Another thing I love in my job as a veterinary nurse is being a part of wound and dressing management.
For better or worse as vet nurses, we see the changes that occur and get to be an integral part of caring for and managing our patients’ wounds.
Understanding the general principles of wounds, how they can progress (or regress), how they heal and change, as well as having knowledge of bandaging techniques and maintenance methods, is pivotal in enabling us to better assess our patients’ progress and more readily identify and address any complications or potential complications that may arise
Stay tuned for part 2 where we get into assisting with wound repair and how to select the appropriate dressing types for your wounds!
Wound Assessment
A thorough wound assessment should always be performed by a vet before any dressings are applied. They will evaluate and ascertain the full extent of the injury via visual probe, palpitation, diagnostic imaging or surgical exploration. Once the extent of the injury has been discovered, the wound should then be classified and staged.
Wound Classification
Wound classification can be done using many different methods (location, type, symptom, etc.) so it’s important to have a unified protocol throughout your hospital that all team members are familiar with, to ensure continuity and analogous record keeping.
Ultimately, wounds will be classified as either open or closed.
Open wounds could include injuries such as:
- Abrasions
- Lacerations
- Punctures
- Incisions
- Avulsions
- Compound fractures, or
- Burns.
Closed wounds could include:
- Contusions
- Crushing injuries,
- Or even surgical site complications.
Wound Staging
The wound should then be staged for the degree and duration of contamination as well as its current stage of healing.
Contamination
The degree of contamination refers to the amount of debris present within or around the wound.
The duration of contamination refers to the amount of time between the injury occurrence and treatment itself.
Contamination can be categorised into three classes or stages:
Class 1: Clean wound with minimal contamination or a duration time of under 6 hours.
Class 2: Wound with significant contamination or a duration time of 6 -12 hours.
Class 3: Wound with gross contamination or duration of over 12 hours.
Remember! The degree of contamination is more important than the duration, so even if you have a new wound that has occurred within the last 6 hours but presents with significant or gross contamination, it must be assigned a higher wound classification and treated accordingly.
Healing
The healing stage refers to the current status of cells, blood vessels, connective and soft tissues and how they are influencing the condition of the wound.
Stage 1: Haemostasis
The blood clotting stage is aimed at reducing blood loss.
Stage 2: Inflammatory
Injured blood vessels leak transudate causing localised swelling, allowing the repairing cells to move into place and begin damage control.
Stage 3: Proliferative
Repair of the wound takes place through granulation and contraction of injured tissues.
Stage 4: Maturation
New collagen formation strengthens tissues and reorganises fibres to allow scar formation.
Next week: Wound and dressing management for veterinary nurses – Part 2 with information on wound treatment, method of repair, bandaging & dressing materials.
A version of this post first appeared on Mel’s Instagram account: vetnursediary_mel