Basic information on the case

Case 1: Adult German Shepherd (details), male, two years old, weighing 50 kilograms. The cause of the injury was trauma caused by a fight with other dogs. After a week of treatment in another hospital, the wound still did not heal, and a large amount of yellow-white pus flowed out from the wound. He was subsequently transferred to this hospital. After examination, the dog had suppurative wounds on the medial and lateral sides of the femoral left hind limb. The lateral wounds were about 10 cm long, and the lateral wounds were "T" shaped. The lengths of the wounds were about 13.5 cm and 5 cm respectively. There was also a wound at the intersection of the "T" shaped wounds. There was a large area of ​​skin defect. The skin defect was in an irregular rectangular shape, with a size of about 4 cm × 3 cm. Because the dog had been treated for a week, and antibiotics and other symptomatic treatment drugs were used every day during the treatment, the dog was so unwell when he came to the hospital for treatment. He has no other clinical symptoms, is in good mental state, has a normal appetite, and has a body temperature of 38 degrees Celsius, which is basically normal.

Case 2: A standard-sized Teddy dog, female, one and a half years old, weighing 15 kilograms, was also injured due to a fight with other dogs, and her leg was injured by the big dog. A week ago, he came to the hospital for a preliminary diagnosis. According to the chief complaint, the dog's wound was on the right hind limb, and the wound was regularly debrided and sutured. A week later, the dog came to the hospital for re-examination. An examination revealed that the dog's left hind leg and thigh were covered in pus. appendix. After careful inspection, another purulent wound about 4 cm long was found on the dog's left hind limb. The wound is a vertical wound perpendicular to the ground. Pus leaks from under the skin. The dog's right hind limb wound healed. The dog's mental state is slightly worse, the body temperature is 39 degrees Celsius, the body temperature is slightly higher, and the appetite is poor. In addition, no other abnormal clinical symptoms were found.

Treatment measures

1. Wound treatment

First, when the dog is Baoding, shave the hair around the wound to prevent foreign body stimulation from causing wound infection. Then use hydrogen peroxide to treat the wound so that the hydrogen peroxide can oxidize the necrotic tissue in the wound. After the hydrogen peroxide acts on the necrotic tissue for a few minutes, rinse the hydrogen peroxide in the wound clean with normal saline. Repeat the flushing with hydrogen peroxide and normal saline several times until the hydrogen peroxide is in the wound. Until there are no more bubbles in the wound, rinse it with hydrogen peroxide, then place a saprophytic muscle removal ointment and a drainage strip made of sterile gauze in the wound cavity, sew the skin on both sides of the wound edge, and wrap the drainage gauze in the wound cavity. , but the drainage gauze head can be exposed outside the body from the lowest end of the wound or both ends of the wound. In order to prevent the drainage strip from sliding out and facilitate replacement, the exposed part of the drainage strip outside the body is fixed on the skin. Do the above on the first day.

In the future, the drainage gauze should be changed once a day and the wound cavity should be cleaned until there is no visible pus on the surface of the wound cavity. The wound surface and wound edges should be trimmed and closed regularly. If during the treatment process, the skin defect of the wound is large and it is difficult to bring the skin together at both ends with one suture, a step-by-step suturing method that gradually closes the wound from both ends to the center can be used, so that the skin defect can eventually be fully repaired.

2. Prevent wound infection

Traumatic purulent wound infection is usually a mixed infection of aerobic and anaerobic bacteria. Therefore, when selecting antibiotics, both aerobic and anaerobic bacteria should be considered. A reasonable combination can achieve the exact effect. Ceftriaxone sodium combined with levofloxacin and metronidazole is recommended.

3. Treatment of secondary symptoms

If the dog has symptoms such as elevated body temperature, inexhaustible appetite, depression, etc., infusion treatment will be required for more than three days, mainly considering supplementing energy, Treatment measures to correct electrolyte balance and acid-base balance disorders. In addition, in order to reduce inflammatory exudation and promote the absorption of inflammatory products, hypertonic liquid intravenous infusion can be used with good results.

Wound recovery status

The wounds of case 1 were completely healed after 20 days of treatment, and the wounds of case 2 were completely healed after 25 days of treatment. One week after treatment, the two dogs were reviewed again. The wounds healed well, the mental state was normal, the appetite was normal, and there were no other pathological abnormalities.

Therapeutic Experience

1. The basic pathological process of severe purulent wound infection in dogs is the wound inflammatory response caused by bacteria and other infections. During this inflammatory process, neutrophils exudate in large quantities, often accompanied by varying degrees of liquefaction necrosis and pus formation. In purulent infections caused by open wounds, there are also a large number of bacterial infections. Common bacteria include Staphylococcus, Streptococcus, Corynebacterium, Pseudomonas aeruginosa, etc. If the infection of a dog's purulent wound is severe and effective measures are not taken in time, the infected area will further expand, which may also lead to canine sepsis. In severe cases, the dog will die. However, as long as you treat the wound promptly, insist on daily treatment of the wound, and ensure the cleanliness of the wound, not only can the ulcerated wound infection be effectively controlled, but the tissue wound will continue to spread and expand until the dog finally recovers.

2. The key to the treatment of this disease is:

(1) Debridement and placement of drainage strips.

Surgical debridement and placement of drainage strips can accelerate the discharge of inflammatory products and pus, which is beneficial to wound recovery. Compared with sterile gauze drainage strips, infusion tube drainage strips cannot simultaneously achieve the effects of anti-inflammation and drainage of wounds, and their drainage effect is slightly worse. Therefore, infusion tubes were not selected as drainage strips in the treatment of this case. In some cases, during the treatment process, in addition to treating suppurative wound infection, the problem of large skin defects must also be solved. If skin grafting is used, the operation is more difficult, the surgical requirements are higher, and the postoperative care requirements are more stringent. Therefore, a step-by-step suturing method was adopted that gradually closed from both ends of the wound to the middle of the wound. The basis for this method is that when suturing the outside of the wound, the tension on the inside of the wound is reduced by the tension of the suture and the tension of the skin itself, and it can also stretch the wound. The inner skin is conducive to the integration of the inner skin of the wound. Although this method prolongs the wound healing time, it can well solve the problem of large epidermal defects.

(2) Reasonable combination and application of antibiotics.

The rational use of antibiotics can control the growth and reproduction of wound bacteria and prevent the continued spread of inflammation. This allows the wound to grow new skin and muscle tissue in a dry and healthy environment.

(3) Inquiry is the first step in clinical examination and plays an important role in obtaining disease information of sick animals. But at the same time, we must distinguish between true and false, and carefully check and touch the sick dog. In the second case, due to over-reliance on the chief complaint and not carefully examining and touching the sick dog, the anterior chest incision was not discovered. When situations arise, lessons should be remembered