Wound Management – First Aid

The nature of the wound often dictates the method of wound management that must be used. Contact your Veterinarian immediately if the wound is deep, bleeding profusely or is not healing.

Stages of wound healing;

  1. Inflammatory Phase; starts immediately after the injury and lasts up to 4 – 6 hrs. Blood fills the wound and cleans the wound surface. This is followed by the constriction of the blood vessels to slow down the hemorrhage for 10 – 15 minutes. Once the bleeding has slowed down, the blood vessels dilate to increase the blood flow to distribute clotting elements into the wound. The blood clot dries and forms a scab.
  2. Debridement Phase; usually 6 hrs after the injury. Blood vessels leak WBC (white blood cells) into the wound. Necrotic (dead) tissue and bacteria are removed from the wound.
  3. Repair Phase; 3 – 5 days after injury. Fibroblasts invade the wound, producing collagen (fibrous scar tissue). The collagen increases the wound strength (although the wound will never regain the strength of normal tissue). Capillaries and granulation tissue appear in the wound. The granulation tissue forms a protective barrier against infection and provides a surface for epithelial cells to divide and produce new cells.
  4. Maturation Phase; scar formation, created by the remodeling of the collagen fibers. The capillaries eventually decrease to reduce the scar.

Wound Care;

Immediate Wound Care; keep your animal calm, movement promotes bleeding.

  • Slow oozing of blood – apply direct pressure for 10 sec. Re-evaluate wound
  • Free flowing blood – apply ample gauze with a sturdy wrap (not to tight!!). Leave this in place for 30 min.
  • Arterial Bleeding (bright red blood that spurts out) – apply very tight pressure with a tourniquet. Use a tourniquet with caution, the resulting lack of oxygen may cause more damage than what occurred with the original wound.

Different kinds of wounds;

  • Abrasion; the hair and upper layer of skin are gone. Irrigate the wound with luke-warm water. Pat dry with gauze. Apply an antibiotic powder or spray. Leave the wound open unless there is oozing involved.
  • Contusion; bruising and swelling of the skin and underlying tissue. Apply cold packs (bag of frozen peas) or cold hosing for 20 – 30 minutes every 4 – 6 hrs during the first 24 hrs followed by hot packs for 24 hrs.
  • Puncture Wounds (bite wounds). Clean the site with Nolvasan or Iodine. Allow this kind of wound to drain.
  • Laceration; wound edges are often irregular, jagged or gaping. If your animal allowes you to clean the wound, use an antiseptic scrub and some clean gauze sponges to clean the wound. Ideally the hair should be clipped away from the edges of the wound. After scrubbing the wound, rinse away the scrub with a saline solution or water. And repeat the scrub and rinse procedure until the wound is clear of debris.

To Stitch Or Not To Stitch a Laceration?

  1. How deep is the wound? If the cut is completely through the skin, it will heal best if sutured.
  2. Location. Wounds located on the lower leg (especially in horses) are more likely to form proud flesh if not sutured, Call your veterinarian immediately, sensitive structures that lie just below the skin, may have been damaged. Proud Flesh = granulated tissue becomes raised above the level of the skin.
  3. How long and deep is the wound? Anything longer than 2 inches, or if muscle or other tissues beneath the skin are damaged, it should probably be sutured.
  4. Are you concerned about scarring? A wound will almost always heal with less scaring if it’s sutured.

We recommend suturing within 8 hrs after the initial injury occurred. Sutures are generally removed after 10 – 12 days, unless they are absorbable and fall out without removal. 

Regardless of the type of wound; watch out for signes of shock (state of collapse following many forms of stress). The signes include depression, rapid breathing and pale gums. If you suspect your animal is in shock, contact your veterinarian immediately. It is important to keep your animal warm, control any bleeding, keep him or her calm. Fluid therapy is essential to an animal in shock. Monitor your animal’s vital signes (heart rate, mucous membrane/gum color, capillary refill time (how fast or slow blood returns after pushing your finger on the gums). At the first opportunity, offer him or her fresh water, to replenish fluid losses.

If you think your animal might have a fracture (not bearing any weight on a limb), try to keep him or her as immobilized as possible to prevent further damage, find something to splint it with. Call a Veterinarian!!

Types of wound bandaging;

  • Cast – Stabilizes fractures below the elbow or stifle. And also immobilizes the limbs to protect ligaments and tendons.
  • Bandages  – Temporarily immobilizes fractures below the elbow or stifle.
  • Splint – Temporarily immobilizes or definitive stabilization of certain fractures. The splint should be placed on the back-side (caudal aspect) of the limb.

Bandage Application (3 layers; primary/contact layer, secondary/padding conforming layer and tertiary/holding & protective layer);

  1. The primary/contact layer is usually a nonstick dressing or gauze. You may apply a small amount of water-soluble wound salve to the wound (triple antibiotic ointment, Silver Sulfadiazine cream or Chlorhexidine cream). Horses: Do not bandage over joints when exercising. And NEVER kneel down to apply the bandage.
  2. The secondary/padding conforming layer consists of a layer of roll cotton to diffuse the pressure
  3. Begin bandaging below the knee.
  4. Wrap the bandage in a clockwise direction, overlapping each round by half.
  5. Secure the bandage. If a knot is required to fasten the bandage; tie the knot on the outside of the leg.

Always apply even pressure and do not bandage to tightly (especially plaster). 

Care of your pet with a bandage (cast, splint or sling);

  1. Your pets toes should be monitored for warmth, color and swelling. Cold, pale and/or swollen toes could be indications that the bandage is on to tight. Please monitor this 2 – 3 times daily.
  2. Monitor the bandage for any foul odor. This could indicate tissue damage (rotting tissue).
  3. Observe for areas of shafting from the cast. These areas, if left untreated, could turn into open wounds.
  4. Do not cover the bandage for more than 30 minutes at a time.

Horses; it is recommended to remove the bandage after 24 hrs to monitor wound healing progress. Because any wound involves direct inoculation of dirt, it’s critical that your horse’s tetanus vaccine is up to date.

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