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100% closure rate of pressure ulcers

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Heavily infected post surgical paw wound in a dog following removal of skin tumour

The dog had a small benign skin tumour on the toe surgically removed. 7 days after surgery all stitches have broken open, the wound is heavily infected and red and must heal by second intention. Four days later after two applications of SertaSil, the wound is no longer infected, but is healing with clear presence of granulation tissue, healthy wound edges and has reduced in size from 2 to 1½ cm in diameter. Application of SertaSil continues and the wound is fully closed 30 days after first treatment. This is achieved in spite of the fact that the dog had bitten off the dressing one weekend and chewed the wound and that three pressure ulcers had formed on the paw, all three infected and one of them with a 1 cm deep pocket formation. These also received SertaSil and progressed fast and steadily to complete healing.

Responsible: Alf Laebro, vet & partner; and Signe L. Dideriksen, vet, Centrum Small Animal Hospital, Denmark.

Detailed description

A 6 years and 3 months old boxer bitch has had a small benign skin tumour surgically removed caudally on the 5th toe of the hind paw dexter.

2 days after surgery the dressing is changed and everything is normal. 5 days later, however, all stitches have broken open. The wound is heavily infected and red, and must heal by second intention. The wound is cleaned with chlorhexidine, rinsed with saline, SertaSil is applied and the wound is dressed with Allevyn, Soffban (padding), VetRap and Tensoplast. Furthermore, the owner is informed of the risk that further complications eventually can result in the amputation of the toe.

The next day, the infection and the redness are reduced. The wound is cleaned with chlorhexidine, covered with SertaSil and dressed as the previous day.

At the follow-up 3 days later, no infection is observed, the presence of granulation tissue is evident, the wound edges look healthy, and the wound size is reduced from 2 cm to 1 ½ cm in diameter.

3 days later at the follow up, the wound still displays a well granulating centre and evident epithelialization around the edges. Again, the wound is cleaned with chlorhexidine, covered with SertaSil and dressed as before.

7 days later, the wound diameter is reduced to 1 cm. The use of SertaSil is continued, and the wound is dressed as before.

16 days later, after dressing change with SertaSil every second or third day, the wound is completely healed despite the fact that the dog had bitten off the dressing one weekend and chewed the wound.

The entire process was complicated by the fact that three pressure ulcers had formed on the paw during this course, all three infected and one of them with a 1 cm deep pocket formation. All three pressure ulcers were cleaned with chlorhexidine and SertaSil was used similarly to the original, broken open surgical wound. All three pressure ulcers showed granulation after 2 days, corresponding to one application of SertaSil. At each dressing change, SertaSil was applied, and the wounds progressed fast and steadily to complete healing.

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