Dogs and cats are very commonly presented for management of acute or chronic wounds in veterinary practice. The goal of wound
management is to accelerate the healing process and not to interfere with it. Therefore, the management of the wounds requires
a good understanding of the healing process of wounds to be able to treat them effectively.
Stages of wound healing
Wound healing includes four different phases: inflammatory phase, debridement phase, granulation phase and maturation. It
is very important to be able to recognize each the phases because the management of the wound is conditioned by the phase
of wound healing. The duration of each stage is a function of an individual wound, the degree of contamination, the degree
of ischemia, and the extent soft tissue damage. More likely, the stages overlap with time.
Wound management
When an animal is presented for the management of an acute or chronic wound precautions should be taken not to further contaminate
the wound. While a physical examination is performed to evaluate for any life threatening injury the wound should be covered
with a light sterile bandage. This will help prevent contamination wit resistant bacteria present in the clinic. After the
animal has been stabilized, the wound should be evaluated and cleaned. Sterile gloves are required to manipulate the wound.
Pain medication should be delivered appropriately to the animal.
Preliminary evaluation
The wound needs to be covered with a water-soluble lubricant or a wet sterile sponge before starting clipping. A large clipping
is performed with a # 40 blade. After completion of the clipping, the water-soluble gel is eliminated with sterile saline.
If the wound is important, tap water can be used first to eliminate the gross contamination and sterile saline should be used
for the last flush. Any obvious foreign material should be removed manually.
After the wound has been flushed, a deep sample should be taken for culture and sensitivity. While results of the culture
are pending, the animal should be placed under broad-spectrum antibiotics. The most common bacteria in a wound are skin contaminant
unless the trauma happened in a specific environment that may contaminate the wound with different bacteria. Usually a first
generation cephalosporin is offering an adequate coverage.
The wound should then be evaluate for exposure of vital structure such as artery, vein, nerve, and joint. If the femoral
artery or the sciatic nerve are exposed it is recommended to move tissue to cover these structures. Joints if exposed need
to be aggressively flushed to remove the foreign material and closed over a drain.
