Treatment options for wounds - small animal

Question 1

What are the types of wound debridement?

Answer 1

1. Surgical
   - remove biofilm & devitalised tissue
2. Mechanical
   - irrigation
   - wet-to-dry dressing
   - -ve pressure wound therapy (NPWT)
3. Autolytic
   - body’s own enzymes beneath a dressing to liquefy tissues
   - hydrocolloids, hydrogels, honey, foam, etc.
4. Enzymatic
   - prescribed topical agent that chemical liquifies necrotic tissues with enzymes
5. Biological
   - maggots, Luilia sericata (green bottle fly)

First 3 most common

Question 2

What kind of debridement is this?

Answer 2

Surgical

Infected tissue debrided with sharp surgery to removed devitalised tissue
Concern is what is going on in deeper layers and preserving vital structures

Case 2: chronic granulation tissue, sometimes wounds get stuck at this point so outer layer scraped away to form healthy granulation bed

Question 3

Describe lavage debridement

Answer 3

Lactated Ringer’s solution is most physiologically perfect lavage solution
- has ideal pH & compatibility with tissue

0.9% saline often used which is acceptable

Fluid should be at body temperature

High volumes should be used on newly presented wounds (e.g 1l)

20-35ml syringe, 18G needle = 7-8 psi

Question 4

Describe wet-to-dry debridement dressing

Answer 4

Question 5

Describe topical negative pressure wound therapy

Answer 5

Pump reduces air pressure beneath dressing, drawing off exudate & reducing oedema in surrounding tissues

Process reduces bacterial colonisation, promotes granulation tissue development, increases rate of cell mitosis & spurs migration of epithelial cells within the wound

Have to create airtight seal & then cover in plastic wrap

Left for 48-72 hours

Question 6

Describe honey for wound healing

Answer 6

Antibacterial effect

Healing stimulating properties
- reduction in wound size, healing time, complete healing, stimulation of granulation tissue & epithelialisation

Debriding effect

Anti-inflammatory effect

Odour reducing capacity

Reduction in wound pain

Question 7

Why does honey have good debridement properties

Answer 7

Low ph (3.7)

Osmotic effect

Both help draw up fluid from wound area (don’t use on granulating or epithelialising wound)

Question 8

Why does honey have antimicrobial properties?

Answer 8

Hydrogen peroxide (glucose oxidase)

Anti-oxidant (flavonoids)

High sugar content (osmotic effect)

Acidic (3.2-4.5)

Methylglyoxal (Manuka honey)
- It’s potency as antimicrobial can be measured by Unique Manuka Factor® (UMF®)
- +15 ensures potent antimicrobial properties over & above those of standard honey

Don’t use table honey (might not be sterile - Clostridium)