Wound classification

Question 1

what are 4 considerations in wound management?

Answer 1

1. anatomic location
2. mechanism of trauma
3. degree of contamination
4. duration of injury

Question 2

Why does anatomic location of a wound affect the wound management?

Answer 2

1. head, body, limbs have different abilities to heal
2. degree of tissue disruption in area
3. supporting structure injury
4. joint involvement

Question 3

What are 11 mechanisms of trauma?

Answer 3

1. laceration
2. avulsion or degloving
3. puncture
4. blunt trauma
5. thermal burns
6. chemical burns
7. gunshot
8. hit by car
9. international harvester
10. vascular injury
11. septic injury

Question 4

What are the features of laceration?

Answer 4

1. direct antomical disruption
2. little collateral injury
3. best wounds to try to reconstruct

Question 5

What are features of avulsion or degloving?

Answer 5

1. direct tissue loss

2. collateral damage

Question 6

What are the features of puncture wounds?

Answer 6

1. extent of injury undetermined
2. common
3. predisposed to infection–bite wounds
4. predisposed to foreign body

Question 7

What are the features of puncture wounds?

Answer 7

1. extent of injury undetermined
2. common
3. predisposed to infection–bite wounds
4. predisposed to foreign body

Question 8

What are the features of blunt trauma?

Answer 8

1. massive soft tissue injury

2. severe skeletal damage

Question 9

What can cause thermal burns?

Answer 9

1. fire

2. radiation injury (similar effect)

Question 10

What can be a consequences of thermal burns?

Answer 10

1. protein loss
2. fluid loss
3. (sepsis in people)

Question 11

What are the features of chemical burns?

Answer 11

1. direct and collateral tissue injury–serum scald, chronic diarrhea

Question 12

What is an example of a product that causes chemical burns?

Answer 12

1. coppertox

Question 13

How do gun shot injuries differ in their mechanism of causing injury

Answer 13

1. low velocity gun shots hit tissues of different density and start to tumble
2. high velocity gun shots hit and cause massive acoustic wave and everything in that wave is traumatized–devastating to body cavity

Question 14

Why should gun shot wounds be considered infected?

Answer 14

because they carry debris, dirt into the wound

Question 15

What are the features of trauma caused by hit by car?

Answer 15

1. high energy injury
2. frequent collateral injury–in area hit and away from it
3. must evaluate major body systems

Question 16

What are two causes of vascular injury?

Answer 16

1. cast complication–can wear through tip of toe, shift in the cast causes pressure points and skin injuries
2. septic injury–hypercoagulable and form clots

Question 17

What is a cause of septic injury?

Answer 17

clostridial myositis

Question 18

What is a cause of septic injury?

Answer 18

clostridial myositis (flunixin meglumine injection)

Question 19

What is a cause of septic injury?

Answer 19

clostridial myositis (flunixin meglumine injection)

Question 20

What are 5 contributing factors to infection risk?

Answer 20

1. aseptic technique
2. tissue handling
3. suture material
4. electrocautery–minimize trauma
5. patient imune status–fasting

Question 21

What are examples of clean contaminated wounds

Answer 21

going into the bladder, upper respiratory tract or lower respiratory tact

Question 22

What are two examples of contaminated wounds?

Answer 22

1. wounds

Question 23

What are two examples of dirty wounds?

Answer 23

1. wounds >4 hours

2. gross contamination of the body cavity

Question 24

If you add suture material to a contaminated wound, how much do you decrease the number of bacteria required to get the wound infected?

Answer 24

by 100x

Question 25

What are 4 features of clean wounds

Answer 25

1. elective 2. aseptic technique 3. no viscus violated 4. no drain

Question 26

What is the infection rate of clean wounds?

Answer 26

2.5% in dogs and cats

Question 27

Should prophylactic antibiotics be used in clean surgeries?

Answer 27

1. only for inexperienced surgeons | 2. only to target the likely pathogen (coliform and staph in dog; cow; actinobacter, coliforms, horse: strep, coliforms)

Question 28

What are 3 types of clean-contaminated wounds?

Answer 28

1. hollow viscous surgery 2. minimal contamination 3. clean surgeries with DRAINS

Question 29

What is the infection rate of clean contaminated wounds?

Answer 29

4.5%

Question 30

Should prophylactic antibiotics be used in clean-contaminated wounds?

Answer 30

only to target likely pathogens

Question 31

What are 3 examples of contaminated surgeries?

Answer 31

1. GI surgery 2. contamination? 3. open fresh wounds

Question 32

What is the infection rate of contaminated surgeries?

Answer 32

5.8% in dogs and cats

Question 33

Should antibiotic be used for contaminated surgeries?

Answer 33

yes, do for best guess but also culture the wound

Question 34

What are two examples of dirty wounds?

Answer 34

1. old wounds >4 hours | 2. GI tract rupture

Question 35

What is the infection rate of dirty surgery?

Answer 35

dogs and cats: 18.1% | human 27-40

Question 36

What is the infection rate of clean wounds?

Answer 36

2.5% in dogs and cats | human 1-5

Question 37

What is the infection rate of clean contaminated wounds?

Answer 37

4.5% | human 3-11

Question 38

What is the infection rate of contaminated surgeries?

Answer 38

5.8% in dogs and cats | human 10-17

Question 39

What is the infection rate of dirty surgery?

Answer 39

dogs and cats: 18.1% | human 27-40

Question 40

Should antibiotics be used in dirty surgeries?

Answer 40

yes, essential

Question 41

What are three different types of factors that determine whether are not wound will get affected

Answer 41

1. surgeon factors 2. patient factors 3. surgery site factors

Question 42

What are surgeon factors?

Answer 42

1. aseptic--surgical technique | 2. patient management techniques

Question 43

What are patient factors?

Answer 43

1. age 2. immune status 3. metabolic status