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Wound Clip and Clean
Views: 18041 - Comments: 9
Megan Brashear, CVT, VTS(ECC), discusses proper technique for how to clip, clean, and flush minor wounds sustained by a dog after a dog fight. Wound irrigation solutions are briefly discussed.
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Megan Brashear
CVT VTS(ECC)
Enrolled: 07/2011
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Great video! Very timely as I will be giving a wound care talk next week :)
Do you like to use sterile lidocaine gel in wounds?
Also, I have a couple of studies that cite dilute (0.05%) chlorhex solutions for wound flushing. Actually shown to promote healing over plain saline. Do you use chlorhex for wound flush?
Hey Liz, I'm also giving a wound lecture in a couple weeks! As far as lidocaine gel, I may use that if it's for a wound that we may not get to for a couple hours (patient needs stabilization for a bit) but since the lube gets cleaned out so quickly in most of these minor wounds I just go for the water soluble stuff. I just got some info from Louise about chlorhex in wound flush, as of now we aren't using it, just NaCl or LRS, but it looks exciting! Again, for the minor wounds we aren't really seeing any healing issues, but for the big bad come back for frequent rechecks and bandages the chlorhex will hopefully become the norm. If you're using chlorhex how are you making it up? Adding it to the liter? Does each patient get their own wound flush bag? How long do you let it hang?
For safety there should have been someone restraining that dog while you were working on him in case he jumped off the table. I understand you are filming a video and wanted optimum "screen presence" but it would have been awful had the dog sustained a leg fracture in addition to the bite wounds. Keep in mind that many students are watching these videos. Even if I had seen this in practice it would have made me nervous for the safety of the dog.
That's a great point Dawn, good for not only students but all of us to remember. I had been working with this patient for a while and was comfortable with his level of sedation but you can never tell what they will do! Thank you for bringing that up.
I loved this video! Usually when we do wound treatments, I find the majority of the time we clip, flush with nolvasan saline solution, and search for pockets. When you are doing wound treatment, are your techs allowed to search for pockets or is that the DVM job?
Kristen, during the wound flush procedure technicians will many times discover pockets and alert the veterinarian performing the wound repair, but technicians do not routinely probe wounds (with a hemostat for example) to search for pockets. Any other technicians have a different experience with wounds?
Wonderful :) watched and loved! Thank you
How much of the area around the wound do you usually clip, 2 inches?
Two inches is an excellent starting point, but I would be careful about being locked into one number. My approach is to clip a generous area that will keep hair out of the wound and allow for easy monitoring at home once the patient is discharged. If you are placing Penrose drains, you may end up shaving a larger area. It's important to think about how the wound will drain and what clipping is necessary to keep the patient clean while they heal. Bottom line, it's not one size fits all and each case may have a different approach. Thanks for the great question Diana!