Treating Wounds and Abscesses

[Kvet Forum]

Definitions​

The word 'wound' is taken to mean any break in the skin or mucous membrane. The underlying tissue is frequently also involved. Wounds occur in all animals on every farm and arise from a variety of causes. Wounds may be classified in various ways. For example they may be described according to their site - wounds of the neck, head, chest, abdomen or limbs. Another classification may indicate their particular type - for example crushing, lacerating or penetrating wounds, bites by other animals, snakes or insects etc, cuts or burns. Wounds may be fresh, bleeding, infected, gangrenous or swollen.

Some wounds may be small and insignificant. Others may be large and even life-threatening, especially if they involve major blood vessels or if they become infested by maggots. Such descriptions are important when describing the nature of a wound to a veterinarian who then should be in a position to offer useful advice even if he, or she, is unable to attend personally to the case.

Action​

It is best to assume that all wounds are potentially infected and to treat them as such, irrespective of their cause, site or nature. Large, deep wounds requiring suturing are best dealt with by a veterinarian but the layperson can do much either to make things easier until the arrival of a qualified person or to treat smaller wounds without outside assistance.

Prevention of infection is important​

Contamination of wounds may lead to severe generalized disease such as gas gangrene, tetanus etc as the bacteria which cause such diseases are found in the soil or even in the buildings where animals are housed and can easily infect untreated wounds. The most important principle in the care of fresh wounds is to maintain the viability and the defensive mechanisms of the tissues, so that they may play a part, unweakened, in the healing process. All harmful influences must be avoided during and after treatment. All instruments and utensils and dressing must be scrupulously clean before use. Hands must be washed and scrubbed.

Stop bleeding​

If there is bleeding this must be stopped. Unless the bleeding is very severe as from a large severed blood vessel then firm pressure with a pad of dry cloth, towel or large wad of cotton wool over a period of several minutes should in time arrest the haemorrhage. If this pressure is not sufficient and the bleeding continues and begins to weaken the animal then a tourniquet may be applied. This is a firm band applied and tied a few inches away from the wound on the side nearest to the heart. This may be made from anything that is strong and long enough - a bandage, a handkerchief, a rope, a piece of inner tubing etc. With any tourniquet the pressure should be maintained for a few minutes after the bleeding has stopped but it should never ever be tied for longer than necessary and never longer than 15 minutes or so.

Once the bleeding has stopped wait for a few more minutes. Then carefully shave the edges of the wound for about 2-3 inches all round. Then clean the edges with antiseptic or spirit. If there is foreign material in the wound such as dirt, grass, glass, grit, dung, this should be carefully removed and the wound washed out with saline or clean water. Apply iodine ointment or Lugol solution (= iodine solution) on the wound. Narrow deep wounds (e.g. dog bites) can be treated by instilling intramammary tubes into the wound openings.

Stitching wounds​

If the wound is a gaping one then it will be necessary to join the edges together with stitches to accelerate healing. This must be done by a veterinary. The stitches may be done with nylon sutures, or with thick sewing-cotton or thin tape if nylon is unavailable. The injection of local anaesthetic along the edges of the wound will greatly ease the insertion of stitches and is obviously more humane. If no surgical needle is available then a large-eyed sewing needle will serve the purpose. The stitches should be single and separate and loosely tied. All material should be boiled before use and the operator's hands must be scrubbed clean.
Stitching up or taping wounds when done by by a lay person results almost invariably in severe anaerobic infection! If there is no veterinarian you must leave the wound open, cleaning it regularly (e.g. with hydrogen peroxide) and reapplying wound ointment or wound powder.

Antibiotic injection​

It should be given for large and for heavily contaminated wounds in addition to the topical treatment. If healing does not proceed cleanly and pus appears then remove the lower stitches to allow drainage and keep the wound clean and open until healing occurs. All wounds must be protected against flies which may lay their eggs in wounds which may then become infested with maggots. Stockholm tar helps cover wounds and keeps flies away.

Wounds on the lower limbs should be carefully bandaged with a firm pressure bandage after treatment and the bandages changed every 2 or 3 days to check on the progress of healing. Do not attempt to stitch wounds on the lower limbs. The stitches invariably will not hold and will tear our.

Puncture wounds and haematomas​

Puncture wounds are wounds such as bites, thorn injury etc, they should not be stitched, but left open to drain and cleaned and treated frequently with antibiotic either locally or by injection. All discharges of pus or serum should be washed away whenever they appear. Contusions or bruises where the skin is unbroken may result in damage to underlying tissues in the form of swelling, internal bleeding and tearing of muscles, tendons and ligaments. There may be considerable pain, and the area may be swollen, tense, hot and become discoloured black, red or purple.

Most bruises resolve without any special treatment but may benefit from the application of cold water, ice or in some cases by the application of a kaolin and glycerine poultice.

Bleeding underneath the skin and inside tissues can result in Haematomas. These are large accumulations of blood, which are usually not painful. If left alone they will gradually shrink as the blood inside clots and is absorbed. A haematoma should never be opened by a lay person, this is what a vet may sometimes do, but not a farmer! If done by a lay person it is the perfect recipy for infecting a sterile haematoma.

Abscesses​

An abscess is a circumscribed swelling with pus usually below the skin. It must be differentiated from other swellings such as those caused by hernias, ruptures, tumours, cysts and haematomas.

Fresh abscesses are usually hot and painful when touched, whereas ruptures, hernias, tumours, haematomas and cysts are normally not painful and not hot. Check by feeling the swelling carefully. A hernia or rupture is usually soft and can be pushed back into the body. When suspecting a hernia or rupture (usually occur on the lowest part of the belly), which may contain a loop of intestine call a vet. Cutting such a swelling could be disastrous, because the intestine may come out. Most abscesses are hard and hot in the beginning and later become soft and cold. An animal with an abscess may have a raised body temperature due to the pus inside the abscess. Squeezing the abscess may cause pus to ooze through the skin.

Abscesses can be treated either by fomenting the overlying skin until the abscess bursts and drains, or by lancing them.

In the former method mix salt or Epsom salts in water as hot as you can tolerate when sticking your hand into the solution(for example add a teaspoonful of salt to half a litre of water). Soak a piece of clean cloth or cotton wool with this solution and hold it on the swelling. When the cloth gets cool soak it again in the hot solution. Continue for about 5 minutes and do this at least 4 times daily. - You may also apply an ointment containing camphor on the skin above the abscess that generates heat locally, such as "Deep Heat".

The skin above the abscess may soften and break, discharging pus, which may smell foul. Keep on flushing the inside of the abscess with Hydrogen Peroxide solution to encourage the drainage to continue so that no pus remains when the skin closes and heals.

If the abscess does not burst then it may be necessary to cut it open. This is done using a scalpel or a very sharp, very clean blade. Shave the hair over the swelling and clean the area with soap and water, followed by surgical spirit or alcohol. Cut boldly through the skin at the lowest point of the abscess to facilitate drainage. Sometimes you may have to cut quite deeply. Make one long vertical cut. Place a clean finger through the hole to help to release the pus which should pour out, often under pressure.

When the pus has stopped flowing, flush the cavity with a working strength solution of iodine or hydrogen peroxide. Continue bathing the area with a warm salt solution or hydrogen peroxide solution for the next few days. If the abscess was large give an injection of antibiotic, such as oxytetracycline. Healing should take place within a week or so.

Tetanus can develop in small narrow deep wounds that heal and close rapidly on the skin surface, but with active infection remaining inside. In such cases animals should be vaccinated against tetanus