Note, how can we tell the age of a wound?
Hold that thought, we'll come back to this later! For now, lets move on…
But what about blood clots?
Back to optimal pressure and fluid choice…
Ally recommended pressure to be 15psi
So moving on
Yes, honey is a good way to reduce bioburden. As Patrick said there are a lot of dressing options out there, but a majority of them fall into categories
This is one type of classification, but there is an other. Dressing do one of three things:
1. Provide a moist environment e.g. hydrogel
2. They debride, e.g a foam dressing such as alevyn
3. They provide something else to the wound, often antimicrobial activity e.g. a silver dressing (note that silver is very expensive – always inform the owner of the cost!)
Note that some dressings fall into more than one category such as honey, which debrides and is an antimicrobial. Also remember your choice of dressing will depend on what you have in your car/ at the practice also!
Going back Laura's tweet about Manuka honey only being useful once granulation has occurred…
So now moving on
Alice replied: The repair phase- granulation tissue or looks like it's gone a bit proud?
This is important to have in the back of mind!
Yes, its a sensible idea to cut back the granulation tissue
Note we could leave to heal by second intention, but the client may want an option for a faster resolution. Always remember to give your client all the possible options for any case.
8 weeks later…
Good idea, lets take a radiograph!
The treatment in this scenario is to remove the sequestered bone surgically.
Note that if there is exposed bone at the time of the initial wound then good debridement and attempts to follow the principles of moist wound management are good options to reduce the risk of sequestration.
Sequestration takes about 4 to 6 weeks so it's always worth warning the client that it may be worth taking some radiographs at that stage to check.
And that's the end of the last ever session for Vet Finals 2017!
A huge thanks to Patrick for the great Day 1 session. It was useful for both smallies and largies!