The principles and practice of wound management

The donkey is liable to skin injury through its relatively exposed limbs and the circumstances of its management. Whilst the horse has a reputation for 'poor healing' with respect to lower limb healing in particular, the donkey seems to have a reputation for good healing with the proviso that proper management is applied. It is always unfair to blame 'nature' for poor healing wounds when the care and attention given mitigates against a rapid and natural repair. These differences make the study of wound healing in equids particularly interesting and also add to the clinical challenges that the species offer to practising veterinary surgeons and owners under all circumstances.

Anatomical knowledge is possibly the most important single aspect of wound management in donkeys. Many problematic wounds have recognizable anatomical complications that could have perhaps been foreseen at the outset. The major constraint in the management of wounds in donkeys is the need to examine and treat wounds within the first few hours after wounding occurs. The second limiting factor is that, under many practical circumstances, the working donkey cannot be rested or hospitalized. A combination of necessity, poverty and ignorance (and unfortunately, in some cses, cruelty) means that many wounds are presented long after the acute stages. Once complicating factors are present, then the wound may pass into a continuing cycle of chronic inflammation and failure to heal as a result. Managmeent becomes problematic and the need for intensive treatment increases.

Where a wound fails to heal as expected the clinician should in most cases be able to recognise the possible reasons for this. The wrong treatment, or the right treatment badly executed, can result in failure of the wound healing process and may even endanger the animal's life.

This chapter describes the principles of wound management.

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