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Treating wounds on a limited budget
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Summary
Experience teaches us that wounds are unpredictable in the amount of effort and cost to achieve not only a cosmetic but functional outcome. Small wounds may require extensive surgical attention and numerous bandage changes, while larger wounds may heal without particular care or coaptation.
To further challenge this scenario, working in developing countries with animals of burden will stretch your ability to adapt and utilize available materials to support and speed the healing process of various injuries. This brief presentation will offer a number of ideas to spark discussion and provide veterinarians with alternative resources when facing wounds in developing countries or where materials are limited.
Body
This lecture is aimed at sharing ideas and techniques which we may need to resort to, when nothing else is available. While not much can be done when we do not have medications and drugs available, the few resources we have access to can be extremely efficient when the wound is assessed thoroughly.
While there are no reports that document wounds in working equids, in the clinical data collected over the last 10 years by the teams I worked with in Africa, wounds appeared as the second most reported welfare concern, second to malnutrition and just above colic and lameness.
Presented wounds tend to be localized mainly on the body (as opposed to the extremities) and could be
divided as being caused by:
a) Trauma – which can be directly work related, or due to poor husbandry or from animal attacks. Or
b) Man MADE - in traditional medicine practices aimed at attempting to help an animal recover, but also intentional and malicious, with the intent to punish the animals owner or the animal itself.
Due to the general lack of veterinary presence and owner time/funding, most cases that are eventually referred for veterinary care are severely contaminated and often older than a few hours or days. While wounds under 8hrs of age were historically considered safe to be cleaned and closed by primary intention, nowadays this is an outdated concept and it is advised that each wound be assessed and a treatment plan made based on the degree and type of contamination, location and extent of the trauma, blood supply and previous treatments, as well as the host’s immune system.
Because of the working and living conditions of working equids, the lack of access to antibiotics and the delay in attending these wounds, common complications encountered are infections, wound dehiscence, neoplastic transformations and habronemiasis presence.
Despite the lack of resources are wound treating kits commonly contain:
- Water
- Soap
- Hydrogen peroxide
- Bleach
- Honey and sugar
- Sugardine (sugar + iodine)
- Salt
- Vaseline (+/- petrol)
- Sunflower +/- tea tree oil
- PVC piping
- Cotton
- Duct tape
- White tape
- Cling film
- Newspapers for cotton
- Clay paper packaging and Plastic bags
- Cotton cloths in strips (old t-shirts) as bandages
- Trouser legs
- Plastic bottles as foot guard
Preventative measures are key to tackling this welfare issue, and include practices such as:
- Utilizing appropriate harness – modify and clean the padding, use humane bits
- Boiling the water used for cleaning wounds and add salt (saline)
- Use washing soap after having shaved and brushed clean the wound
- Boiling cloths used/reused for bandaging
- Covering the wounds with sections of mosquito netting to avoid fly/maggot infestation (+/- petrol in vaseline)
(This is not an exhaustive list)
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