Treating Wounds

Treating Wounds

1. Clean wound

   • 6 hour window clean contaminated wound
   • Pack with sterile salineswabs/ gel prevent hair in wound when clipping
   • Gloves, mask. hat, gown?
   • Flush wound
     • sterile saline
     • lactated ringers, chloro hexidine, 0.01%-1% Povidone-Iodine
       • Dilute prevent tissue damage
     • 500ml minimum
   • Bacterial swab for culture
   • Sterile dressing & bandage

2. Debridement

   • Wet to dry in small animals
   • En-bloc
     • Pack wound sterile swabs & close before surgical excision.
   • Layered
     • superficial tissues removed first then new instruments used for deeper layers
   • Hydrosurgery
     • burst of water slices away tissue (equine)
   • Autolytic Debridement
     • Hydrogel (gel foaming agent in saturated water)
     • Honey (supersaturated sugar solution)

3. Vacuum Assisted Closure Therapy

   • Vacuum sucks exudate out of wound and aids contraction of edges
   • Applied after debridement
     • sterile foam pad, plastic tubing, occlusive adhesive film, suction tubing, collection cannister and adjustable suction pump
   • Dressing may needed changing every 48-72 hours unless heavily contaminated.

4. Monitoring wound healing

   • Record dimension, shape/outline, type,areas of inflammation, infection, necrosis)
   • Wound progresses
     • Areas of granulation
     • Areas of epithelialisation

5. Wound Closure

   • Re-establish integrity of deficit
   • depends on contamination level & tissue viability
   • Primary closure= immediate closure
   • Delayed primary closure: 2-5days post injury
   • Secondary Closure: after 5 days
   • Secondary intention: granulation healing