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Wound Care / Touching your pet's incision

Quick Answers: The risk of infection is greater when skin's natural barrier is broken.

Please use an alcohol-based hand sanitizer to cleanse your hands before and after touching the skin around your pet’s incision to reduce risk of infection to your pet or to yourself. 

     Until all swelling has resolved, please apply a cold compress (a bag of frozen peas works well) to the surgery site for 5 minutes at least three times daily (more frequently is helpful), pat dry, and then re-apply Neosporin (or generic triple antibiotic) ointment to the incision. 

     After the swelling has resolved, warm compresses (hot washcloth, wring out excess moisture) can be beneficial in promoting healing and resisting infection. Continue to apply Neosporin (or generic triple antibiotic) ointment to the incision until it is completely healed.

     Monitor the wound for increasing redness, heat, swelling, pain, and discharge. A small amount of thin, watery, slight red fluid is OK, but if the wound is draining actively or the discharge is becoming thicker or malodorous, your pet should be rechecked immediately. 

     E-Collar at all times. Leaving the E-Collar off will likely result in wound infection, dehischence, and possibly a second surgery, or even limb- or life-threatening complications.

More detail: 

Skin is a natural barrier to infection.

  • An incision breaks that barrier, and so if you touch the incision, the normal (or any other) bacteria on your skin could potentially infect your pet's incision and possibly spread to deeper tissue.
  • Infection can be potentially catastrophic, causing a number of major complications, including: 
    • Dehiscenceopening up of the incision
    • Herniation - passage of, most commonly, abdominal contents through a dehisced incision
    • Septic arthritis - devastating infection of a joint
    • Destabilization/breakdown of a fracture repair
    • Loss of tissue - skin, pads, nails, digits, etc. can all be destroyed by infection
    • Loss of a limb - infection can be so severe that a limb is rendered non-viable, and/or amputation may be required to save a pet's life from severe infection
    • Death

YOU could become infected! Your pet has been in a veterinary hospital and has likely been on antibiotics. It is possible that there may be bacteria on his or her skin and/or incision that are aggressive and resistant to treatment. If you have a break in your own skin, or you transmit this bacteria to your eye or to mucus membranes, you could potentially become infected.

To help prevent infection in your pet or yourself

  • Avoid touching the incision directly with your skin
  • Alcohol-based hand sanitizer - you can minimize the risk of problems by using an such sanitizer before and after handling your pet. The ethyl alcohol in these products is the best protection against bacteria.
  • Triple antibiotic ointment (such as Neosporin) should be applied to your pet's incision to help protect the incision from infection.
    • This is both an antibiotic preparation, and the petroleum base is a physical barrier to bacteria. 
  • When treating an open wound or an infected incision, I offer recommend Manuka honey.
    • Honey is so concentrated that bacteria has a harder time growing in its presence.
    • Honey helps wounds to heal more quickly.
    • Manuka honey is a special medical-grade honey that is optimum for healing and fighting infection.
      • Manuka honey may be available via your veterinarian. If not, you can purchase it on-line. Simply do a Google or other search on the internet and you will find it to be readily available.
      • If Manuka honey is not available or affordable, other pasteurized or organic honeys can be used.
  • Some people recommend hydrogen peroxide or other products for wound care. I do not recommend these; peroxide, for example, is toxic to tissue, and is best when there is dead or unhealthy tissue to debride (remove).

Do wounds need heat or cold?

  • Cold compresses are helpful in:
    • Reducing swelling
    • Decreasing discomfort
    • Especially helpful in reducing joint swelling, inflammation, and pain
  • Warm compresses are helpful in:
    • Improving blood flow to tissues
    • Promoting healing
    • Helping fight infection
    • Encouraging drainage of fluid.
  • Sometimes, it is beneficial to alternate warm and cold compresses. For example, when recovering a pet from an orthopedic procedure, warm compresses may be used prior to exercise to warm up joint fluid and increase comfort during rehabilitation exercises ("physical therapy"), while cold compresses can be used after exercise to minimize swelling and associated discomfort.

Monitor the wound for signs of inflammation/infection

     In the first century AD, the Roman scholar Celsus characterized the clinical symptoms of inflammation as dolor (pain), calor (heat), rubor (redness), tumor (swelling). To this list is frequently added discharge as a sign of inflammation and/or infection.
     Inflammation is one of the earliest phases of healing and is normal. However, excessive inflammation can be detrimental and may be a sign of infection or other problems.
  • Pain
    • Though we manage pain aggressively, there is likely going to be some discomfort associated with your pet's incision and surgery site.
      • The initial trauma or event causing a problem is often painful
      • The surgery itself is often painful
      • Chemicals released from your body's white blood cells, etc. may be painful
    • Pain should generally decrease in severity over time (as long as appropriate pain management is provided).
    • When the surgical site is becoming more painful, especially if associated with heat, redness, swelling, and/or discharge, your pet should be rechecked to evaluate for the presence of excessive inflammation or even infection. 
    • If the surgery site appears OK, your pet may need to have the pain management plan revisited.
  • Heat
    • Reactions caused by white blood cells, their chemicals, and other processes cause an increase in temperature.
    • A local increase in temperature of the tissue around the surgery site is consistent with inflammation and possibly infection (see above notes on appropriate how to touch your pet's incision to minimize risk of contamination/infection)
    • A body-wide increase in temperature (fever)
    • When your pet is running a fever, and/or the surgical site is becoming more warm or hot, especially if associated with pain, redness, swelling, and/or discharge, your pet should be rechecked to evaluate for the presence of excessive inflammation or even infection. 
  • Redness
    • As white and/or red blood cells, and the chemicals from white blood cells or various processes accumulate, the tissue may become more red in color.
    • When the surgical site is becoming more red, especially if associated with pain, heat, swelling, and/or discharge, your pet should be rechecked to evaluate for the presence of excessive inflammation or even infection. 
  • Swelling
    • Red and White Blood Cells accumulate in tissues, and chemicals released by the White Blood Cells cause fluid to leak from other cells and from blood vessels
    • Swelling may also be caused by:
      • Hemorrhage into tissue
      • Obstruction of a vein or lymphatic vessel by a clot (thrombus) and/or internal external pressure
      • Tumor growth
      • Many other causes
    • When the surgical site is becoming more swollen, especially if associated with pain, heat, redness, and/or discharge, your pet should be rechecked to evaluate for the presence of excessive inflammation or even infection. 
  • Discharge
    • A small amount of thin, watery, slightly red fluid is common and not necessarily a problem
    • If the wound is draining actively or the discharge is becoming thicker or malodorous, your pet should be rechecked immediately. 

     If you have questions or concerns, please e-mail Dr. Christiansen.