Author:
Ted S. Stashak & Christine L. Theoret
The second
edition of this textbook was long overdue. Indeed, since the first edition
appeared in 1991, a
number of ground-breaking studies have modernized the art of wound management in both human and veterinary patients. New topical medications, interactive dressings, and surgical procedures are now available,
enabling veterinarians to treat serious injuries once deemed incurable. Moreover, research has shown, unequivocally, that many aspects of the horse’s healing response are unique, such that a textbook dedicated to the art
and science of wound management in this species would be a most valuable tool for equine practitioners. Subsequent to the recent publication of two journal volumes on this topic ( Clinical Techniques in Equine Practice, June
2004, TS Stashak, guest editor; Veterinary Clinics ofNorth America, April 2005, CL Theoret, guest editor), it seemed
most opportune to provide readers with a single, comprehensive source of theoretical and practical information,
enhanced by an abundance of helpful tables, line drawings, and color figures. Thus, the purpose of this book
is to provide an authoritative, state-of-the-art text on equine wounds and their management.
The first chapter provides an update on the physiology of cutaneous wound healing, with a special focus
on the newly discovered mediators that govern the mechanisms underlying repair. Horses have a distinctive
response to trauma; therefore, the second section of the chapter endeavors to describe the major differences
from the relatively normal healing profile of ponies. The chapter concludes with an enlightening discussion of
innovative solutions to the specific problems encountered when dealing with a traumatic wound in a horse.
Chapter 2 addresses selected factors that can exert a negative impact on the physiologic mechanisms that
contribute to repair. This is followed by a review of wound management practices that influence infection and
healing. The chapter emphasizes the importance of thoroughly assessing the wound and the patient as well as
various measures such as hemostasis, cleansing, debriding, and disinfecting the wound in the first few hours
following injury. The subject is approached in the order in which a case involving a wound would be evaluated
and managed clinically. Because infection is a major cause of delayed healing, this chapter emphasizes management practices that reduce its incidence.
The third chapter is devoted to topical wound treatments. It includes an updated list of dressings and woundcare products. The authors have prepared a number of valuable tables in an effort to guide the practitioner
through the maze of commercially available products; they outline indications and suggest the best use for each.
This chapter is enhanced by a new and separate section focusing on the use of biologic scaffolds engineered from
the extracellular matrix as a potential therapeutic option for treating soft tissue injuries in veterinary medicine.
The fourth chapter leads the reader through the decision-making process preceding the closure of a traumatic wound. Factors which may preclude this approach are considered, as are the selection of suture materials
and patterns as well as the use of drains and alternative, innovative approaches to wound closure in the event
that this method is deemed appropriate.
Chapter 5 begins with a review of the physical and biomechanical properties of skin which will help the
practitioner develop an appropriate surgical plan. That is followed by a detailed description of practical reconstructive techniques that can be used in conjunction with primary or delayed wound closure.
The next series of chapters (6, 7, and 8) is devoted to the management of wounds in various regions of the
body: the head, the neck and body, and the distal extremities, with a focus on how to treat degloving injuries
and how to prevent or manage the species-specific problem of exuberant granulation tissue.
Chapters 9 and 10 focus on the fact that a fair proportion of traumatic wounds in horses compromise deep,
underlying structures. They present detailed anatomical reviews that should enable the practitioner to identify
involvement of synovial structures or tendons/ligaments and promptly instigate the recommended therapy to
improve the overall prognosis.
number of ground-breaking studies have modernized the art of wound management in both human and veterinary patients. New topical medications, interactive dressings, and surgical procedures are now available,
enabling veterinarians to treat serious injuries once deemed incurable. Moreover, research has shown, unequivocally, that many aspects of the horse’s healing response are unique, such that a textbook dedicated to the art
and science of wound management in this species would be a most valuable tool for equine practitioners. Subsequent to the recent publication of two journal volumes on this topic ( Clinical Techniques in Equine Practice, June
2004, TS Stashak, guest editor; Veterinary Clinics ofNorth America, April 2005, CL Theoret, guest editor), it seemed
most opportune to provide readers with a single, comprehensive source of theoretical and practical information,
enhanced by an abundance of helpful tables, line drawings, and color figures. Thus, the purpose of this book
is to provide an authoritative, state-of-the-art text on equine wounds and their management.
The first chapter provides an update on the physiology of cutaneous wound healing, with a special focus
on the newly discovered mediators that govern the mechanisms underlying repair. Horses have a distinctive
response to trauma; therefore, the second section of the chapter endeavors to describe the major differences
from the relatively normal healing profile of ponies. The chapter concludes with an enlightening discussion of
innovative solutions to the specific problems encountered when dealing with a traumatic wound in a horse.
Chapter 2 addresses selected factors that can exert a negative impact on the physiologic mechanisms that
contribute to repair. This is followed by a review of wound management practices that influence infection and
healing. The chapter emphasizes the importance of thoroughly assessing the wound and the patient as well as
various measures such as hemostasis, cleansing, debriding, and disinfecting the wound in the first few hours
following injury. The subject is approached in the order in which a case involving a wound would be evaluated
and managed clinically. Because infection is a major cause of delayed healing, this chapter emphasizes management practices that reduce its incidence.
The third chapter is devoted to topical wound treatments. It includes an updated list of dressings and woundcare products. The authors have prepared a number of valuable tables in an effort to guide the practitioner
through the maze of commercially available products; they outline indications and suggest the best use for each.
This chapter is enhanced by a new and separate section focusing on the use of biologic scaffolds engineered from
the extracellular matrix as a potential therapeutic option for treating soft tissue injuries in veterinary medicine.
The fourth chapter leads the reader through the decision-making process preceding the closure of a traumatic wound. Factors which may preclude this approach are considered, as are the selection of suture materials
and patterns as well as the use of drains and alternative, innovative approaches to wound closure in the event
that this method is deemed appropriate.
Chapter 5 begins with a review of the physical and biomechanical properties of skin which will help the
practitioner develop an appropriate surgical plan. That is followed by a detailed description of practical reconstructive techniques that can be used in conjunction with primary or delayed wound closure.
The next series of chapters (6, 7, and 8) is devoted to the management of wounds in various regions of the
body: the head, the neck and body, and the distal extremities, with a focus on how to treat degloving injuries
and how to prevent or manage the species-specific problem of exuberant granulation tissue.
Chapters 9 and 10 focus on the fact that a fair proportion of traumatic wounds in horses compromise deep,
underlying structures. They present detailed anatomical reviews that should enable the practitioner to identify
involvement of synovial structures or tendons/ligaments and promptly instigate the recommended therapy to
improve the overall prognosis.
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