By Christie Long
Wounds can create special challenges in animals. Unlike our counterparts in the human medical field, we routinely deal with our patients licking on or chewing at their bandages and/or wounds.
We also find it challenging to impress upon our patients how important it is to keep their healing wounds clean, and frequently deal with the after effects of running through the mud, rolling in the dirt and tramping through the weeds. Add to this the unique difficulties posed by the anatomy of our patients, including the fact that they have tails and that they walk on all fours, and you can see that wound healing can be problematic.
Without question, surgical closure of wounds provides the quickest and typically cleanest path to healing. Unfortunately, based on the location and inciting cause of the wound, surgical closure, also known as healing by first intention, is not always possible, at least not immediately. Large wound areas, wounds on extremities where there is little noncompromised skin for closure, or those that are exceptionally contaminated, such as bite wounds or older wounds, may need to be left open to heal for some time. This is called healing by second intention. With some wounds, once the wound size has contracted with second intention healing, the patient is taken to surgery to achieve surgical closure of the wound and speed healing.
Depending on the location of the wound, a bandage may be placed while second intention healing is occurring. Traditionally, the purpose of the bandage has been to keep further contaminants from the wound bed. But we have begun relying on bandages to actually decrease the size of the wound bed, ultimately decreasing the time until the wound heals or until it can be definitively closed with surgery.
Most of these types of bandages are referred to as wet-to-dry bandages. The basic design involves using a substance that draws fluid from the wound, thus removing contamination and helping the wound to contract. Sometimes this is just wet bandaging material, but other substances, such as sugar or honey, are often added directly to the wound bed first because they pull fluids from the wound into the bandage material. Dry bandage material goes on top of the wet material, and it’s in this dry layer that the fluid ends up. These bandages must be changed frequently, typically every day, and the wound bed copiously flushed with sterile saline between bandage changes. Antibiotics are an extremely important part of the healing process, and often the specific bacteria present in the wound must be identified to ensure that the antibiotic being used will actually treat the infection.
Christie Long is a veterinarian at the VCA Animal Hospital in Fort Collins, CO. Long left her job in software sales in 2000 to travel for 13 months. Along the way, she was touched by the plight of the animals she saw and somewhere in the Nepalese Himalayas she vowed to return to school to become a veterinarian. While she often finds end-of-life situations heart-wrenching, she considers herself blessed to be called upon as a trusted adviser to families during difficult times. Dr. Long’s family includes her husband and travel partner, Wiley, their 5-year-old son, Wiley IV, their dogs Pancake and Gizmo and cats Sneaky and Sidh.