Fistulous wounds may form anywhere when an accident has happened to a part and a bone has been injured, and as the result of the inflammation the bone dies, and the wound will not heal until the dead bone comes away either naturally or by operation.
Another example of a fistulous wound is found when a dog has swallowed something sharp, such as a pin, needle, bone, or a corn sheck, which may pierce that part of the gullet situated in the neck; as the result, a large abscess often forms, and until the foreign body has come away the wound, the result of the bursting or lancing of the abscess, will not heal. These cases are often very troublesome, as the foreign body causing the mischief may be buried very deeply in the tissues, and when small is difficult to find even with the assistance of the X-rays.
Treatment: The first and principal thing to do in the treatment of all wounds is to clean them; but sometimes if the bleeding is very severe it may not be possible to do it thoroughly at once, for the dog may bleed to death, so when there is severe hæmorrhage this must be stopped as soon as possible. As a rule, a thick pad of medicated wool or antiseptic gauze, or failing either of these, a clean sponge wrung out in some hot water and bandaged firmly over the wound, will generally answer. This is cleaner and better than applying a stringent, as the tincture of iron or Friar’s Balsam, though in some cases it may be necessary, and the pressure afterwards applied. Four or five hours afterwards the temporary dressing may be removed, and after cutting off the hair from the edges of the wound it should be thoroughly cleaned with a solution of Pearson’s Disinfectant Fluid, 1 in 120 of warm water, or with a teaspoonful of boracic acid in half a pint of warm water. All dirt, clots of blood, hairs, etc., must be removed, and if it is an incised wound the edges should be brought together with stitches of strong silk, catgut, or silver wire; failing any of these, pin sutures may be used in the following way: A pin should be run through the skin on either side of the wound about a quarter of an inch from the edge, and the severed edges brought close together and kept there by winding a piece of cotton, figure-eight fashion, round the pin. Each pin should be placed about the third or half an inch apart, and after applying the cotton the point and head should be cut off. Afterwards cover the wound over with a few layers of dry antiseptic gauze, and bandage. Two days afterwards the gauze may be changed, but the wound need not be interfered with so long as it is dry and there is no swelling. If there is much swelling, one suture should be removed and the fluid gently squeezed out, afterwards apply the dry dressing as before. When there is much discharge the dressing must be repeated once or twice daily, the surface of the wound being cleaned with a solution of Pearson’s Fluid or boracic acid. On the sixth or seventh day the sutures may be removed, but the dressing should be continued for another day or two or until the parts are quite sound.
Lacerated and Contused Wounds require practically the same treatment; they must be thoroughly cleansed with a warm solution of some disinfectant, all shreds or loose and hanging bits of skin removed with scissors, then dust over the wound a powder made with powdered iodoform one part, powdered boracic acid eight parts, mixed together, a few layers of antiseptic gauze applied and the parts bandaged. When there is much discharge the dressing should be repeated twice a day, otherwise once a day is sufficient. Do not continue the compound iodoform powder for more than three or four days. After a week or so, if the wound is healing very slowly, apply instead of the gauze some boracic ointment on lint, which may be occasionally changed for the following lotion:—
Recipe:
| Sulphate of Zinc, | 1 scruple. |
| Tincture Calendula, | 2 drachms. |
| Water to | 8 ounces. |
This should be applied on a piece of lint doubled once and just big enough to cover the wound, which should be covered over with oil-silk and then bandaged. Repeat the dressing twice a day. When proud-flesh, or excessive granulations—that is, the newly-formed tissue to fill up the wound—forms and grows above the surface of the surrounding skin, nitrate of silver in the form of a stitch should be applied by just wiping it once across the surface of the parts. These wounds often take a long time to heal.
In treating punctured wounds the principal thing to do is not to let the skin heal before the parts underneath have, otherwise an abscess is sure to form, and there is a danger of blood-poisoning. A puncture wound may be cleaned by being syringed out with a solution of some disinfectant, then a small strip of disinfectant gauze should be placed in the wound to prevent its healing. This is to be covered over with a few layers of gauze and a bandage applied. Repeat the dressing twice a day, and so long as there is any discharge the wound on the skin must not be allowed to heal.
Fistulous Wounds are sometimes very difficult to heal, and often require operating upon before they will do so—especially in cases of a fistulous wound in the anus which may extend to and open into the bowel. However, before submitting the patient to an operation try the following lotion:—
Recipe: