Table of Contents

• List of Contributors xv
• Foreword xvii
• Preface xix
• About the Companion Website xxi
• 1 The Skin 1
• M.S. Amarendhra Kumar
• Cutaneus Immune Barrier 3
• Pigmentation 5
• The Normal Keratinization Process 11
• The Abnormal Keratinization Process 12
• Dermis 15
• The Hypodermis (Subdermis or Subcutis or Superficial Fascia) 17
• Connective Tissue and Fascia 23
• Skeletal Muscle 26
• Skeletal Muscle Trauma and Regeneration 28
• References 30
• 2 Physiology of Wound Healing and Clinical Considerations 37
• Daniel J. Lopez
• Stages of Wound Healing 37
• Proliferative Stage 41
• Inherent Detriments to Wound Healing 46
• Conclusion 49
• References 49
• 3 Postoperative Complications 53
• Ryan P. Cavanaugh
• Introduction 53
• Seromas 54
• Wound Dehiscence (Indolent Pockets, Pseudo Healing) 57
• Biofilms 65
• References 68
• 4 Wound Types and Terminology 73
• Desiree D. Rosselli
• Classifications of Veterinary Wounds 73
• Wound Closure 80
• References 82
• 5 Patient Presentation and Evaluation of Wound 85
• Colin Chik
• Initial Stabilization of the Wound Patient 85
• Acute Critical Wound Patients 85
• Stable and/or Chronic Wound Patients 89
• Evaluation of Patient Factors 90
• Evaluation of Wound Factors 92
• Initial Treatment 93
• Decision-Making for Primary Closure 95
• Debridement 95
• Drain and Bandage Placement 98
• References 101
• 6 Cleansing Solutions 103
• Julia P. Sumner
• Cleansing Solutions 103
• Tap Water 106
• Isotonic Intravenous Crystalloid Fluid Preparations (e.g., 0.9% Saline, Lactated Ringer's Solution, Hartman's Solution, Plasmalyte, Normosol) 106
• Antiseptic Solutions 106
• References 109
• 7 Topicals 111
• Nicole J. Buote
• Hydrogels 111
• Zinc-Oxide Hydrophilic Pastes 113
• Honey/Sugar 114
• Antimicrobials (Nitrofurazone, Triple Antibiotic, Silver Sulfadiazine) 117
• Triple Antibiotic (Neomycin, Polymixin B, and Bacitracin) 118
• Silver Sulfasalazine 119
• Oxygen 120
• Nitrous Oxide 120
• Miscellaneous Topicals 121
• References 123
• 8 Wound Dressings 127
• Nicole J. Buote
• Moist Wound Healing 127
• Characterization of Dressings 127
• Adherent Dressings – Woven Gauze and Lap Sponges 131
• Non-adherent Semiocclusive (Porous-Dry or Petrolatum-Impregnated) 132
• Absorbent 133
• Moisture Retentive Dressings 135
• Antimicrobial 138
• Bioelectric Dressings 141
• Xenograft Dressings 143
• Miscellaneous 149
• References 150
• 9 Drains: How and When to Place Them 155
• Angela C. Banz
• Passive Drains 155
• Closed-Suction/Active Drains 158
• References 163
• 10 Vacuum-Assisted Bandages (Negative Pressure Wound Therapy) 165
• Kathryn A. Pitt and Bryden J. Stanley
• Physiology 165
• Increased Granulation Tissue 165
• Reduced Bacterial Load 166
• Increased Blood Flow 167
• Decreased Hematoma and Seroma Formation 168
• Increased Cytokines/Growth Factors 168
• Microdeformation with In-Vitro Modeling 168
• Indications of NPWT 168
• Description of Technique 169
• Postoperative Care 173
• Outcomes/Complications 173
• References 174
• 11 Biologic Treatments 177
• Subsection A: Medicinal Leech Therapy 177
• Celine S. Kermanian and Nicole J. Buote
• Anatomy and Physiology 177
• Indications 179
• Description of Technique 181
• Postoperative Care 185
• Outcomes/Complications 186
• References 188
• Subsection B: Maggot Therapy 191
• Megan Mickelson
• Background/Physiology 191
• Indications 192
• Description of Technique 193
• Post-Procedural Care 195
• Outcomes/Complications 196
• References 200
• 12 Bandages 205
• Kristin A. Coleman and Nicole J. Buote
• Introduction 205
• Light or Modified Robert Jones Bandage 205
• Wet-to-Dry or Dry-to-Dry Bandages 208
• Tie-Over Bandages 210
• References 214
• 13 Hyperbaric Oxygen Therapy 215
• Cheryl Braswell
• Introduction 215
• Physiology 215
• References 224
• 14 Low Level Laser, Photobiomodulation and Electromagnetics for Wound Therapy 225
• Nicole J. Buote
• Low Level Laser Therapy 225
• Photobiomodulation 226
• Pulsed Electromagnetic Field Therapy 228
• References 231
• 15 Platelet Rich Plasma and Stem Cell Therapy 233
• Aarthi Rajesh, Rebecca M. Harman, and Gerlinde R. Van de Walle
• Platelet Rich Plasma (PRP) Therapy 233
• Stem Cell Therapy 241
• Combinational Therapy Using PRP and Stem Cell Therapy 246
• References 247
• 16 Reconstructive Techniques for Wounds 253
• Jill K. Luther and Nicole J. Buote
• Equipment 253
• Basic Tissue Handling Tenants 256
• Skin Tension 257
• Tension-Relieving Techniques 258
• Triangular, Square, Rectangle Wounds 264
• Circular and Crescentic Wounds 266
• Skin Flaps 267
• Specific Axial Pattern Flaps 272
• Skin Grafting 281
• References 285
• 17 Specific Wounds 289
• Subsection A: Bite Wounds - A Case Study 289
• Nicole J. Buote
• Presenting Signs 289
• Examination and Initial Wound Characteristics 289
• Diagnostics 289
• Initial Therapy and Procedure 289
• Follow-up Bandage Care 290
• Surgical Procedure 292
• Outcome 292
• Prognosis 292
• Clinical Lessons 293
• Subsection B: Penetrating Wounds 295
• Galina Hayes
• Clinical Presentation 295
• Triage and Imaging 297
• Management Plans 298
• Prognosis 301
• References 301
• Subsection C: Abscess Case Study 303
• James D. Crowley and Julia P. Sumner
• Presenting Signs 303
• Outcome 305
• Prognosis 305
• Subsection D: Burns 309
• Galina Hayes
• Clinical Presentation 309
• Anatomy and Physiology of Burns 309
• Comparative Aspects of Burn Physiology 309
• Acute Management Plan 310
• Bandage Management 312
• Split Thickness Grafts 312
• Possible Complications 313
• Future Directions 313
• Prognosis 313
• References 314
• Subsection E: Wounds Over Joints 315
• Galina Hayes
• Clinical Presentation 315
• Specific Challenges 315
• Management Plans 316
• Prognosis 317
• References 319
• Subsection F: Shearing Wounds – Case Study 321
• James D. Crowley
• Presenting Signs 321
• Outcome 323
• Prognosis 323
• Subsection G: Necrotizing Fasciitis (Necrotizing Soft Tissue Infections) 327
• Nathan Peterson
• Presenting Signs 327
• Wound Characteristics 327
• Physiologic Effects 328
• Shock/Sepsis 329
• Prognosis 332
• References 332
• Subsection H: Snakebites 335
• Nathan Peterson
• Presenting Signs 335
• Wound Characteristics 335
• Physiologic Effects 337
• Treatment 339
• Possible Complications 340
• Prognosis 340
• References 342
• Subsection I: Pythiosis 343
• Kristin A. Coleman
• Introduction 343
• Presenting Signs 343
• Diagnosis 344
• Wound Characteristics 344
• Physiologic Effects 345
• Treatment 345
• Possible Complications 349
• Prognosis 349
• References 349
• Subsection J: Eyelid Wounds 351
• Brian Marchione
• Introduction 351
• Presenting Signs 352
• Physiologic Effects 354
• Treatment 354
• Possible Complications 356
• Prognosis 359
• References 359
• Subsection K: Lip Wounds 361
• Nicole J. Buote
• Introduction 361
• Anatomic Considerations 361
• Wound Characteristics 362
• Surgical Treatments 362
• Avulsion Injuries 365
• Primary Repair 365
• Wedge Resection Techniques 365
• Full-Thickness Advancement Flaps Full-Thickness 365
• Postoperative Care 367
• Complications 369
• Prognosis 369
• References 369
• Subsection L: Pinna Wounds 371
• Nicole J. Buote
• Anatomic Considerations 371
• Wound Characteristics 371
• Surgical Treatments 372
• Postoperative Care 374
• Complications 376
• Prognosis 377
• References 377
• Subsection M: Circumferential Wounds – A Case Study 379
• Nicole J. Buote
• Introduction 379
• Case 1 379
• Other Examples of Circumferential Injuries 383
• Case 2 383
• Case 3 383
• Clinical Lessons 384
• References 385
• Subsection N: Preputial Reconstruction – Hypospadia Case Study 387
• Galina Hayes
• Presenting Signs 387
• Examination and Wound Characteristics 387
• Diagnostics 387
• Surgical Procedure 387
• Outcome 388
• Prognosis 388
• Clinical Lessons 388
• Index 393