Wound Care
for all Animals

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Four Stages of Wound Healing

When wounds occur in a body, the body tissues react in a sequence of events to start the healing of that wound. It is important to learn that sequence of events so when you, as the animal carer, are presented with a wound, you can understand and recognize the stage of wound healing.

In the following pictures, we will present wounds at different stages of healing, the care required for such wounds, and the products we recommend to treat the wounds.

   Treatment Goals:

  • Achieve Cosmetic Wound Healing

  • Return of normal tissue function & strength

  • Hair regrowth

  • Minimise scarring

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Stage One – Inflammatory Phase  - First Hour

  • When blood vessels are damaged, they initially constrict which slows the amount of blood loss in a wound. After about 10 minutes those blood vessels then start to dilate, fluid and white blood cells “leak” into the surrounding tissues. Little cells called “platelets” invade the wound to form a clot (like a “plug”). More clot forming substances arrive to form a stable “fibrin clot” that provides a tissue framework for wound repair.

  • A lot of the wbc die quickly and form “pus”; these cells and the fluid leaking into the tissue cause the classic signs of inflammation:

      “swelling, redness, heat and pain”.

WHAT DOES THE WOUND LOOK LIKE?

  • Fresh pink/red tissue ; possible fresh blood or bleeding; skin moist, floppy; possible contamination by debris

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TREATMENT GOALS:

  • STOP BLEEDING WITH PRESSURE BANDAGE IF NECESSARY

  • Decontaminate wound by generous lavage with saline/clean water

  • Keep wound moist and protected

  • Veterinary advice should be sought for all large wounds; severe trauma; lacerations into joints, major body cavities, eyes, genitals or wherever you may be uncomfortable or unsure about a wound.

To allow a wound to heal as quickly and simply as possible we want to prevent infection and provide a wound environment that will allow the body to heal the wound.

Wounds can become infected by:

  1. Excess contamination with bacteria

  2. Foreign material (foreign bodies) are present e.g. soil, sticks, leaves

  3. Excess necrotic material 

  4. Wound continues to bleed excessively

  5. Tissue has lost blood supply

  6. Body defences are weakened. Eg in burnt tissue

 

Healing Delays:

  • Contamination

  • Infection

  • Excess movement

  • Proud flesh

  • Low blood supply

  • Excess swelling/oedema

 

CARE REQUIRED:

  1. Restrain the animal in a safe place. Horses should be either tied safely or put in a crush. Small animals may need to be muzzled to prevent biting reaction from pain.

  2. Clip or shave away all hair from the edges of the wound. Prevent clipped hair contaminating the wound itself by covering wound with moistened gauze.

  3. All wounds must be clean and free of hair and foreign material to be able to assess the wound properly, clean, dress, and monitor progress of healing. All wounds need to be cleaned to remove dirt, organisms and foreign material. Some of this material you will see eg soil, mud and some you won’t see eg dust, bacteria.

  4. Ideally Sterile Saline should be used; practically, plain clean water can be used initially to remove the bulk of the debris. Small animal wounds can be washed by hand with cotton swabs. Cotton wool can be used but care must be taken to prevent shreds of the wool being left in a wound. Large animals are generally kept in paddocks so their bodies are often covered in dirt and mud. In most cases large animal wounds will be dirty and contaminated. Large animals with leg and body wounds may need to initially hosed to remove large amounts of dirt from the wound itself and surrounding tissues.

  5. We want to remove bacteria from the wound as well as any dirt. Bacteria can be tricky to remove as they like to adhere to the wound surface. The best way to remove bacteria is by lavage (washing) of the wound with a solution under pressure. This can be achieved by using a spray bottle or a large 20 ml syringe.

  6. After initial lavage, we will use Sterile Saline for the final rinsing of the wound. Antiseptics (Betadine, Chlorhexidine) or Medicinal Herb Extracts (Calendula) can be added to lavage fluid to make a solution that will kill bacteria. Wound lavage and wound dressings all help to keep a wound moist. If the patient is dehydrated, blood supply to surface tissues can be slowed down. This will result in the new epithelial cells drying out and a scab will form. Wound healing will be delayed in a dry wound that has formed a scab.

RECOMMENDED PRODUCT:

  • HONEYPRO WOUND WASH - contains the Medicinal Herbs Calendula extract in Sterile Saline

  • THERAPEUTIC LASER THERAPY (TLT) - achieves 30-50% increase in the RATE of wound healing in ALL wounds

  • TLT is not used in cancer wounds.

      Read more about TLT HERE

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Stage Two – Debridement Phase - 2-48 hours

  • At a cellular level, inside the wound, white blood cells arrive whose job it is to help clean up the wound. The two main cells are neutrophils and monocytes. Monocyte cells can change into one of the most important cells for wound healing - called a “Macrophage”. This cell eats bacteria  - the process is called “phagocytosis” and helps “debride” or clean up the wound.

  • The more contaminated a wound the longer this phase will last so thorough cleaning, surgical debridement and good drainage are essential for rapid healing.

  • Further healing may be delayed if decontamination does not occur; such wound may be stuck in this phase for days to weeks.

  • SURGICAL DEBRIDEMENT must occur if there are large flaps of tissue that cannot be repaired; tissue flaps quickly lose blood supply and become nonviable tissue.

WHAT DOES THE WOUND LOOK LIKE? 

  • Pink/red/grey tissue that may be devitalised, necrotic (dying), may be ragged edges to wound, discharge or exudate may be present; wounds are generally still moist, possibly contaminated. Skin surrounding wound may be dry with crusty edges to wound.

  • Yellow, white with heavy discharge will be starting to slough or lose tissue, fluid and cells.

  • Black flat layers of tissue or eschar indicate completely devitalised tissues.

  • Yellow/green thick discharges indicate heavy infection and antibiotics will be required.

TREATMENT GOALS

  • Copious lavage with large volumes of Sterile Saline, with pressure if possible. Minimum of one - three litres depending on the size of the wound.

  • Antiseptic solutions can also be used if infection, contamination or sloughing is present.

  • Surgical debridement of tissue flaps, devitalised, dry, dead or black tissue must occur and will require veterinary attention.

  • Application of wound balms once lavage completed and/or before bandaging.

  • Bandaging of wounds provides the correct ph, temperature and moisture level for optimal wound healing.

RECOMMENDED PRODUCTS:

  • HoneyPro Wound Wash for copious lavage of wound bed.

  • HoneyPro SeaHoney Gel for moist, deeply sloughing wounds.

  • HoneyPro Wound Wax for the majority of skin wounds.

  • THERAPEUTIC LASER THERAPY 

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Stage Three – Repair Phase  Day 2 - Day 25

  • The tissue framework mentioned above is formed by the macrophages, new red blood cells and other cells called fibroblasts (connective tissue cells) and collagen. It is called “Granulation Tissue” and is very important in wound repair, forming a bed of tissue over the wound surface.

  • Once a bed of granulation tissue is formed, new epithelial cells at the edge of the wound start to move. This process called “Epithelialisation” describes the division of epithelial cells of the skin at the edge of the wound, the new cells start to move over the surface of the wound; the wound is healing by contraction of the wound edges towards the centre of the wound.

  • Granulation tissue can become excessive, delaying wound healing. Excess granulation tissue may grow up above the leading edge of the skin of the wound. This can cause the skin edge to “roll in” under the bed of granulation tissue and delay healing. Healing is delayed because new cells cannot be laid down across the wound bed. This is especially a problem on horse leg wounds where excess granulation tissue or “proud flesh” grows very easily – becoming “proud” above the wound bed. Proud flesh often needs to be controlled by either resection (cut away) or with specific wound treatments.

The photo shows:

  •  “Epethelialisation: green arrows

  • “Granulation tissue becoming excessive “Proud flesh”: yellow arrow

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WHAT DOES THE WOUND LOOK LIKE?

  • Moist, "granular", light pink to pink/red;  possibly uneven lumpy tissue

  • These is a good blood supply; the tissue can bleed easily under trauma

  • If excessive, lumps will be large and raised above skin level; skin edges may be rolling in underneath granulation tissue

TREATMENT GOALS

  • Continue daily washing with HoneyPro Wound Wash or sterile saline.

  • The Calendula extract in HP Wound Wash can assist in controlling proud flesh.

  • Continue dressing and bandaging the wound as above.

  • Massage the edges of the wound (gently)to assist blood flow to the wound edges.

  • Very heavy proud flesh may need surgical resection. 

  • Copper sulphate powder can also be used in a puffer pack or sprinkled onto the bed. Only use once or twice as required to control the excess growth. Avoid the skin edges where new cells are being laid down.

Stage Four – Maturation Phase

  • As new epithelial cells are made, little muscle-like cells called myofibroblasts start to contract and work to pull the edges of the skin towards the centre of the wound. The wound effectively contracts or “shrinks”.

  • This works best where the skin is loose and with proper cleaning, these wounds can heal with minimal scar formation. If there is a lot of tension on a wound e.g. on lower horse leg, contraction may not be complete and without very attentive wound care, a large scar will be left.

  • As the wound continues to shrink, it reaches a Maturation phase where the fibroblast cells orientate themselves along the lines of tension. i.e. the cells move into a position, according to the tension on the wound, to where they will have the greatest strength. This movement causes “remodelling” of the shape of the wound and can continue for months until eventually the scar is left. Scar tissue will always be weaker than surrounding normal tissue.

  • With attentive nursing care, scars can often be minimal, unnoticeable under the hair coat. 

TREATMENT GOALS:

TO PREVENT SCAR FORMATION IT IS VITAL ALL WOUNDS RECEIVE NURSING CARE UNTIL HEALING IS COMPLETE AND ALL HAIR COAT HAS REGROWN.

This leg wound in the photo may have healed with minimal scarring if attentive nursing care had been continued.

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WHAT DOES THE WOUND LOOK LIKE?

  • Wounds in the maturation phase will be at least 14 days old. The periphery of the wound will have new epithelial cells - this skin is tender and pink; it needs more time to strengthen and mature.

  • The tissue will strengthen as GENTLE (exercise) forces are applied so the new cells are laid down along the lines where most tension is applied.

  • The centre of the wound will still have pink granulation tissue. Careful monitoring is necessary to ensure the granulation tissue is not excessive, stays level with the periphery of the wound and the skin edges are not "diving underneath" the granulation tissue bed.

RECOMMENDED PRODUCTS

  • HONEYPRO WOUND WASH

  • HONEYPRO WOUND WAX

  • HUNGEVIT-A - rich in Vitamin A, this salve can assist in achieving cosmetic wound healing by encouraging hair regrowth and minimising scar formation.

  • THERAPEUTIC LASER THERAPY

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MUDFEVER, SCRAPES, GEAR RUBS & DERMATITIS

HONEYPRO DERMATITIS BALM is an exceptional product, now proving to be one of our best sellers! Useful for all cases of dermatitis in any animal, keep it as a staple in your First Aid kit.

INFORMATION ON SURGICAL WOUNDS

Sutured wounds, that have been made surgically or to repair trauma, still undergo the above stages of wound healing. 

  • Movement is your enemy with sutured wounds; keep the area as immobile as possible for 10-14 days

  • The majority of sutured wounds should heal faster and with less scarring because the skin edges are already opposed.

  • HUNGVIT-A is ideal to massage onto shaved areas of skin surrounding the surgical site.

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