Dog Owner's Home Veterinary Handbook.pdf - Mr. Walnuts

EMERGENCIES • 45
Tap water is an acceptable and convenient irrigating solution. Tap water
has a negligible bacterial count and is known to cause less tissue reaction than
sterile or distilled water.
If possible, add chlorhexidine solution or Betadine solution to the tap
water for antibacterial activity. Chlorhexidine has the greater residual antiseptic
effect, but either antiseptic solution (not soap solutions) is satisfactory
when correctly diluted. To dilute chlorhexidine, add 25 ml of the 2 percent
stock solution to 2 quarts of water (2 l), making a 0.05 percent irrigating solution.
To dilute Betadine, add 10 ml of the 10 percent stock solution to 2
quarts of water to make a 0.2 percent irrigating solution.
The effectiveness of the irrigation is related to the volume and pressure of
the fluid used. A bulb syringe is a low-pressure system. It is least effective and
requires more fluid to achieve satisfactory irrigation. A large plastic syringe
removes a moderate amount of dirt and bacteria. A home Water Pik unit
(used by people to clean their teeth) or a commercial lavage unit that provides
a high-pressure stream of fluid is the most effective.
A garden hose with a pressure nozzle for the initial lavage, or a kitchen sink
spray unit, followed by one of the methods just described to deliver the antiseptic,
is a good alternative. You want to flush and clean the wound, not force
dirt deeper into the tissues. Angle your flow of liquid to accomplish that and
let the fluid pool to bring debris to the surface.
Debridement
Debridement means removing dying tissue and any remaining foreign matter
using tissue forceps (tweezers) and scissors or a scalpel. Debridement requires
experience to determine the difference between normal and devitalized tissue,
and instruments to control hemorrhage and close the wound. Accordingly,
wounds that require debridement and closure should be treated by a veterinarian.
Closure
Fresh lacerations on the lips, face, eyelids, and ears are best sutured or stapled
to prevent infection, minimize scarring, and speed recovery. Lacerations
longer than half an inch (1.25 cm) on the body and extremities probably
should be closed, but small lacerations may not need to be. Small V-shaped
lacerations heal best if they are closed.
Wounds contaminated by dirt and debris are quite likely to become
infected if closed at the time of injury. These wounds should be left open or
sutured around a drain that can be used for through-and-through irrigation.
Similarly, wounds older than 12 hours should not be closed without drainage.
Suturing or stapling should be avoided if the wound appears to be infected (is
red, swollen, or has a surface discharge).
Your veterinarian may decide to close a wound that has been left open for
several days and has developed a bed of clean tissue. Wounds that are clean
after several days are resistant to infection and usually can be closed with