybe
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
With an abcess - what species should I use a caustic to help destroy it?
cattle only- not recommended in our other species
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
What can cause an Indolent wound?
- -poor nutrition
- -epithelial fatigue
- -chronic infection
- -applying too many drugs that prevent healing (proud flesh treatments)
What is a product we can use to stimulate epithelialization?
Scarlet red oil (a mild irritant)
What 3 things can cause SQ air?
- - wounds that pump air (axilla area)
- -trachea wounds/resp tract
- -Clotridial spp.that form gas
What is the prognosis for a wound with SQ air due to clostridial infection?
Poor- death likely
what is the most common skin tumor on a horse? what age do we see these?
What breeds of horses are more likely to get sarcoids?
- Quarter horses
- Donkeys- esp males
What is the best treatment for Sarcoids?
cryosurgery- freezing with liquid Nitrogen
Where are we most likely to see SCC on a horse?
- muco cutaneous junctions
- eye and adnexa most common
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
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
What layer of skin is invovled with verrucous dermatitis?
Keloids form most commonly why?
improperly managed wound or secondary to prolonged irritation
What is the most common underlying cause of pressure sores?
chonic laminitis- horse spends too much time laying down
What is the problem with pine shavings a bedding?
contain turpentine- causes furthur irritation especially to pressure sores
What is the most common MO found in burns?
Where are dentigerous cysts most commonly seen on the horse?
base of the ears, can be on other areas of the head too
Do I have to removie a dentigerous cyst?
NO- blemish only
What would you like to do?
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