Crystal D Ritenour, LVT

Wound Management -- now this is a full statement in, and of, itself, a vast topic with many different variances along the way.  The most important thing to remember when treating wounds is to use your common sense.  Any one who has owned an animal, had a child, or just been a klutz, has certainly had to deal with a wound of some kind.  There are the lucky ones; those that only had to deal with a small bump or bruise, or a few scratches.  Then there are those that have had to deal with missing body parts.  I know this sounds gruesome but it is so true.  After dealing with several catastrophic injuries, some on my own animals, I have gained a great respect for what a body can do to heal itself, given the proper encouragement.  I think everyone should have a basic understanding of how wounds heal.

This is the somewhat boring and tedious part to understand.  There are three stages of wound healing.  After an injury the first stage begins, which is the inflammatory stage.  The purpose of this inflammation is to neutralize toxins so that the repair process can occur.  The second stage is proliferation.  During this process there is epithelialization, granulation tissue grows and the wound contracts.  The third stage of wound healing is the maturation or remodeling stage.  During this time the collagen that helped form the scar will be replaced by stronger collagen. The amount of time that it takes for each stage to complete varies on how extensive the wound is and how well it is cared for.   There is, of course, much more that can be discussed about each stage of the healing process, so if you have questions about a certain stage just call us and we do our best to help you.

Now that you have a basic understanding of the healing process it is time to explain the forms of wound management.  Before going any further, I want to remind you that it is very important to have a veterinarian examine the wound first to be sure the damage is not worse than it appears.  At this time the veterinarian can make the decision on how the wound should be treated.  There are three ways to help a wound heal; primary closure, delayed primary or secondary closure.  Primary closure is when a wound is fresh and the skin edges can be pulled together with sutures.  This is the ideal form of healing because it generally takes less time to heal and there will be less of a scar.  Time is of the essence in this situation; a veterinarian should be called immediately upon finding the wound.  Delayed primary closure is attempted when the wound is still fairly fresh but there is some wound contamination.  The wound is cleaned and bandaged for a few days.  Once infection is controlled and swelling is reduced the wound then can be closed with sutures.  The final form of healing is secondary wound closure, which must be used when the wound is not fresh, if it is contaminated, or if it is too large to be sutured.

In the situation where primary closure or delayed primary closure is chosen the area will need to kept clean and dry so that the wound can heal properly.  Sutures are generally kept in for 10–14 days and then they are removed.  A veterinarian will give any other specific instructions needed in this situation.  Now with secondary closure it can be a long process with great rewards if cared for properly.  This is the one type of closure that you can not let yourself get discouraged with.  I have witnessed wounds that one would never think could heal, look as if nothing ever had happened Following are photographs of a llama by the name of Quincy.  Quincy tried to jump over a fence and impaled himself in his thigh.  Like me, you will be truly amazed at what a body can do and will soon find that when working with secondary closure, your best friend will become a garden hose.

Quincy was healed with diligent care, a cold water hydrotherapy garden hose, a little bit of betadine scrub and wound ointment.  Large wounds that have happened due to a great bit of trauma usually look worse before they look better.  When bruising occurs a lot of tissue will die and become necrotic.  This is when it is necessary for a veterinarian to cut away tissue as it dies so that the good tissue can heal more efficiently.   Basically while in the process of helping the wound heal it should be cold hosed at least 2x a day for 15 – 20 minutes, gently (and I mean gently) scrubbed, then rinsed, dry the area slightly by blotting it with a towel or allow it to air dry, then apply a wound ointment that has been agreed on by you and the veterinarian.  My favorite ointment at the moment is derma-gel.  If this procedure is followed the outcome will, in most cases, be amazing.

There is so much that still can be said about wound healing but I must keep this short and sweet.  There are always going to be variances along the way and it is important to keep in touch with a professional that has knowledge of how the wound is going to look at different times.  Always remember that we at Rose Hill are here to help you during the process.  We provide many different services to help you.  If you do have an unfortunate event that will force you to deal with a secondary closure, we provide care at the clinic facility where your animal can stay and receive proper care.  During the time that tissue may be dying and need to be trimmed it may be best to have them at the clinic facility.  If this care is out of your budget a technician or vet can come to your farm or you can schedule clinic appointments to do regular checks and help decide what care is need along the way.  I hope that this article will help you in some way of understanding basic wound care.  Do not become discouraged if you find a wound on your animal.  Stay calm and call us at Rose Hill, we’ll be happy to help come up with a plan for you.