Wound Management Recommendations
- Topics: Article
Ted Stashak, DVM, MS, Dipl. ACVS, emeritus professor of veterinary medicine and surgery at Colorado State University, and Laurie Goodrich, DVM, MS, Dipl. ACVS, of Cornell University, moderated a table topic on wound management at the 50th annual American Association of Equine Practitioners (AAEP) Convention, held Dec. 4-8, 2004 in Denver, Colo.
Stashak noted that for heavily contaminated and infected wounds, the wet-to-dry plain gauze or antimicrobial-impregnated gauze (Kerlix AMD antimicrobial dressing, Tyco Healthcare/Kendall, Mansfield, MA) dressing can be effective, but they are often used for too long a period. In general, the gauze is wetted with a sterile salt solution, excess fluid is squeezed out, and the dampened dressing is applied to the wound surface.
For plain gauze, a dilute 0.01% (1 mL/100 mL) povidone iodine or 0.05% (1:40 dilution) chlorhexidine or physiologic saline solution alone are most commonly used to wet the material.
If Kerlix is used, the gauze is moistened with saline alone. When applied to the wound surface, the moisture liquefies the wound exudate, allowing movement (egress) of fluid and bacteria through the gauze mesh. As the dressing dries, fibrin from the wound bed causes temporary bonding of the dressing to the wound bed. As the dressing is peeled off the wound, fibrin, debris, bacteria, and necrotic (dead) tissue are removed (debrided) from the wound surface. Since the debridement process is non-selective, and healthy newly formed tissue can be damaged, he recommended using them for one or two bandage changes only. Once the wound appears clean, another dressing type is indicated
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