SURGERY
Article reprinted with the permission of DVM360, MARCH 2016, Veterinary Medicine
is a copyrighted publication of Advanstar. Communications inc. All rights reserved.
Treating The Wounded:
New Strategies in Healing
Mar 30, 2016
By Heather Lewellen, DVM
VETTED
Don’t just scrape by with your wound care practices.
Here’s the latest on promoting healthy tissue.
We all want that magic wound-healing bullet—the
one treatment or dressing or bandage to use on every
wound on every patient. Sure would simplify things,
wouldn’t it? Unfortunately, wound healing is a complicated process and requires different approaches for
optimal care. Fortunately, Emily Miller, DVM, DACVS,
from the University of Missouri College of Veterinary
Medicine, has laid it all out regarding what’s new in
wound care.
The 6 basic wound management steps:
1. Prevent further contamination, such as nosocomial infections.
2. Debride necrotic tissue. Devitalised tissue incites inflammation, and as long as inflammation
is there, the wound won’t progress to the repair
phase.
3. Remove foreign debris and contaminants—for
the same reason as the necrotic tissue.
4. Ensure that the wound has adequate drainage.
5. Establish a healthy vascular wound bed. Healthy
granulation tissue is essential!
6. Select appropriate methods of closing the wound
if required.
Flourishing with fluid
Keep in mind that the goal for treating acute wounds
is simple—to relieve any roadblocks to uncomplicated
wound healing. In a nutshell, Dr. Miller says, “We want
to do what we can to foster a happy, healthy wound
environment to let this animal’s body do its normal
wound-healing thing.” More and more these days that
appears to be fostering a moist wound environment in
early healing.
For any wound that needs it, surgical débridement is
a must, but autolytic débridement has recently been
gaining ground, Dr. Miller says. This is the crux of moist
wound healing. It’s taking advantage of the body’s own
capability to débride wounds.
A note about exogenous enzymatic products:
Exogenous enzymes can be used as an adjunct to
lavage and surgical debridement. Most will spare
healthy living tissues but can be irritating to local tissue