What is important for wound treatment?
The vet first gets as accurate a picture as possible of the injury. How big is it and how serious? Does it involve, for instance, an extensive abrasion that is painful and looks dangerous but is hardly bleeding? Or is it a small stab wound but one that goes very deep? Are other organs injured in addition to the skin, e.g., tendons, joint capsule, internal organs or nerves? Are there foreign bodies in it that must be removed? How old is the injury and what is the risk of infection? These are all questions that the vet must clarify as they are very important for correct management of the wound.
Further investigations such as X-ray or ultrasound can be necessary to look for foreign bodies or find out if internal organs or involved. If it is a bite wound, all bite sites must be found and examined. Depending on how the wound occurred, other injuries can be present (e.g., after accidents), which are less obvious, which is why the vet always examines the entire animal. If you know the details of how the wound occurred, you will help the vet greatly.
There are two principles for wound management: the wound can be closed and can heal primarily, that is, directly. This applies especially for recent wounds in which little skin has been lost and which probably are not contaminated deep down. Primary wound closure is the top goal of wound treatment and is always done whenever this is possible. The wound is cleaned thoroughly, any dead tissue is removed and the entire wound area is irrigated. Finally, all tissue layers (muscle, connective tissue, skin) are stitched with medical thread. For additional protection, including against chewing, the wound is bandaged.
Deep injuries with severe contamination or older wounds that cannot be freshened must heal by what is called secondary intention – from within outwards. They are left open under a dressing and are irrigated regularly with aseptic solutions and monitored. The body then closes them successively from the inside. This takes much longer than primary wound healing but cannot always be avoided. Secondary wound healing is also desirable when wound closure would possibly prevent secretions such as tissue fluid and pus from draining.
Secretions can also collect with primary wound healing. If the vet fears this, he or she will insert a drain, that is, a potential drainage route is created so that congestion in the wound does not occur. This would delay healing.
If the animal has severe pain due to the injury, it will be given pain relief. For serious wounds, the vet often gives an antibiotic as well to avoid blood poisoning (sepsis). This can be topical, directly into the wound, or else “systemic”, that is, it acts in the entire body.
After the initial wound management, further appointments with the vet will be unavoidable depending on the extent of the injury. He or she will supervise the healing of the injury. If it becomes inflamed and perhaps produces pus, you should definitely go again. If the wound was sutured and dissolving stitches were not used, the skin sutures must be removed after 7-14 days (depending on healing progress).
You may be given instructions for wound care at home. A cream may have to be applied or the wound may have to be irrigated with disinfectant. Animals are often given a plastic funnel for their head so that they don’t lick and chew the wound or remove the dressing. In the case of cats you can remove this by agreement with the vet under supervision for a few grooming sessions and then put it on again afterwards. Alternatively, you can assist your cat a bit with its personal hygiene.
Wound management after surgery
Wounds are naturally produced after operations. The “advantage” is that the vet knows how they arose and how they must be managed. As they are produced under sterile conditions, healing is usually much less complicated. Unfortunately, however, even operation wounds can become inflamed and heal poorly. Good wound treatment after the operation minimises this risk.