Wound Clip and Clean

Hi I’m Megan. Today we’re going to do some wound clipping and cleaning on this dog. He was attacked by a larger dog in his yard and picked up a couple of times so he’s got multiple puncture wounds. He has been given some pain medication and a little bit of sedation. Any time we’re dealing with wounds it is painful and so we want to make our job easier and make them a little bit more comfortable. We’ve also taken some chest x-rays to make sure that none of these wounds penetrate his thoracic cavity and everything looks good so it’s time to start clipping. So with wounds you want to make sure that you clip a nice wide area around them. We often say that wounds are the tip of the iceberg – there’s more damage underneath the skin than on top of the skin and so in case the doctor needs to explore any of these wounds we just want to clip a nice wide margin around them. In larger and deeper wounds it’s a good idea to apply sterile lubricant to them before you clip and so I’m just going to slide some of that in there and what the sterile lubricant will do is prevent hair that I’m clipping from sticking to this wound and making it harder for us to clean it out later. So this is a water-based lubricant so it will wash out when we flush the wound and again it’s just to make our job a little bit easier keeping the tissues moist and then keeping hair from sticking to it. So for flushing wounds the best setup to use as a 35 ml syringe and an 18 gauge here we like to use a catheter you can also use a needle and that’s going to provide the best psi for cleaning out of wound and then this is hooked up to a bag of saline you can also use LRS and you’re just going to take this and kind of flush out the wound now these are small puncture wounds but teeth can inject all kinds of bacteria under the skin there could be grass and little bits of hair in there as well so I just am kind of holding it up a little bit and then flushing saline into this wound and then kind of squeezing it out. There’s a pretty good pocket underneath the skin which is very common with these type of wounds often as the dog bites kind of lifts up and shakes a little bit and separates the skin from the muscle layer and so it’s really important to make sure that we flush all of these out and that we know what type of pocket that we’re dealing with because we may need to place drains. So I’m going to do this sorry buddy I’m going to do this for all of these wounds and flush multiple times, use as much saline as necessary to make sure that these are cleaned out. Another way that you can flush out large wounds or wounds that cover a large portion of the body is to use the bottle of saline irrigation and we keep ours warm, and just take an 18-gauge needle and puncture some holes in the lid so it makes like a shower and you can also again flush large areas of the body this dog since these are all puncture wounds this isn’t the best use of this flushing method I much prefer to use the 18 gauge catheter but that’s another way that you can clean out large body areas that have been wounded. And then after the wound has been flushed you want to clean the skin surrounding it especially because the dog is probably going to have some Penrose drains placed. So I do have some chlorhexidine scrub and also some solution and what I’m going to do with this is just clean the skin around the wounds. I don’t actually want to scrub over the wound itself. I also want to make sure that I’m not really rough and actually breaking the skin with the gauze and causing more problem. I really just want to clean off as much debris surrounding these wounds so I’m being gentle with his skin so that I don’t cause more damage and more irritation that’s going to impede healing. I’ll use the scrub and then I will use the solution to just clean around these bite wounds and prepare the skin for the doctor who’s going to come through and make some decisions about how we’re going to treat these wounds. (Ok buddy) and that is how we clip and clean bite here at DoveLewis.

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