How to carry out initial treatment of traumatic wounds: assessment, preparation and lavage
Abstract
Traumatic wounds are commonly seen in veterinary practice, and can have a wide range of aetiology and severity. What all traumatic wounds have in common is that they present with the same impediments to healing: bacterial contamination; foreign material; and necrotic tissue. These impediments will be present in varying degrees depending on the aetiology and the time elapsed since injury, but in all cases they need to be addressed in the early stages of wound management.
Wound lavage and debridement are commonly performed with the aim of producing a healthy wound bed. This article looks at how wounds can be succesfully managed from presentation through to lavage. The goals are to prevent further contamination from the clinic environment and patient's skin, and then reduce the contamination present in the wound with effective lavage technique.
This articles will look at the initial management of traumatic wounds in small animal patients; from presentation, through to lavage. While some differences have been shown between cats and dogs in the speed and manner in which cutaneous wounds heal (Bohling et al. 2004), the initial management does not differ, and both species will be dealt with together in this article.
Most of the wounds seen in veterinary practice are as a result of trauma. The initial triage and assessment of trauma patients focuses on the major body organ systems; the ‘ABCD’ of triage focuses on airway, breathing, circulation and disability, initial stabilisation addresses oxygenation and circulatory concerns (Aldridge and O'Dwyer 2013). While life-threatening conditions are the priority, temporary and emergency management wounds should not be neglected (Pead and Langley– Hobbs, 2007). Initially, to prevent dessication and further contamination of the wound, a sterile water soluble gel, or saline soaked gauze swab can be placed on the wound, and covered with a sterile towel or soft padded bandage; this protects the wound from the hospital environment.
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