Reducing wound dehiscence and surgical site infections - tips
One thing that is occasionally overlooked, is consciously thinking about how we can reduce a patient from chewing at their wound. This is probably the most effective way of reducing wound dehiscence.
For this, we need to think about reducing pain and irritation at the surgical site. How?
1 - Bury your knot! I have a video of burying a knot on my website;
Your buried knot can be an Aberdeen knot, and this is a demonstration here that I demonstrated for versatile vet;
2 - Don't use tissue glue to hide your lack of technique in burying your knot (haha - we have all done it). It can be irritant, so may make the patient more inclined to chew the wound. If you have not buried your knot, (this won't be a problem once you have watched the video), then you are better off using a small gauge suture material to close over the knot.
3 - You don't need more than 4 throws, especially when burying a knot – it just creates are more bulky, more irritating knot.
4 - Use a head collar. ALL my patients get sent home with a head collar if they have a wound.
5 - Use fine suture material in the skin and handle the skin gently (as per Halsteds principles, which are especially important in the skin) – 3-0 in dogs or 4-0 in cats, of quick absorbable (e.g. monocryl, monosyn) suture.
6 - Analgesia! Good analgesia makes it far less likely that a patient will chew it's wound.
Picture: I am soon to release some exciting news about about our new Brachycephalic Unit at VSS Jindalee. Brachycephalic health is a passion of mine, and we have a collaborative team that have determined the best way a specialist service can help these dogs. I am highly dedicated to this project. Please feel free to give me a call if you would like more details.