2012.09.04.

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OPEN INJURIESClassification, symptomes; Open injuries in particular

tissues and organs

Péter Tóth, DVM

Szent István University,Faculty of Veterinary Science,

Large Animal Clinic2012

General SurgeryTRAUMATOLOGY

INJURIES

1. Mechanical caused traumaOpen injuries, woundsClosed 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. erythematosaDry fur, swollen skin, edem, warm, loss of epithels

- II. degree – c. bullosaVasodilatation, leak of serum, vesicals,The base of this is the corium - pain

- III. degree – c. escharcticaCell 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, infectionIII. degree – cell degeneration, stop of circulation,necrosis, loss of larger body parts

DO NOTBURN OR FREEZE

FOR THERAPY!!

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Chemicals

• Acids, alkalics• Acid – coagulation necrosis

• Alkali – colliquation necrosis

Radioactive injuries

• Very rare problem in the vet. medicineLocal symptoms:

Redness – vesicals –loss of hair –necrosis - depigmentation –hyperkeratosis – ulceration

General symptoms:

Vomitus, diarrahoea, apathy

Electricity caused injuries

Strong current, lightningAbove 50mA critic general statusAbove 100mA always death

Local symptoms: celldegenerationcellcoagulation

Inlet – OutletShock

DETERMINATIONDETERMINATIONLoss of continuity in the skin, Loss of continuity in the skin, mucuous membrane or in the mucuous membrane or in the

organ with or without underlying organ with or without underlying tissue damage.tissue damage.

CLASSIFICATIONCLASSIFICATION•• LocalisationLocalisation

•• Shape and sizeShape and size

•• TypesTypes

•• OrigineOrigine

•• AgeAge

•• Healing stadiumHealing stadium

•• In what wayIn what way

LocalisationLocalisation•• Anatomical region (head, neck, Anatomical region (head, neck,

thoracicalthoracical etc.)etc.)

•• skin, mucuos membrane, muscle, skin, mucuos membrane, muscle, tendon, joint, etctendon, joint, etc

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Shape and sizeShape and size•• Point likePoint like

•• Line likeLine like•• LobedLobed

•• CavernousCavernous•• Loss of materiaLoss of materia

•• Loss of body partLoss of body part

•• RegularRegular

•• IrregularIrregular

TypesTypes•• SuperficialSuperficial

Graze, erosion, abrasion Graze, erosion, abrasion Denuding of the epidermis, minimal Denuding of the epidermis, minimal bleeding, some serum exsudationbleeding, some serum exsudation

•• DeepDeep

OrigineOrigineSurgicalSurgicalTraumaticalTraumatical

––PhysicalPhysical

––ChemicalChemical

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AgeAge•• FreshFresh

•• OldOld

Healing stadiumHealing stadium•• Regularily healingRegularily healing

•• Irregularily healingIrregularily healing

•• Infected or with complicationInfected or with complication

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In what wayIn what way•• IncisedIncised

•• LaceratedLacerated•• ContusedContused

•• PuncturePuncture•• GunshotGunshot

•• BiteBite

⇒⇒Vulnus Vulnus scissum et caesumscissum et caesum

⇒⇒Vulnus Vulnus lacerum s. ruptumlacerum s. ruptum⇒⇒Vulnus Vulnus contusumcontusum

⇒⇒Vulnus Vulnus punctumpunctum⇒⇒Vulnus Vulnus sclopetariumsclopetarium

⇒⇒Vulnus Vulnus morsummorsum

Incised woundsIncised woundsVulnus scissum et caesumVulnus scissum et caesum

•• Produced byProduced by

•• Tissue damageTissue damage•• Edges of woundEdges of wound

•• PainPain•• Underlying tissueUnderlying tissue

•• PrognosisPrognosis

⇒⇒sharp objectssharp objects

⇒⇒minimalminimal⇒⇒linear and smoothlinear and smooth

⇒⇒minimalminimal⇒⇒damaged only in the damaged only in the

lineline

Lacerated woundsLacerated woundsVulnus lacerum s. ruptumVulnus lacerum s. ruptum

•• Produced byProduced by

•• Tissue damageTissue damage

•• Edges of woundEdges of wound

•• Shape of woundShape of wound

•• PainPain

•• Underlying tissueUnderlying tissue

•• PrognosisPrognosis

⇒⇒irregular objectsirregular objects

⇒⇒extensiveextensive

⇒⇒smoothsmooth

⇒⇒lacerated, loss of materialacerated, loss of materia

⇒⇒painfulpainful

⇒⇒extensive damageextensive damage

⇒⇒depends on the objectdepends on the object

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Contused woundsContused woundsVulnus contusumVulnus contusum

•• Produced byProduced by

•• Tissue damageTissue damage•• Edges of woundEdges of wound

•• PainPain•• Underlying tissueUnderlying tissue

•• PrognosisPrognosis

⇒⇒dull objectsdull objects

⇒⇒extensiveextensive⇒⇒irregularirregular

⇒⇒very painfulvery painful⇒⇒extensive damageextensive damage

⇒⇒unfavorableunfavorable

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Puncture woundsPuncture woundsVulnus punctumVulnus punctum

•• Produced byProduced by

•• CharacterisedCharacterised

•• TypesTypes

•• PrognosisPrognosis

⇒⇒Sharp ended objetsSharp ended objets

⇒⇒Superficial (point like)Superficial (point like)

Deep (channel)Deep (channel)

⇒⇒PenetratingPenetrating

PerforatingPerforating

⇒⇒Anaerob infectionAnaerob infection

nail prick nail bind ok

Bite woundsBite woundsVulnus morsumVulnus morsum

•• CarnivorasCarnivoras

•• HerbivorasHerbivoras•• PrognosisPrognosis

⇒⇒Puncture woundsPuncture wounds

⇒⇒Contused woundsContused wounds⇒⇒infection (anaerob), infection (anaerob),

tissue damagetissue damage

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Gunshot woundsGunshot woundsVulnus sclopetariumVulnus sclopetarium

•• InletInlet

•• ChannelChannel

•• OutletOutlet

•• Direct effectsDirect effects

•• Indirect effectsIndirect effects

•• Primer necrotical zonePrimer necrotical zone

•• Necrobiotical zoneNecrobiotical zone

•• Molecular commotional zoneMolecular commotional zone

•• Bullet wanderingBullet wandering

•• Bullet capsulationBullet capsulation

Gunshot woundsGunshot woundsVulnus sclopetariumVulnus sclopetarium

•• ArrowArrow•• Ball, bulletBall, bullet

•• ShotShot•• Splinter, shrapnelSplinter, 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!