Franklin Vets Blog
The continuing adventures of Jack
You may recall the little fox terrier Jack, who at the end of 2020 had a dislocated hip that would not stay in place, and at the grand old age of 17 had surgery to replace and stabilise his hip joint. This was so successful, that Jack was fully mobile and active again in a few weeks, and promptly got hit by a car.
Now, Jack doesn’t do things by halves, and he managed to have a large flap of skin pulled off from the side of his shoulder. He was treated at the emergency clinic, where the flap was cleaned and sutured back in place, but unfortunately, the wound was too contaminated and the skin flap too damaged, so the tissue was not going to survive.
3 days after having the accident, Jack came to see us for his first dressing change. It was obvious the skin flap was dead, but removing the flap would leave a very large area of tissue with no skin at all. It was decided to manage this as an open wound until it was ready to be closed.
Jack was sedated and the wound flushed, and the dead skin flap was removed. The wound was dressed with a Manuka honey dressing and wrapped up for the night.
The next day Jack was anaesthetised, and the surface of the wound was debrided with a scalpel blade, which is essentially scraping off all the diseased tissue to get back to live tissue. The wound was dressed again with the addition of a paraffin gauze dressing, which stimulates in-growth of new blood vessels and connective tissue.
Dressing changes continued for ten days, by which time the whole wound was covered with healthy granulation tissue. At this point, we decided Jack was ready for what we call secondary closure of his wound. The edges of the skin around the wound were trimmed, and the skin pulled over and sutured.
The wound healed normally, and Jack is back to his normal self again.
Secondary wound closure is an excellent technique for severely contaminated, dirty, infected, or necrotic wounds. It basically means treating the wound until it is clean and healthy, and has a good covering of granulation tissue, which normally forms at around 10-14 days.
As long as you have blood supply, there are always options for treating wounds, which may involve delaying closure by a few days or even a couple of weeks.