Introduction:
Except for spaying and neutering, we do more soft tissue surgery than anything else. Often 4-5 cases a day. What I'm talking about here is the repair of cuts, wounds, and abscesses.
Pets are always getting bit, cut, punctured, or wounded, but luckily most of these problems, while potentially serious, are pretty easy to fix. Also luckily, this is my favorite type of surgery; cleaning, trimming, and fixing up wounds.
Despite the fact that most of these cases are relatively easy, there are quite a few steps involved that require careful attention:
1. Exam of the patient. In addition to the obvious wound, there is often fever, infection, glandular swelling, GI stasis, mild shock, and additional less obvious wounds present that need to be identified.
2. Deal with the patient's fear, panic, and pain if necessary.
3. Consider pre-anesthetic testing, pre-surgical antibiotics, and other pre-anesthetic medications.
4. Careful anesthesia
5. Aggressive cleaning of the patient or at least the wound area. A lot of wound patients are filthy with combinations of dried blood, mud, urine, and stool.
We like to clean the whole patient in order to look for additional wounds and because many of these patients will need to be kept indoors during their recovery period. And of course we need to clean the actual wound , as well as clip or shave the hair in the area to minimize the chance of infection.
6. Trimming of any damaged tissue, removal of ingrained grit and debris, ligation of any bleeders, repair, if needed of underlying structures, place wound drains if needed, and repeat hydro-therapy.
Some older wounds, especially bite wound abscesses in cats have fistulas (tunnels of inflammatory tissue containing bacteria ) that needed to be carefully dug out of the surrounding tissue.
7. Closure of the wound. Sometimes this will require skin grafts, and sometimes the wound will need to be left partially open.
8. Bandaging and application of dressings and ointments, if appropriate, that speed healing and prevent or fight infection. Whether or not this step is needed depends on the wound.
9. Recovery and follow up care.
The wound will need attention 1-2 times daily; to include cleaning, possible bandage changes, and topical medications may need to be applied.
The patient will also need attention; to include systemic antibiotics, anti-inflammatories, pain control, and medications to minimize wound itching and irritation.
Some vets like to recommend additional support in the form of high protein diets, anti-oxidants, Co-Enzyme Q10, or vitamins. Some pets will need either restraint collars and/or sedation in order to prevent them from mutilating the healing wound.
10. Don't be surprised if follow up care is needed. Sometimes fluid builds up that needs to be drained and repeat surgeries are needed for some wounds.
And sutures or staples, if used, will need to be removed...usually about 10-14 days after the surgery.
