Treatment Of Wounds
Wounds can be anything from minor abrasions to dog bites or burns, so this is a broad topic! As we have covered burns already, I will not include them here.
Obviously, we all try to prevent things happening, but as with us humans, accidents do happen, dogs will still bite and cats will still hunt, so knowing what to do in an emergency, particularly if your vet is unavailable, might prove useful.Minor Cuts and Abrasions.For example:
Skinky getting wedged between basking rock and dinner plate and shearing scales off a 10x10cm area. A minor wound I will classify as one with a depth of no more than 0.5mm and of not greater than a 5% total body area.
Shallow <0.5mm depth
Less than 5% total body area
Small or no blood loss
No fissure or cavity
Mild wounds can be treated by cleansing with warm water or normal saline, drying the wound thoroughly and preventing contamination of the area by removing substrate or debris from enclosure until healed. Covering with a light dry dressing such as primapore, may be necessary if you skink refuses to stop bathing in his dinner plate, for example and keeps making the wound dirty.
Monitor for increase in moisture in wound, or a smell developing which might indicate infection.
Stating the obvious, but consider removing or rearranging the offending item that caused the injury to prevent further problems!ANY
wound should be observed closely for infection as a break through the surface provides a portal for infection and allows for bugs to get in.Moderate to Severe wounds.Dog bite over hips, lacerated to bone.# Remember, these are guidelines only, that can be used in emergency situations and to suggest options for ongoing treatment, they should not replace or override the care and advice from a qualified veterinarian #
Wound greater than 5% body area or greater than 0.5mm in depth.
Dog bites/cat claws or teeth and other animal attacks
Any infected wound
Each wound is pathologically and physiologically different and thus should be treated uniquely and these guidelines are therefore not set in stone. Largely they are based on my experiences and evidence-based practise as a carer for sick lizards. (I have pictures of wounds to show progression of treatments to help assit you in caring for your animals, but unfortunately I have to insert these later, just bear with me!)My advice is based on my experiences, but should not replace that of your vet.Treatment
Where possible, calm animal by keeping it low to ground or solid surface, table/floor etc.
Consider covering head with a towel to keep calm
Clean wound with normal saline or betadine (iodine) solution. Ideally use 10 parts water to 1 part betadine, as idodine has been known to cause toxicity with topical application to open wounds. It is very effective as an antibacterial, but be cautious with prolonged use.
Allow wound to dry
If wound is 'sloughy' ... dead tissue buildup ... then a topical agent to assist with slough removal can be used.
Intrasite, aquagel, solusite are all water based agents.
SSD, silver sulfadiazine, is an effective antibacterial on dead skin and can prevent or help prevent a wide spectrum of yeast and bacterial infection.
Medihoney, sterile honey, Manuka or similar, can be bought in chemists for a reasonable price and I advocate it as a successful treament in bacterial infections, although it is not widely accepted as a treatment by many vets due to lack of research.
DO NOT USE alcohol or chlorhexidine based products to bathe or cleanse wounds. While they are effective antibacterial agents, they macerate the wound bed and healthy tissue and should therefore not be used on broken areas.
Iodine has also been known to macerate healthy tissue, particularly with prolonged use, therefore should be used with caution.
(Dressings will depend on the wound's pathology. I will continue to write more in this section when I have access to my documented photos, so please be patient for now. I apologise for the wait, but it will be easier to explain further with the use of pictures.)Burnum's Story
Burnum had a dog bite over his hips, with a depth penetrating to bone, degloving of tissue and near complete removal of flesh. The wound was severe, quickly became infected and subsequently adversely affected Burnum's health.
He was a wild eastern, living in the rockery garden of someone's house. Their dog had attacked him. The safest thing for Burnum was to remove him completely from the area and it was obvious that reintroduction to his habitat would not be appropriate.
His wound was weepy and inflammed, seen below. Because Burnum had quickly deteriorated and wasn't eating or drinking, he was dehydrated and malnourished, though fortunately, still at a reasonable weight, but it made treatment with medications more risky.
He was given a low dose course of baytril injections, a broad spectrum antibiotic, based on his current weight. His wound was deep and because of the position, posed difficult to treat. The risk of losing the tail were high, as were the potential threats of necrosis, bone infection and septicaemia.
Burnum's wound was initially cleaned with a 10 % betadine solution. The wound was irrigated 3 times daily and left open. Animal bites are notoriously difficult to treat without antibiotics/low doses, due to the high bacterial content of the mouth, so betadine was used as a parallel treatment to assist with healing, although, as mentioned, it carries it's own risks.
Once the wound started to dry out, I used an antibiotic based powder, which is applied topically to the wound.
The greyish, dry, dead areas are dying scales. It is common for scale death to occur following a traumatic injury. One theory suggests it is a protective mechanism to help isolate infection and prevent bacterial DNA replication in healthy tissue. Small areas are managable, larger areas can result in extensive tissue or limb loss. It is usually isolated to scales immediately surrounding the wound.
Over time, the powder proved to be ineffective and as Burnum was being syringe fed water and food, it was a poor outlook. His resistence was low and ability to withstand another course of antibiotics, questionable.
I decided to try something different, which is not wholly supported by vets, but I personally advocate it in such situations. Manuka honey, or medicated honey is not widely used, but research in humans deems it a viable treatment for open wounds. It is an all natural product, unlikely to adversely affect a compromised renal system and was a treatment I was willing to chance. Burnum was very sick, but there seemed nothing to lose.
I applied a thin layer over the infected tissue and kept him warm and dry, continued with small syringe feeds of food and water and kept my fingers crossed. Incredibly, he started to respond and within days the wound was receding and the depth reducing. His appetite picked up and he started to take an interest in his surroundings.
It took several months, but eventually, the only evidence of his ordeal was the round scar over his behind. As a nurse, I do have experience in wound care and I have many lizards under my care as rescues. Just be reminded that these pictures should be used as a guide only and under no circumstance should my experiences replace that of a vet. Please feel free to PM me for advice, but I will always strongly encourage anyone with a sick animal to have them under the care of a veterinarian.