|
|
Discussion on Open wound - no granulation yet
|
| Author |
Message |
New Member:
Cbz9
|
Posted on Friday, Jan 16, 2004 - 10:28 am:
Hi Dr. O-
I have read through the articles re: first aid, open wound care and proud flesh -- plus all the messages, but of course I am questioning how things are going with my mare's wound.
She got a very bad wire cut, anterior hock, an inch or two below the hock. It happened on 12/31, so it's been more than two weeks and I don't see any granulation at all. It still looks like a totally fresh wound (I have to admit it looks better than when it happened though!). It was fairly deep, there was thought that she may have nicked one of the tendons, but it looks like both tendons are in good shape.
My vet is adamant on one thing that's different than in your articles, and that is to leave it wrapped 2-3 days between cleansing and rebandaging. I asked about the difference from your recommendation. He said that as long as the wound is clean, not infected, pussy etc it is safer to not hose it frequently as our water can have something (I don't recall the technical term he used), that can actually start an infection.
So - I have followed his advice on that point.
The wound shows no granulation, even around the edges (in my very inexperienced eye). Should I be worried about that? I have a picture from yesterday of the leg that I can try to post.
Thanks for any thoughts.
|
Member:
Dres
|
Posted on Friday, Jan 16, 2004 - 10:43 am:
i had a filly with a nasty cut about the same place only on the outside leg / lower.. anyway.. my vet told me NOT to hose it clean and to leave the wrap on a couple of days before changing too...instead of hosing i used cotton balls to wipe the slime off, and to remedicate it... it healed up nicely but took longer then 2 weeks.. i think more like 4 before i could take the wrap off...
Ann
|
Moderator:
DrO
|
Posted on Saturday, Jan 17, 2004 - 4:10 pm:
It looks like it is granulating but I can't really tell from the picture, can you get a closer picture? The infrequent cleaning actually will increase granulation tissue rather than discourage it so I think this is fine, until the granulation becomes exuberant.
Though you can certainly get a wound healed up this way there is a obvious weakness in your vet's argument that this is safer: if it became infected would he then continue to clean it every 3rd day and if not why? I personally think if the water is suitable for human consumption it is suitable for wound cleaning.
DrO
|
Member:
Cbz9
|
Posted on Sunday, Jan 18, 2004 - 12:09 pm:
Dr. O and Ann -
Thanks to both of you - reassuring to hear I'm not doing anything wrong. The vet did tell me that if the wound should become infected, or just not as healthy looking as it is now, he would not hesitate to begin with daily hosing. But, as long as it is healing and healthy, he wants me to stick with just as Ann said, cleaning with a cotton daub, using a Tefla pad with triple antibiotic, and re bandaging (every 2-3 days).
I plan on taking a new picture once a week to record the progress of it.
|
Member:
Cbz9
|
Posted on Monday, Jan 19, 2004 - 4:00 pm:
Okay - on yesterday's re-bandaging there was a big change, and I think what I'm seeing is proud flesh. First, it was extremely pussy with lots of drainage - alot more than I've seen since she was injured. We did have a week of sub zero (-15 to -35 degree) weather immediately after she cut it, so perhaps that slowed everything down for her. The second change besides pussy drainage, is that the surface of the wound is real lumpy and bumpy (proud flesh?!). And thirdly, there is a "hole" or hollow spot in the center of the wound, sort of next to and behind the inside tendon. This wasn't there on the previous bandaging. It's a little pocket that is probably holding some of this fluid rather than draining out into the bandage.
I have a call into my vet already to discuss this and make an appt to have him take a look. It may be 3-5 days til I get her in though. Any thoughts on the three changes that suddenly happened? I am pretty certain that the new lumpiness is proud flesh. The excessive drainage this late (almost 3 wks after cut), and the "hole" are what I'm really wondering about. (no new pictures yet, but I'll take some tomorrow)Thanks to anyone who has seen this and has any advice.
|
Moderator:
DrO
|
Posted on Monday, Jan 19, 2004 - 10:03 pm:
And the reason he would have you would clean it daily is because it is better at fighting infection.
Concerning the changes your descriptions are not good enough to make judgements but I suspect, like before, you are overreacting. Increasing swelling and lameness are the main signs that bad stuff is happening.
DrO
|
|
|
