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At the end of January a young terrier
called Bruce was brought in as an emergency because he had
been in a road traffic accident. He was bleeding badly and
most of the skin of his right front leg and toes had gone.
On top of this the hock of his left hind leg was dislocated.
Bruce was admitted straight away to
assess the situation. X-rays were taken of both his legs
and these fortunately showed no fractures.
After contacting the owner, discussing
the costs and months long healing process, treatment was
started.
Golden Period
The early time after a wound is called “the golden
period” – an interval of about 6 hours during
which prophylactic antibiotics are effective.
For proper care it was necessary to
anaesthetise Bruce. The area was prepared for surgery, and
the wound was thoroughly irrigated with large amounts of
sterile saline to remove all the foreign particles like
dirt, hair and clotted blood. The wound was debrided ( dead,
devitalized and contaminated tissue removed ) and the wound
edges were closed with sutures.
Wound healing is basically divided in
3 overlapping series of events:
- 1) Inflammation
- 2) New tissue formation
- 3) Scarring and remodelling.
A clean incised wound begins to heal
by 5-8 days. The cells of the top layer of the skin (the
epidermis) multiply and the connective tissue and other
layers of the skin fill up the area underneath.
In Bruce’s case his young age and
general good health would enhance or hasten wound healing.
However other factors like infection, devitalisation, dead
space, and movement of the wound could delay the wound healing.
This is what happened in the first week,
despite our good efforts the wound became infected, and
copious amount of pus started to ooze from the wound. Bruce
had to be sedated and the devitalised tissue had to be removed.
This meant that there was not enough skin to close the wound
and it had to heal by secondary wound healing.
New tissue in the form of granulation
tissue appears in open wounds in 3 to 6 days, and will slowly
get smaller by wound contraction.
Putting two screws on either side of
the joint and connecting these with a loop of suture material
making an artificial ligament remedied the damage in his
hock.
Bruce needed to have bandages to protect
the wound for 5 weeks to allow proper healing, and finally
after removing the screws from his joint we can say he made
a great recovery after 2 months of intensive treatment.
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