Hi gang,

Once again I am placing a post here that a poster on another board
requested. It is very long but I thought perhaps some of you would
find the information useful.

First Aid for Lacerations, Abrasions and Avulsions.

Laceration - a torn, ragged wound. As opposed to an incision which is
made by a sharp instrument like a scalpel or knife. Lacerations are
often caused by dogfights; dogs cutting themselves on sharp objects like
tin or broken glass, etc.

Abrasion - a lesion of the skin caused by the wearing away action of some
unusual or abnormal mechanical process. A scrape. Commonly occurs to a
dog as a result of being hit by a car. (Road rash)

Avulsion - a lesion caused by tearing away forces to the skin. Again,
often caused in dogfights, like when a dog grabs another and shakes it.
Big dog / little dog fights - avulsion wounds are common on the little
dog in the fight. Gunshot wounds are often avulsions.

Many of you are wondering what difference all this makes. Well it can
make a lot of difference as to how you should treat a wound and as to
how long you can expect the healing process to take. Most lacerations
can be closed (sutured) if treated early. Abrasions will rarely need to
be closed by suturing (unless they are very small and even then will
often heal with appropriate topical treatment of the wound). Due to
the fact that the blood supply to the affected skin is often compromised
and localized necrosis (tissue sloughing) of the affected area will
undoubtedly occur, very few avulsions should be initially closed by
suturing but should be allowed to heal by secondary intention and then
sutured once a proper bed of granulation tissue is formed.

As far as field first aid of wounds, this really will depend on you and
what your comfort zone is as far as treating them. But there are some
things that you can do as an owner that can greatly affect how a wound
will heal and minimize its chances of becoming infected. First, remember
that there is such as thing called the "golden period of wound healing".
What this refers to is that if most lacerations and even some avulsions
are treated appropriately and sutured within the first four hours after
they are incurred they will have a much better chance of healing without
dehiscence (this means coming back open). Proper early treatment of
wounds will greatly increase the chances that they will heal without
complications such as dehiscence or infection.

Once a wound incurred the first order of business is to clean the
affected area. Remember the "solution to pollution is dilution". Flush,
flush, flush and then flush wounds again if they are heavily contaminated
with debris. Plain warm water will work if no other types of irrigation
solutions are available. I do not recommend using solutions like
isopropyl alcohol or hydrogen peroxide to clean wounds. While these are
very good antiseptic solutions they are also cytotoxic (they kill the
tissue which lines a wound). This cytotoxic affect will leave a wound
lined with a layer of dead tissue that is a perfect environment for
bacteria to grow in. In very few cases, are we able to keep wounds
totally free of bacteria when dealing with animals and by leaving this
dead tissue in the wound we are inviting infection. Also once a wound
occurs almost immediately the body begins to build a bed of tissue to
line this wound. The formulation of this granulation tissue is very
important in the wound healing process. Use of chemicals like isopropyl
alcohol or hydrogen peroxide will kill this granulation tissue and will
ultimately retard the wound healing process instead of aiding it. The
granulation tissue is very resistant to infection and will serve the dog
much better in fighting infection as opposed to the use of a chemical
agent.

I recommend using solutions like chlorhexidine (Nolvasaan) or betadine
to clean wounds initially. Both of these solutions come in a scrub and
a solution formula. Use the scrub formula to clean the wound initially
and then use the solution formula to clean the wound for future
applications. Every attempt should be made to remove as much debris as
possible when cleaning the wound. I would also recommend shaving the
hair closest to the wound edges if possible. Use a pair of scissors if
you have to and trim the hair then shave or if you have clippers use them. Drainage from a wound will occur and be trapped
against the skin by hair. This will increase the chances of infection or even a localized cellulitis at the wound edges that can also
delay healing.
Wounds that are not sutured will almost always drain, this drainage will
be caught in the hair around the wound. When this occurs it will trap
moisture next to the skin and this can lead to a localized cellulitis
around the wound edges which can further delay wound healing. By clipping
the hair away from the wound edges we can help to prevent this.

After the wound has been cleaned, if excessive bleeding is occurring
efforts should be made to control it. The best method to use to control
bleeding is pressure. Apply as much pressure as needed to stop the
bleeding. Depending on where the wound is, a tourniquet may also be
beneficial in stopping the bleeding. A word of caution here
if a tourniquet is needed to control the bleeding I would recommend
seeking appropriate veterinary care as soon as possible since you will
also be depriving the rest of the area of blood flow as well. A leash or
belt can be used as a tourniquet. It is also a good idea to periodically
loosen the tourniquet every few minutes while you are on your way to the
vet. Probably the best method to apply pressure is to use large of cotton
sponges and then wrap with gauze or tape to apply pressure. Depending on
how severe the wound is and how excessive the bleeding is, shock can
occur. If your dog is showing signs of shock [pale or white mucous
membranes, tachycardia (rapid heart rate), tachypnea (shallow rapid
breathing pattern), lethargy or depression, weakness, prolonged CRT
(capillary refill time)] then wrap it up in a blanket and head for the
vet NOW. CRT is measured by lifting the dog's lip and mashing on the
gums where they are pink. When you mash on the gums the area where you
mashed will turn white and then should rapidly turn back pink. Normal
CRT is less than 2 seconds.

Once a wound has been cleaned and the bleeding is controlled then you
need to consider what is the best way to deal with it. As I have already
stated lacerations when dealt with properly can be closed by suturing.
For the most part abrasions and avulsions will not be closed initially
by suturing but should be allowed to heal by secondary intention (by this
I mean we allow a bed of granulation tissue to develop and let the wound
heal naturally). In many cases once a certain amount of healing by
secondary intention has occurred we can then close the wounds by primary
intention or suturing. An alternative to suturing wounds to close them
is surgical glue (super glue). There is a product called Nexaband on the
market. I have recently been told that regular super glue can be used to
close some wounds but I have never done this so I am somewhat reluctant
to recommend this. I would caution all of you to consult with your
regular vet before attempting this. In order for this type of treatment
to be successful there are a few things to consider. It must be a wound
that has very little tension on the edges. All bleeding must be
controlled. The edges of the wound must be dry in order for the glue to
stick properly.

There are several important things to remember when bandaging a wound.
First use large amounts of padding so you can wrap the wound tightly but
the blood flow to the area will not be totally restricted. I use large
cotton bandages, but you can use sponges instead just be sure to use a
lot. Second, check the bandage for swelling both above and below it.
If either is present you probably have it on too tight. Try to keep all
bandages dry. Moisture will precipitate or lead to infections. Change
bandages on a daily basis. Apply some type of ointment to the wound
before bandaging like Derma Clens or Furacin ointment or you can use the
Betadine solution applied to some sponges and then wrap the wound. Put
the dog on appropriate antibiotic therapy for at least 7 to 10 days when
dealing will all wounds in order to prevent or curtail infection.

One of the biggest challenges when dealing with wounds in dogs is keeping
them from licking them excessively. Prevention of licking can be achieved
by applying bandages in some cases. But frequently dogs will chew the
bandages. Elizabethan collars can be used to prevent unwanted chewing of
bandages if necessary.

Danger signs to look for with wound management are redness, swelling,
excessive cloudy discharge, and loss of function. (By this I mean that
if the wound is on the leg and lets say the dog cuts the leg and limps
for a day or two but gradually improves and then all of a sudden begins
to limp again or becomes more lame) Under no circumstances would I
recommend hunting the dogs while they are healing. Two important factors
to consider are: 1. If the dog has a hurt leg it will undoubtedly favor
it to some extent. By favoring this leg it will place the other legs
under additional strain and this could lead to tendon or ligament damage
such as a ruptured ACL. 2. Keeping wounds dry and free from
contamination is an important key to successful wound management. There
is almost no hunting or training situation I can think of that a wound
can be kept clean and dry.

In closing I would recommend that anyone that attempts to bandage wounds
get some instruction from your regular vet first as to the proper methods.
An improperly placed bandage can cause very severe problems in and of
itself.

DR.J
Good Luck and Good Hunting!!!!!!!!!!!!!!!!!!!!