Large animal wounds
Similar to abscesses, nonhealing wounds typically involve an underlying issue. These tend to appear in two different forms.
If granulation tissue is not covering the wound and/or drainage is noted:
- foreign body – remnant from the original trauma or suture material from the repair
- lack of ventral drainage – a pocket or tract that is being forced to drain upwards
- – fragment of bone serving as a foreign body
- damaged or decaying tissue – tendon fragments, etc
- flow of fluid (milk, synovial fluid, urine) – fluid flow acts to keep the pathway open
Evaluation includes ultrasonographical examination, wound probes and surgical exploration.
For most, treatment involves removing the foreign body and/or creating ventral drainage. En bloc resection of the entire tract may be performed if drainage is persistent but a source cannot be identified.
If the granulation bed is complete but epithelialization has stalled, consider:
- motion – especially wounds over joints
- continued trauma
If the limb wound has covered in granulation tissue but not skin, skin grafting is recommended. If the area is repeatedly traumatized, bandaging may be required (with concomitant management).
pieces of dead bone that cause persistent draining tracts as the body tries to liquefy them
exuberant granulation tissue