Good article about deep wounds and infections.

[philodice]

TREATMENT http://www.wildlifeinformation.org/S...-Punctures.htm

* In general, treatment of wounds is likely to require sedation or general anaesthesia of the animal.
* This is particularly true if extensive cleaning and debridement (surgical removal of dead and severely damaged tissue) is necessary.
* The stress and pain involved in wound management must be remembered: just because it is possible to hold a conscious animal of a particular species sufficiently immobile for wound management to take place does not mean that treatment of the conscious animal without sedation and analgesia is appropriate.

Initial inspection and cleaning:

* Careful inspection should be carried out for the presence of fly eggs or maggots (which may not be superficially visible) and action taken to remove these. See: Myiasis.
* Clipping of hair around the wound should be carried out using curved, blunt-ended scissors. Moist cotton wool may be placed in/over/along the edge of the wound to minimise clipped hair contaminating the wound by falling into it. (P19.2.w5)
* The area clipped should not be excessive, as hair normally provides the animal with protection from cold, some trauma etc. Loss of hair from a large area will increase the risk of the animal becoming chilled, particularly in small animals. (P19.2.w5, V.w5)
* For birds, feathers around the wound may be cut or may be plucked gently. Plucking will encourage regrowth of feathers; if feathers are cut they will not regrow until the next normal moult. The minimum area should be plucked and great care is required to avoid tearing the skin.
o N.B. plucking of feathers is painful; this may be best carried out on an anaesthetised bird if more than a few feathers are to be plucked.
o N.B. Care should be taken not to damage the feather follicles and thereby prevent proper regrowth of feathers. This is imperative for the flight and tail feathers of birds of prey, and any other species with a high dependency on flight such as swifts and swallows. If there is any doubt, such important feathers should not be plucked until absolutely necessary (which could be due to damage to blood feathers or the proximity of physical damage). (V.w6)

(B13.16.w11, B14, P19.2.w5, V.w5, V.w26)
* It is important to minimise the area of feathers removed as these provide the bird with its protection against weather and water and loss of feathers may delay release until the feathers regrow. (P19.2.w5, V.w5)
* The wound should be cleaned using a non-irritant antiseptic solution. Povidone iodine 0.5% solution is suitable. Savlon diluted 1:20 in water may be used. Product such as Dettol and TCP should be used only a last resort as they sting severely on open wounds. (B13.16.w11, P19.2.w5, V.w5)
* For extremely contaminated wounds, thorough flushing with sterile normal (0.9%) saline is recommended. When this is not available a suitable substitute saline solution may be produced by dissolving one teaspoon of salt in a pint of water (preferably boiled and cooled). (B13.16.w11, P19.2.w5, V.w5)
* Hydrogen peroxide, diluted 1/10 with water, may be used for flushing contaminated wounds such as abscesses (P19.2.w5)
* Considerable debriding of wounds may be necessary to remove contaminated and devitalised tissue. Anaesthesia will often be necessary for this process as it will often be appropriate to remove the damaged tissue as far back as to where there is an effective blood supply (and thereby usually pain sensors) to encourage healing.

(B13.16.w11, B14, P19.2.w5, V.w5, V.w26, V.w6)

Suturing:

* Puncture wounds should never be sutured.
* Suturing may be appropriate with fresh lacerations or with older lacerations if the tissue deficit following debridement is not too extensive.
o Absorbable sutures should be used to avoid the necessity for additional handling to remove sutures.
o Consideration should be given to wound drainage; the placement of a drain may be required.
o Care must be taken to avoid attempting to suture wounds with a large tissue deficit which would place excessive pressure on the wound.

Encouraging healing by secondary intention:

* In many cases it may be necessary to leave the wound to close by secondary intention.
* The application of topical preparations that encourage epitheliogenesis (stimulate healing) may be useful, e.g. Intrasite Gel (Smith and Nephew).
* Where possible, the use of dressings which promote healing may be used.
o Many wild animal casualties, particularly adult mammals, may not tolerate dressings and bandages.

Antibiotics:

* All wounds in wild animals should be considered to be contaminated and appropriate antibiotic treatment instigated.
* With "cat-caught" puncture wounds it is particularly important to ensure that antibiotics are likely to be effective against Pasteurella multocida as infection with this organism is very common.

Species/Group specific considerations:

In waterfowl:

* Insect repellent should be applied to avoid myiasis (Myiasis) (P4.1992.w1).
* Systemic and local antibiotics should be given
* Simple skin wounds may be cleaned, debrided as necessary, and sutured with non-absorbable sutures (B10.20.w16, B14).
* "Freshly created (within eight hours), uncomplicated wounds should be treated by primary closure with anticipated first intention healing; however, this is not appropriate for the treatment of open, contaminated wounds." (B13.40.w13)
* Deep wounds should not be sutured. Remove necrotic tissue, flush twice daily, ensure ample drainage (P8.3.w1, B11.36.w4).
* Small open wounds usually granulate if kept clean and fly-free (P4.1992.w1)
* Bite wounds should not be sutured (P8.3.w1)

In hedgehogs (Erinaceus europaeus - West European hedgehog):

* Sedation/general anaesthesia is required for adequate examination, cleaning and debridement of the wound (B22.27.w3)
* Cut the spines surrounding the wound short by using a short pair of sharp-edged blunt-ended scissors placed flush with the skin surface. Electric hair clippers are not suitable for cutting hedgehog spines (J15.21.w1, B156.7.w7, V.w26)
* Old and contaminated wounds and those with large deficits may best be treated by cleaning and debridement, then allowed to heal by secondary intention (J15.21.w1).
* All wounds must be checked carefully for fly eggs or maggots
* Rapid healing of large wounds may be promoted by the application of topical medication such as Intrasite gel (Smith & Nephew) or Orabase (ConvaTec). (J15.21.w1, V.w26)
* Fresh wounds may be closed using standard suture techniques and drainage provided using e.g. fenestrated drip tubing (J15.21.w1)
o The muscle layers should be identified and sutures should be placed in appropriate layers. (B22.27.w3)
* Strimmer wounds (fresh) can often be flushed, debrided and sutured for primary closure (V.w26).
* Systemic and local antibiotics may be used to control or prevent bacterial infection (B228)

In badgers (Meles meles - Eurasian badger):

* Extensive wound flushing and debridement is essential for management of badger bite wounds.
* Under-run tissue and sinuses must be explored, flushed and debrided and examined for evidence of fly eggs or maggots (Myiasis).
* Hair clipping must be performed over as small an area as possible. The badger's thick coat provides some protection against attack and therefore clipping a large area of hair may mean that release must be delayed for a period exceeding that required for wound healing whilst the hair regrows (V.w26, P25.2.w2, P25.3.w3).
* Wounds are generally highly infected and should NEVER be sutured.
* Healing by secondary intention is advised although skin grafting onto a prepared and clean tissue bed has been suggested for closure of large deficits in some cases (P25.2.w2).
* Appropriate antibiotic and analgesic medication should be given and topical preparations that encourage epitheliogenesis (stimulate healing) may be used (Intrasite Gel, Smith and Nephew).
* Bacterial examination of wound pus smears with gram or Diffquick and Ziehl-Nielson stains, culture and sensitivity may be advisable. Culture of Streptococcus spp., Staphylococcus spp., Pasteurella spp. and anaerobes (organisms that grow in anaerobic conditions) occurs commonly. (P27.5.w5)
* Euthanasia may be advisable for aged emaciated animals with severe wounds or dental attrition. (B157.w10, P27.8.w8, V.w26)
* Protective clothing, gloves and face masks may be appropriate when dealing with badger bite wounds given the possibility of tuberculous infection in the badger.(V.w26)
o any staff involved with handling badgers should ensure that their BCG vaccination is current and immunosuppressed individuals should not deal with badger casualties in particular V.w26 and B151.

[Charis]

Great article. I saved it to favorites.

[Trees Gray]

Thank you for sharing.