Wound aetiology and classification

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This chapter examines those aspects of the aetiology and classification of wounds that relate specifically to the external surface and its associated structures. Since wounds have a wide variety of aetiologies and their patterns of tissue trauma vary considerably, it follows that the clinician’s ability to appreciate the cause, likely progression, options for treatment and possible complications are of paramount importance. The following topics are covered: Wound classification; Wound complications and assessment; Incisional injuries and lacerations; Abrasions; Degloving and avulsion wounds; Shearing injuries; Puncture wounds; Burns; Pressure sores; and Cast- and bandage-related wounds.

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2.3 Laceration from an unknown object sustained by a dog during a walk. The mobility of the skin on the lateral thorax results in a large gaping wound. Wounds in this area are prone to breakdown due to tension and the pulling effect of the front leg to the relatively loosely adhered skin.
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2.4 Abraded nail and surgically closed traumatic laceration above it, the initial trauma being the result of a road traffic accident.
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2.5 Mechanical and physiological degloving. Drawn by S.J. Elmhurst BA Hons (www.livingart.org.uk) and reproduced with her permission.
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2.6 This Border Terrier had been dragged by a car. The skin has been severely contused and there was underling avulsion of the mucosa from the dental arcade. The dog had also suffered a proptosis and the eyelids have been temporarily sutured closed; unfortunately, the eye subsequently underwent enucleation.
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2.7 A badly sheared leg. There is loss of many layers of soft tissue and bone, with joint exposure and severe contamination.
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2.8 A typical puncture mark caused by a cat bite. The cat has been treated with antibiotics for a infection and the wound is healing by second intention.
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2.9 Cartridges for (left to right): .22 calibre rimfire rifle; 7 mm 08 calibre centre fire rifle; .410 bore shotgun; 12 gauge shotgun. (Courtesy of J Niles)
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2.10 Depth of skin damage caused by partial- and full-thickness burns. Drawn by S.J. Elmhurst BA Hons (www.livingart.org.uk) and reproduced with her permission.
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2.12 A cat with a broken pelvis following a road traffic accident that 5 days post-injury developed a large skin wound due to being trapped by a hot exhaust pipe.
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2.13 The ‘rule of nines’ allows an estimate of percentage total body surface area affected by burns.
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2.15 This dog had been tied up with electrical cable, doused with petrol and then ignited. Following conservative management, his injuries showed marked contraction and the prepuce had deviated abaxially. A caudal superficial epigastric axial pattern flap was created to release the contraction.
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