tvpjournal.com | July/August 2015 | TodAy's VeTerinAry PrAcTice
MoisT Wound HeAling: THe neW sTAndArd of cAre Peer reviewed
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animal wounds by focusing on the following 4 types
(in order from most absorptive to least absorptive):
1. Calcium alginate
2. Polyurethane foam
3. Hydrocolloid
4. Hydrogel.
Table 3 (page 36) summarizes the characteristics
and indications for each of these dressings.
Selection of MRDs
To select the most appropriate MRD, the clinician
must ask:
• How much exudate do I expect this wound to
produce?
• What does this wound need (eg, debridement
or granulation)?
Table 4 (page 37) provides guidelines for
selecting a dressing based on the answers to these
2 questions. Examples of appropriate dressing
selection and application in veterinary patients are
provided by Figures 5 to 16 (pages 35 to 41).
APPLICATION OF MRDS
MRDs are typically applied after surgical
debridement and lavage. However, in a compromised
patient in which anesthesia and surgical debridement
are not possible, MWH provides a safe means of
getting wound debridement underway until the
patient is more stable.
Fitting the Dressing
As for any wound, use aseptic technique when
handling the MRD and tissue.
1
MRDs retain moisture
in the wound. To avoid maceration (overhydration) of
the skin and subsequent compromise of its epithelial
barrier function, ensure the dressing is in contact with
the wound surface but not with the skin (Figures 5, 6,
and 10 to 12, page 38).
9,14
• To help achieve the right fit, press the dressing
on the wound and cut along the resulting imprint
(Figure 11, page 38).
• When fitting the dressing to the wound, consider
the wound's depth and contour:
» Dressings that absorb and retain a lot
of exudate, such as calcium alginate and
FIGURE 5. A German shorthaired pointer dog
with multiple maggot-infested bite wounds.
The appearance of this right lateral wound
near the stife was typical of this dog's
wounds. After the dog was anesthetized,
wounds were lavaged and debrided of
clearly nonviable tissue and maggots. Sutures
were placed around the wound to secure a
tie-over bandage.
FIGURE 6. Patient from Figure 5: Calcium
alginate was placed in the wounds to
absorb the anticipated high level of
exudate and support ongoing autolytic
debridement by WBCs.
TablE 2.
Examples of Companies That Carry a Line
of MRDs
Covidien Animal
Health
covidien.com/animalhealth
Kruuse
kruuse.com
Jazz Medical
jazzmed.com
Derma Sciences
dermasciences.com/medihoney