A 9-year-old male Lhasa Apso came into the clinic on March 12, 2007. Another dog had attacked him the previous weekend. Initially he was treated at another vet clinic were his wounds were cleaned and he was started on antibiotics. When the pet first presented to our hospital, the wounds were large black areas where the skin had been traumatized. It was evident that these areas of skin would eventually die and slough away. This leaves an open wound. Bite wounds are contaminated and should be treated as open wounds in order to allow drainage and healing by granulation tissue.
The challenge at hand for our staff was to keep the wound clean and provide an environment to allow healing. We used a treatment approach involving hydrotherapy and wet to dry bandages. Basically hydrotherapy is done by applying a pressurized water source to the wound for 15 – 20 minutes twice daily. This water lavage decreases bacterial numbers, and loosens and flushes away necrotic debris. This is preferred to scrubbing a wound which can cause significant tissue damage. The wet to dry bandages assist in removing devitalized tissue.
After two weeks of therapy the wounds were finally healthy enough, with a nice bed of granulation tissue and significant wound contracture, to allow secondary closure. The patient went into surgery on March 29th. We resected the granulation bed and skin margins, lavaged the wound and closed the skin edges with minimum tension.
On April 9th, our patient was seen for the sutures to be removed. The incision looked great except for a small area where he had chewed out the sutures. This area was already healing on its own. The owner was instructed to use a triple antibiotic ointment twice daily until completely healed.