Management Practices That
Infl uence Wound Infection
and Healing

Ted S. Stashak,

DVM

,

MS

,

Diplomate ACVS

Introduction
Historical Considerations
Duration since Injury
Cause of Injury
Previous Treatments
Management Practices
General Anesthesia and Duration of
Surgery
Wound Anesthesia

Wound Preparation
Antiseptic Skin Preparation
Wound Exploration
Wound Debridement
Antibiotics
Anti-Infl ammatory Drugs
Conclusion
References

Introduction

Preserving life, preventing infection, and creating an optimum environment for wound healing to continue

should be major objectives when a veterinarian is presented with a patient suffering a traumatic wound.

1

On

initial examination, a minor wound should not divert attention from a more serious problem such as hemor-
rhagic shock, exhaustion, or cerebral contusion associated with head injuries.

2

Thus, a rapid assessment of the

wound should be followed by a thorough physical examination. Hemorrhage should be controlled and therapy
directed toward returning the patient to function and obtaining a cosmetic outcome as quickly as possible.

3

This section will review wound management practices that infl uence wound infection and healing. The

subject will be approached in the order in which a case involving a wound would be evaluated and managed.
Because infection is a major cause of delayed healing and wound dehiscence following suturing, the manage-
ment practices that reduce the incidence of infection will be discussed in detail.

Historical Considerations

Duration since Injury

Historically, it was accepted that wounds treated within 6 to 8 hours after injury could be safely sutured

with little risk of infection. This temporal relationship, referred to as the “golden period,” was suggested as a
result of research performed in laboratory animals, indicating that bacterial contaminants took longer than 6 to
8 hours to reach suffi cient numbers to cause infection in a sutured wound. Subsequent experiments using
quantitative bacterial analysis documented a very high incidence of infection in sutured wounds containing 10

5

organisms per gram of tissue.

4

Others found that it took only 3 hours for some bacteria to proliferate to infective

levels of 10

6

organisms per gram of tissue.

5

85

2.2