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OPEN INJURIES Classification, symptomes; Open injuries in particular tissues and organs Péter Tóth, DVM
General Surgery TRAUMATOLOGY INJURIES 1. Mechanical caused trauma Open injuries, wounds Closed injuries (commotion, rupture, etc.) Bone fracture 2. Chemicals caused injuries
Szent István University, Faculty of Veterinary Science, Large Animal Clinic 2012
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
3. Thermal origine injuries 4. Radioactive injuries
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!!
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Chemicals
• Acids, alkalics • Acid – coagulation necrosis • Alkali – colliquation necrosis
Electricity caused injuries Strong current, lightning Above 50mA critic general status Above 100mA always death Local symptoms: celldegeneration cellcoagulation Inlet – Outlet Shock
CLASSIFICATION • • • • • • •
Localisation Shape and size Types Origine Age Healing stadium In what way
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
DETERMINATION Loss of continuity in the skin, mucuous membrane or in the organ with or without underlying tissue damage.
Localisation • Anatomical region (head, neck, thoracical etc.) • skin, mucuos membrane, muscle, tendon, joint, etc
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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
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Age • Fresh • Old
Healing stadium • Regularily healing • Irregularily healing • Infected or with complication
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Incised wounds
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
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
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Contused wounds Vulnus contusum • • • • • •
Produced by Tissue damage Edges of wound Pain Underlying tissue Prognosis
⇒dull objects ⇒extensive ⇒irregular ⇒very painful ⇒extensive damage ⇒unfavorable
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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
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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
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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.
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Thank you for your attention!
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