OPEN INJURIES Classification, symptomes; Open injuries in particular tissues and organs Péter Tóth, DVM
Szent István University, Faculty of Veterinary Science, Large Animal Clinic 2012
General Surgery TRAUMATOLOGY INJURIES 1. Mechanical caused trauma Open injuries, wounds Closed injuries (commotion, rupture, etc.) Bone fracture
2. Chemicals caused injuries 3. Thermal origine injuries 4. Radioactive injuries
Thermal effect caused injuries I. Burn - combustio - I. degree – c. erythematosa Dry fur, swollen skin, edem, warm, loss of epithels - II. degree – c. bullosa Vasodilatation, leak of serum, vesicals, The base of this is the corium - pain - III. degree – c. escharctica Cell injuries, protein aggregation, thrombosis necrosis - IV. degree – carbonisatio
Thermal effect caused injuries II. Frostbite – congelatio I. degree –
ischaemia, hyperaemic, leak of serum, not sensitive II. degree – stasis, thrombus, vesicals, infection III. degree – cell degeneration, stop of circulation,necrosis, loss of larger body parts DO NOT BURN OR FREEZE FOR THERAPY!!
Chemicals
• Acids, alkalics • Acid – coagulation necrosis • Alkali – colliquation necrosis
Radioactive injuries • Very rare problem in the vet. medicine Local symptoms: Redness – vesicals –loss of hair – necrosis - depigmentation – hyperkeratosis – ulceration General symptoms: Vomitus, diarrahoea, apathy
Electricity caused injuries Strong current, lightning Above 50mA critic general status Above 100mA always death Local symptoms: celldegeneration cellcoagulation Inlet – Outlet Shock
DETERMINATION Loss of continuity in the skin, mucuous membrane or in the organ with or without underlying tissue damage.
CLASSIFICATION • • • • • • •
Localisation Shape and size Types Origine Age Healing stadium In what way
Localisation • Anatomical region (head, neck, thoracical etc.) • skin, mucuos membrane, muscle, tendon, joint, etc
Shape and size • • • • • •
Point like Line like Lobed Cavernous Loss of materia Loss of body part
• Regular • Irregular
Types • Superficial Graze, erosion, abrasion Denuding of the epidermis, minimal bleeding, some serum exsudation
• Deep
Origine Surgical Traumatical – Physical – Chemical
• Fresh • Old
Age
Healing stadium • Regularily healing • Irregularily healing • Infected or with complication
In what way • • • • • •
Incised Lacerated Contused Puncture Gunshot Bite
Vulnus scissum et caesum Vulnus lacerum s. ruptum Vulnus contusum Vulnus punctum Vulnus sclopetarium Vulnus morsum
Incised wounds Vulnus scissum et caesum • • • • • •
Produced by Tissue damage Edges of wound Pain Underlying tissue Prognosis
sharp objects minimal linear and smooth minimal damaged only in the line
Lacerated wounds Vulnus lacerum s. ruptum • • • • • • •
Produced by Tissue damage Edges of wound Shape of wound Pain Underlying tissue Prognosis
irregular objects extensive smooth lacerated, loss of materia painful extensive damage depends on the object
Contused wounds Vulnus contusum • • • • • •
Produced by Tissue damage Edges of wound Pain Underlying tissue Prognosis
dull objects extensive irregular very painful extensive damage unfavorable
Puncture wounds Vulnus punctum • Produced by • Characterised • Types
• Prognosis
Sharp ended objets Superficial (point like) Deep (channel) Penetrating Perforating Anaerob infection
nail prick
nail bind
ok
Bite wounds Vulnus morsum • Carnivoras • Herbivoras • Prognosis
Puncture wounds Contused wounds infection (anaerob), tissue damage
Gunshot wounds Vulnus sclopetarium • Inlet • Channel • Outlet
• Primer necrotical zone • Necrobiotical zone • Molecular commotional zone
• Direct effects • Indirect effects
• Bullet wandering • Bullet capsulation
Gunshot wounds Vulnus sclopetarium • • • •
Arrow Ball, bullet Shot Splinter, shrapnel
References Auer & Stick: Equine Surgery 3rd Ed. Slatter: Textbook of Small Animal Surgery 2nd Ed. Knottenbelt: Handbook of Equine Wound Management Swaim & Henderson: Small Animal Wound Management 2nd Ed.
Thank you for your attention!
