Open wounds - the how and what with? your opinions please!

Re: Open wounds - the how and what with? your opinions please!

James Allsop — Fri, 11 Dec 2009 16:41:28 GMT

A homeopathic/alternative medicine vet once recommended Green Clay directly on the wound. im not sure what this does one of the vets in our practices swears by it but the rest of us call in 'Magic Clay'. I remain sceptical but appreciate feedback if anybody else has experience of this.

Re: Open wounds - the how and what with? your opinions please!

Richard Carter — Mon, 07 Dec 2009 19:01:19 GMT

Pretty much any hygroscopic action will have an antiseptic effect - honey, sugar. In South Africa we used to have acriflavin glycerine - wonderful colours, stains like mad and very good for impressing the client. Barrier ointments/creams such as vaseline etc all help if removing dressings regularly

Re: Open wounds - the how and what with? your opinions please!

Hannah Wynne Richards — Mon, 07 Dec 2009 16:54:53 GMT

OUCH!!!!!

H2O2 STINGS

Wynne

Re: Open wounds - the how and what with? your opinions please!

Sandy Edwards — Mon, 07 Dec 2009 16:51:01 GMT

The Gypsy horsemen in my area , who are always treating horses with major bits of skin missing , with no involvement with the vet , usually spray them twice daily with hydrogen peroxide ( probably 6 % ! ) or diluted potassium permaganate probably just enough to make the water a good colour of purple , dressings are never used and I think I probably for the best , though i guess flies are a prob for you but we get them here . Results seem comparable with anything else i've seen and i confess to being a bit of a fresh air fan myself !!

Re: Open wounds - the how and what with? your opinions please!

Tim Cheyne — Sat, 05 Dec 2009 14:56:34 GMT

Wynne, I am sure that you would cope magnificently. Going back to basics does not necessarily imply poor treatment. Provided that you have good eyes, ears, sensitive fingers and can do a proper clinical examination it is surprising what you can diagnose and treat without the benefit of x-rays, ultra-sound and lab tests (and, because you are not fluent in the local dialect, you do not have owners misleading you!). The inability to perform complex surgery can be frustrating but the need does not arise often.

Don't forget that you are dealing with a different class of animal, one that has survived so far and is hardy with a good immunity to local conditions, not one with inherited weaknesses, hormonal in-balances, etc. Much of the 'treatment' can involve educating the owner on correct feeding, housing, and general management (a bit like UK, perhaps?).

Each time that I went to a new country I wondered what I would find, and feared the worst. Generally I left (usually sadly) wondering whether I had learnt more from the locals than I had taught them. Never did I regret having been there.

Tim.

Re: Open wounds - the how and what with? your opinions please!

Tim Cheyne — Sat, 05 Dec 2009 14:25:00 GMT

Niall,

One per cent povidone iodine (which is what is mostly available these days, even in developing countries) does not have the aggressive effect of the old Tincture of Iodine or Lugols and it also has a depot effect, acting steadily over several days. Generally it makes an effective and fairly benign antiseptic wound dressing.

In the past I liked propamidinr cream, marketed as M&B ( and later 'Boots") Antiseptic Cream but unfortunately it seems to have disappeared from the market and the catalogues. It cleaned dirty, gravel-rash type, wounds beautifully and promoted healthy but not exuberant granulation tissue.

Tim.

Re: Open wounds - the how and what with? your opinions please!

stuart mcmorrow — Sat, 05 Dec 2009 12:49:05 GMT

Hi,

www.vetwoundlibrary.com

is a place where you can get free dressings to use on wounds as long as you take photos of the case. I don't know if they could send out to Asia but it is worth a look.

As some of the others have said honey is brilliant, as is granulated sugar. The sugar will need changed very frequently if there is any amount of exudate.

An old fashioned thing to protect the surrounding skin is egg white. I have never used this but my Mum - who used to be a district nurse - suggested it as an option.

I also think that wounds can be left open to the elements much sooner than most people think. Once you have got a good granulating bed there is no need for antibiotics. I generally use amoxycillin and don't think amox/clav is required for most cases. (there is an interesting discussion on the SAMsoc forum running just now on antibiotics). I had a vet at my practice a while ago who did some volunteer work in India and she said that most of the wounds they treated there were wet-to-dried and then left to their own devices - like you she have very little eqpt or options.

Cheers,

Stuart.

Re: Open wounds - the how and what with? your opinions please!

Louisa Huntington — Thu, 29 Oct 2009 08:58:45 GMT

Thank you very much for all your suggestions - I really appreciate them all. Today i applied the saline soaked swab/cling film bandage - am a lttle nervous about leaving if for a week, i dont think this place or the wound is clean enough for that.

I will check out the aloe vera option too.

My time here is drawing to an end but i am pleased to say that certain wounds are looking alot healthier, cleaner and smaller! Quite satistying after arriving to find all wounds - open fractures with torn flesh and serious infections included - left to the to the open air in grubby cages and not even any pretence of the knowledge of the word debridement! anyway - i have taught them a new way of handling them and i hope it continues after i leave!

once again thank you very much

Re: Open wounds - the how and what with? your opinions please!

Niall Taylor — Wed, 28 Oct 2009 19:08:16 GMT

[quote user="Laurence Webb"]Aloe Vera[/quote]

I love that name, always sounds like an opening line from Coronation Street !

Niall

Re: Open wounds - the how and what with? your opinions please!

Laurence Webb — Wed, 28 Oct 2009 18:46:19 GMT

Aloe Vera gel makes a decent replacement for intrasite. Is proflavin still made? That was very cheap if a little old fashioned!

Re: Open wounds - the how and what with? your opinions please!

Niall Taylor — Wed, 28 Oct 2009 10:58:06 GMT

I have used saline soaked swabs on such wounds then applied an impervious layer of plastic (a polythene bag or cling film) onto the swab to hold it in place and to retain the moisture before applying a bandage over the whole lot. If infection isn't too bad and the area is reasonably stable you can get away with weekly bandage changes rather than the usually advised 3 days.

Once you've got sufficient granulation tissue in place then a dry, breathable bandage will encourage epithelialisation. Eventually, once the area has shrunk enough just leave it open to allow the last bit to heal over.

I like the honey idea but I've a feeling that iodene soaked swabs might be a bit hostile to tissues which are trying to heal.

You may be in Asia but the facilities sound very much like my first job - and that was in Cornwall!

Good luck,

Niall

Re: Open wounds - the how and what with? your opinions please!

Hannah Wynne Richards — Wed, 28 Oct 2009 10:08:15 GMT

I really admire people who can work in 3rd world countries. I know I couldn't cope. It's upsetting enough when people in this country force me to give 2nd rate treatment because they won't pay for doing things properly

Wynne

Re: Open wounds - the how and what with? your opinions please!

Louisa Huntington — Wed, 28 Oct 2009 09:17:23 GMT

Dear Toby,

Thank you very much for your reply, I really appreciate it. Every animal in this place seems to present it self with a wound of one sort or another and most are far beyond a clean fresh wound!Your reply has certainly given some food for thought!!! I am in Thailand and will now be on the look out for a suitable product. I am sadly not here long enough to get supplies sent etc.

Thank you so much - I will look into this further / try this out if i can!!

Thank you

Louisa

Re: Open wounds - the how and what with? your opinions please!

Toby Birch — Sun, 25 Oct 2009 11:06:12 GMT

Hi Louisa,

You might like to try honey. The effects are amazing and have to be seen to be believed. Dechra have some wonderful products which are very easy to use but are pricey and may not be available to you. Before I found these products I used a jar of honey.

It has to be unpasteurised (it doesn't have to be manuka) so you can't just walk into a supermarket and buy it. There is a slim risk of botulism (obviously in the UK this is only a very small risk but not sure where you are). It may be that you can have some flown over - would be happy to help if necessary. The pasteurisation process destroys some of the beneficial properties but generally it will kill bacterial incl MRSA, is very good at debriding and promotes a healthy environment for granulation and epithelisation. If the animal is not systemically ill no antibiotics are required so will keep you costs down.

I used to soak/dip knitfirm in the honey and then bandage and over with sterile swabs and then more knitfirm over the top. Surigfix netting is a great final layer if you can get it and is cheap. Change the dressing as often as required. Generally I find this starts as TID but rapid decreases to BID/SID etc. Once wet obviously the honey can't work (just like making jam!). Granulated sugar is another alternative but doesn't have the antibiotic properties and relies purely on osmotic effects. Easier to tip into holes than use on legs but is fantastic for ruptured mastitic wounds.

Hope this helps or at least gives you something to think about. Get in touch if you would like any further tips or some supplies.

Toby