Thursday, June 11, 2015

The Pet PT Pit Stop: Wound Care 101 (Part II Wound Management)

by Susan E. Davis, PT “pull in for a helpful refuel!”  

It’s all about guiding and empowering you to help your dog avoid injury, provide practical solutions and achieve rapid restoration of health and function!   

Photo David Resz

Wound management 

First: stop the bleeding.
Control it with direct pressure, even if it is your bare hand. Ideally use a clean cloth, towel or gauze pad.

Reduce inflammation and swelling with a cold compress, ice or cool water. 

Prepare to examine and treat the wound
Wash your hands, use plastic or latex gloves if you feel the wound is very deep.

Debridement
This step is needed if a wound has debris or dead and dying tissue on it. The tissue must be removed in order for healing to begin. Debridement should be performed by a veterinarian, vet tech, or physical therapist, using forceps, scissors, gauze, water jet sprays, even a scalpel.

Photograph wound if possible
Measure it (length, width, depth), document this plus any details such as shape, color, any odor plus the date.

Irrigation
Also called lavage, is a rinsing of the wound to decontaminate it, remove surface dirt and some bacteria. It may be necessary to first clip long hair or fur around the wound site. Warm tap water can be used, or if it appears to be at risk for infection, you can substitute sterile water, distilled water, saline solution or hydrogen peroxide. There are some who feel hydrogen peroxide can further damage a wound, but my experience is that it provides a good cleaning for wounds that are deep and may contain debris hard to locate.

Dry the wound simply by keeping it open to the air or use a hair blow dryer on a low, cool setting.

Medicate
Your veterinarian and their staff are the best ones to give advice on a suitable type of medication to protect the wound and facilitate healing. Types are antibacterial ointments, hydrogels, foams, creams and sprays. Burns may require special creams and topical agents.

Covering the wound
Some wounds should be kept open and others covered with dressings and bandaging. Ask your vet about this. Dressings can be wet, dry and “wet to dry” type. If you are unable to reach your vet, my general advice is with deeper wounds it is usually better to cover them, providing a moist environment and re-bandage 2-3 times per day. Start by placing a non- stick pad on the wound, then secure it with a gauze roll. Cotton batting can be placed next, then finish with a rolled elastic bandage or a light vet wrap. When the wound starts to epithelialize and appear pink, at that point it is best to leave the healing wound uncovered.

Skin Grafts will be needed for full thickness wounds that have granulation tissue. 
These wounds will not epithelialize on their own without grafts, which your vet will apply to the wound. Skin grafts use normal skin harvested from areas where skin is loose, such as the lateral thoracic areas or from other donor sites.

Underlying diseases may cause a longer time than normal for wounds to heal.


Wound care can be painful, so if necessary, apply a muzzle before treatment.


If your dog was bitten by another animal, obtain rabies vaccination status (depending on your local statutes).


Puncture wounds must be treated by vet, period.
Never try to treat a puncture wound at home or you risk the dog developing a serious infection, an abscess, loss of appetite, fever, lethargy and other dangerous complications.

Physical therapy can help most type of wounds, especially those that are complicated and present a challenge to heal.

Cold laser, applied through a clear sterile barrier can be used, but only in non- infected wounds or those controlled with antibiotics.

Other PT modalities used to treat wounds are electrical stimulation, hydrotherapy whirlpools with iodine additives, pulsed ultrasound delivered through water, targeted pulsed electromagnetic field, and hyperbaric oxygen chambers. Physical therapists can also be of great use with scar and fascial massage and fibrous tissue release techniques.

Negative pressure vacuum assisted therapy
Veterinary clinics and hospitals that handle trauma and specialty care for deeply infected wounds often have negative pressure vacuum assisted therapy units. These increase granulation tissue formation, reduce areas of pus, and help draw the edges of a complex wound together.
 
How long does it take for wounds to heal?
For a dog without metabolic disease or complications, the time length is similar to human beings, though slightly faster.

Should a dog be allowed to lick their own wounds?
Animals in the wild use their saliva and teeth to clean and heal wounds; however the methods used in veterinary care facilitate quicker, safer wound healing. It is best to keep your dog from biting or licking wounds by monitoring them or use of a barrier collar. 

*** 

Susan E. Davis (Sue) is a licensed Physical Therapist with over 30 years of practice in the human field, who transitioned into the animal world after taking courses at the UT Canine Rehabilitation program.  She is located in Red Bank, New Jersey.

She has been providing PT services to dogs and other animals through her entity Joycare Onsite, LLC in pet’s homes and in vet clinics since 2008.

She also provides pro bono services at the Monmouth County SPCA in Eatontown, NJ.  Sue is the proud “dog mommy” to Penelope, a miniature Dachshund with “attitude”.  For more information see her website www.joycareonsite.com , or follow on Twitter @animalPTsue.


Sue is also the author of a fantastic book on physical therapy, Physical Therapy And Rehabilitation For Animals: A Guide For The Consumer.  

Physical therapy can do so many great things for your dog. Understanding all the possibilities physical therapy can offer will change your dog's life. This book definitely belongs on the shelf of every dog lover.



Articles by Susan E. Davis:
Functional Strengthening Exercises: the What, Why and How
One Thing Leads To Another: Why The Second ACL Often Goes Too
Compensation: An Attempt To Restore Harmony
Paring Down to the Canine Core
Canine Massage: Every Dog ‘Kneads’ It”
Photon Power: Can Laser Therapy Help Your Dog?  
Physical Therapy in the Veterinary World  
Reiki: Is it real? 
Dog Lessons: Cooper  
The Essentials Of Canine Injury Prevention: 7 Tips For Keeping Your Dog Safer 
It's Not Just Walking, It's Therapy! 
Treatment And Prevention Of Canine Intervertebral Disc Disease (Part I)
Treatment And Prevention Of Canine Intervertebral Disc Disease (Part II Physical Therapy)
Range Of Motion: It’s A Matter Of Degree…
The Weight Of Water And How It Helps Dogs 
By Land or By Sea? A Comparison of Canine Treadmills 
Unraveling The Mystery Of Fascia And Myofascial Trigger Points (Part I)
Unraveling The Mystery Of Fascia And Myofascial Trigger Points (Part II) 
Scar Tissue: Is it Too Much of a Good Thing? 
Physical Therapy Tip Of The Month: Ramps! 
Physical Therapy Tip Of The Month: Indoor Duo Dog Exercises!
Physical Therapy Tip Of The Month: Best Practices After Your Dog’s Surgery 
Physical Therapy Tip Of The Month: Ideas to Chew on - Can Physical Therapy Help with my Dog’s Digestive Problems?
Wrap It Up: Using Soft Supports For Your Dog
When Do I Use Heat versus Cold? : A Tale (or Tail) Of Two Temps! (Part I) 
When Do I Use Heat versus Cold? : A Tale (or Tail) Of Two Temps! (Part II) 
Physical Therapy Tip Of The Month: Safe Summer Boating Tips for your Dog 
Physical Therapy Tip Of The Month: Hip Dysplasia - What’s a Dawg Mama to Do?
PT Pit Stop: Wheeled Carts Keep Them Doggies Rollin' (Part I)
PT Pit Stop: Wheeled Carts Keep Them Doggies Rollin' (Part II)
Staying in the Loop with Targeted Pulsed Electromagnetic Field Therapy
Addressing Frailty Syndrome in Geriatric Dogs 
The Pet PT Pit Stop: "Where's The Evidence?"
Physical Therapy is Great, Except When It Isn’t 
Top Dogs and their Toplines at the Westminster Kennel Club Dog Show (Part I)
Top Dogs and their Toplines at the Westminster Kennel Club Dog Show (Part II) 
What's in a Dog's Gait? 
A Practical Method to manage your Dog’s Care Plan 
Wound Care 101 (Part I The Basics) 

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