Back in the middle of June just under 2 months ago Rocky came in to see me on a Saturday afternoon because he had been run over by a car and had a wound on his leg. Rocky had a shocking wound that was very painful and bleeding profusely.
The car had gone over his leg and the inside of his leg had been scraped along the road. Bits of bone, ligament and tendons had been scraped off on the road and as you can imagine Rocky was not a happy camper at all. Rocky was not going to let me get anywhere near that leg!
I had to anaesthetise Rocky just so I could make an assessment of the wound. The first thing we needed to determine was whether this foot was actually going to be viable. There was a good chance with sort of wound that the blood supply to the foot can be lost and foot can become gangrenous and need amputation. Fortunately none of the major vessels that supply the foot were located where the wound was so I felt there was a good chance that we could save this foot. The next step was to stop the bleeding. We applied a pressure dressing just to get the bleeding to stop and started pumping some pain relief into him.
Assessment & Planning
The next day we again anesthetised him again to take some xrays to make an assessment of exactly how much of the structure of his foot was missing:
- The good news for Rocky: the other bones that were not exposed in his foot were OK
- The bad news for Rocky: his metacarpal bone was shattered and bits were missing. At some point in the future it wound be neccessary to remove some of the non-viable bone fragments.
Wound management
We commenced dressing Rocky's wounds using various dressings with the aim of providing the wound with a moist healing environment. Most wound healing allows wounds to heal much faster and with less scarring than allow wounds to dry out. Some of the dressing materials we use which keep the wound surface moist while adsorbing the heavy discharge from this type of wound are quite expensive but the good part is that they need to be changed much less frequently than older, cheaper dry wound dressings such as melolin. This along with the fact that they speed up wound healing means that the overall cost of banding is reduced.
Surgical intervention
Once the wound bed was filled with granulation tissue (the pink bubbly material the wound is resistant to infection and well on the road to healing. It was now time to help the wound out by removing the dead bone-fragments and closing some of the wound edges that could be closed without tension. Partially closing the wound like this meant that the wound would heal up faster.
We now dressed the wound every 5-7 days and you can see how quickly the wound healed up over the following 6 weeks.
- The wound edges grow in
- the wound contracts
- before long the edges touch and the skin then thickens up
Rocky is now not in any pain and was even happy to see me at his last visit. It was great to have him finally jump up on me for a pat. When I went to have a look at his leg though his attitude changed- that's the down side to being a vet, sometimes the dogs remember you for the bad stuff that happens to them. That's far outweighed though by having Rocky back to his normal happy self and able to walk on all 4 feet again.
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