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Discussion on Is lavage different from pulsating cold water wound therapy?
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Member:
ellebell
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Posted on Thursday, Jan 6, 2011 - 9:21 pm:
My colt suffered an extremely deep and wide wound to his shoulder-you could see his jugular vein within the 8 inch wide opening(It was over 10 inches long). He's just come home from a 5 night vet stay, during which the wound was sewn up. The sutures have come loose several places along the vertical line of the opening so there is quite a large and deep area exposed. They made a hole below for drainage and it seems to be working well to discharge the fluids/puss.
He's on antibiotics of course, and the vet said to wash the wound once or twice a day with lukewarm water (lavage). I mentioned using cold water therapy and he said no, it would change the blood flow negatively. In a previous similar situation, another vet prescribed twice daily pulsating cold water pressure at least twenty minutes long to aid healing, saying it stimulated the blood flow and creation of granular tissue.
Why would the pulsating cold water treatment be prescribed for one large wound but not another?
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Moderator:
DrO
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Posted on Friday, Jan 7, 2011 - 7:10 am:
Hello PRUs,
In a perfect world large volumes of warmed isotonic fluid would be used to flush a open wound for cleaning purposes. However this is not very practical in a barn, especially if the wound is large. I will presume from his reply your current veterinarian is objecting to the fact that cold water causes a peripheral vasoconstriction: the blood vessels react by decreasing their diameter. And I will presume your past veterinarian considered the volume of fluid more important than the temperature of the fluid as there is no reason to prefer cold water for a wound flush.
In most cases I too would choose volume over temperature but I don't set particular times, but instead set specific goals: a clean wound surface or flush return. This is explained in more detail in the article associated with this discussion area.
DrO
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