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Equine Wounds - Coggle Diagram

- - - - fresh, clean wounds, minimal trauma/tissue loss
      - surgical incisions
      - to prevent desiccation of underlying structures
      - partial primary closure to reduce the area that must heal by second intention
      - minimal tension on closure
    - - infected wounds/ with contamination
      - Tension on closure
      - Swollen/ contused wounds, tissue loss, blunt trauma
      - unknown deeper structure involvement
      - Avascular wounds edges/ unknown tissue viability
  - - - excess tension/ skin loss
      - Protects against desiccation of underlying structures
      - reduces area of second intension healing
      - Improved cosmetic and functional outcome
    - - WOUND PREP
        
        prepare surrounding skin (apply gel, clip and prep skin
        Lavage and debride= make it clean
        Prepare edges- 2mm excision/ until vascular ooze
      - Suture Techniques for SKIN
        
        monofilament synthetic non-absorbable (nylon/propylene)
        
        cutting needle (thick skin on distal limbs and rump)
        
        Suture SIze: smallest (2-0) for apposition, 1/2 for tension
        
        Interrupted pattern
      - for TENSION RELIEF
        
        undermining
        mattress sutures
        near-far-far-near
        Pre-suturing
        Reconstructive techniques
      - Minimise DEAD SPACE
        
        closure of deep layers
        drains
        pressure bandage/ cast
        stent bandages
      - SUPPORT
        
        Bandage, stents, adhesive dressings, cast/splint to immobilise
  - - - allows sound time for debridement phase and management until CLEAN
      - can determine tissue viability
      - Time to stabilise patient
      - Granulation tissue newly formed is removed and skin edges are mobilised for closure
  - - - severe contamination, infected/ chronic
      - skin loss, trauma, swelling, devitalised tissue
      - Failed primary closure or remaining area of partial primary closure
      - High movement areas
    - - clip and clean skin
      - Debride: remove foreign material and necrotic tissue, sharp OR lavage
        
        wet-dry dressings or hypertonic dressings 1-3d
    - - Exudative: change every 1-2 d
      - Primary layer: non adherent E.g. paraffin impregnanted
      - Secondary layer: cotton wool/ gamgee
      - Tertiary layer: conforming, elasticated wrap e.g. vet wrap
      - UNTIL a flat bed of granulation tissue with good edges.
      - Topical Tx
        
        lavage when change bandage with clorhex/ iodine
        
        Silvazine aqueous cream
        
        INtrasite gel?