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Wound Care - Coggle Diagram

- - - - Eye wounds
        
        need special care
    - - Sedation
        
        butorphanol (if not excited) otherwise xylazine + butorphanol
      - Pain
        
        NSAIDS (will slow healing but not as much as swelling does)
      - Tetanus toxoid?
        
        yes
        
        but camelids are not as sensitive to clostridium as horses and small ruminants
  - - - Sedation
        
        midazolam/butorphanol
      - Pain
        
        NSAIDS (will slow healing but not as much as swelling does)
      - Tetanus toxioid?
        
        YES!!!
        
        IF IT HAS BEEN MORE THAN 6 MONTHS SINCE LAST VACCINE
    - - Bite wounds
        
        oral bacteria are a big concern
  - - - heal well due to
        
        thick hide
        
        strong myofibril response
        
        EXCEPT
        
        urogenital wounds
    - - Sedatives
        
        not usually needed but if it is
        
        zylazine 10-20 mg if required
      - Pain
        
        NSAIDS (will slow healing but not as much as swelling does)
        
        flunixin meglumine (approved) meloxicam (off label)
      - tetanus toxoid?
        
        not needed
  - - - limb degloving injuries
        
        skin is pulled away from limb, HEAVILY TRAUMATIZING WOUNDS
        
        injuries can take months to heal and are $$$
        
        Wounds to the thorax, shoulder and abdomen occur as animals run through fences
      - Puncture wounds
        
        penetrating wounds (easy to miss)
        
        can easily lead to infection
      - Eye wounds
        
        need special care
    - - Sedation (per 500 kg)
        
        5 mg detomidine +/- 5 mg butorphanol iv
        
        detomidine is better for eye lacerations
        
        for an ill tempered horse
        
        EXCLUDING HORSES WITH PENILE INJURIES OR SIGNIFICANT BLOOD LOSS
        
        Acepromazine (hyoptensive) 10mg + 200 mg xylazine + 10 mg butophanol)
        
        150-250 mg xylazine +/- 5-10 butorphanol iv
      - Pain
        
        NSAIDS (will slow healing but not as much as swelling does)
        
        phenylbutazone, firocoxib, flunixin meglumine
      - tetanus toxoid?
        
        GIVEN EVERY TIME UNLESS...
        
        HORSE IS PROPERLY VACCINATED W/IN THE LAST 6 MONTHS
        
        if already vaccinated, you risk serum sickness
      - anti-anxiety
        
        Reserpine
        
        B vit. magnesium sulfate, herbal combinations
- - - - significant lameness
      - Vascular damage
      - synovial damage
      - flexor tendon injury
      - limb instability
      - Body Cavity trauma
      - Bone Damage
        
        fractures
        
        sequestration
      - Exuberant granulation tissue
      - Tensor tissue damage
  - - - Location
        
        How extensive is the injury?
        
        skin flap or skin loss
        
        periosteal or bone damage
        
        muscle injury
        
        sharp vs blunt
        
        Extensor tendon damage
      - clean vs contaminated
      - horse factors (temperment, ability to tolerate anesthesia and recovery etc.)
      - Chronic or fresh?
    - - Lower limb wounds frequently have issues and MUST BE DISCUSSED WITH THE CLIENT
        
        While most are not life threatening, they add time and money... common complications are:
        
        sequestration management
        
        splinting/bandaging/rehabilitation needs
        
        stall rest
        
        skin grafting
        
        Proud flesh
    - - nostick pad
      - padding
      - compressive layer
      - tape
- - - - Airway, breathing circulation
        
        involvement of the abdominal cavity
        
        blood loss? loss of blood supply to limb?
        
        risk of flexor tendon and/or joint or tendon sheath involvement
        
        risk of fx
        
        invovement of the chest cavity, airways or vessels
        
        significant lameness
  - - - prone to proud flesh
    - - sequestrum and/or infection
    - - fibrotic myopathy
    - - closure might need to wait
    - - blunt trauma has delayed affects
    - - Will it let you treat it?
    - - is it new or has it been going on for a while?
        
        treated vs untreated vs poorly treated lead to different strategies
    - - stablization will be needed
    - - Distal limb (proud flesh risk) vs eyelid laceration (exposure keratitis risk)