Lacerated or Jagged Wounds
Definition.—By these are meant that description of injury to the soft parts where the skin and subtextures, instead of being simply divided, are torn asunder and present a jagged and irregular appearance, and are often much bruised.
Causes.—They are caused by mechanical injuries, such as hooks and nails in stables, or by carriage poles or shafts running into a horse.
Treatment.—Our first object is to remove all foreign bodies from the wound, and to cut off all lacerated portions, whether of skin, muscle or tendon, which cannot be retained in their original position. Then all grit or sand must be washed away by dashing cold water on the wound, should there be much hemorrhage; or bathing it with warm water, should the bleeding be inconsiderable. Having thus produced a tolerably even and clean wound, and removed those parts which we know would be removed by sloughing, we assist nature by sewing up such portions of skin and muscle as are not too much injured to preclude the hope of their growing in their original position, although we may abandon all hopes of the wound uniting by the first intention. This we accomplish by thread sutures, as in the case of incised wounds, but with this difference, that we do not bring the lips of the wound together, but at once have recourse to hot applications and bandages wherever they can be applied. The use of the latter is to preserve the lacerated parts in their original position, to exclude air, and to prevent the water washing away the lymph, which is necessary for the filling up of the wound; consequently the bandage should not be removed for a few days, except that the swelling renders it actually necessary to do so. The warm application reduces the tension in the part, favors circulation and the exudation of lymph, and by its soothing effects prevents that constitutional disturbance which is so much to be dreaded in this class of wounds. In about a week the inflammation will have partially subsided and suppuration will most probably have taken place, when we remove the bandage and discontinue the hot application, merely letting a little water run over the wound to remove superfluous matter. It is undesirable to use a sponge, because it would remove the lymph at the same time and expose the small vessels to the atmosphere, which are busily engaged in repairing the injury, which, acting on them as an irritant, causes them to secrete exuberant and unhealthy granulations called “proud flesh.” For the same reason, unless the matter is very plentiful and has a bad smell, it is better not to apply even water, or in any way remove the lymph.
The best possible dressing for all such injuries is Humphreys’ Veterinary Oil, which should be applied to all the raw or cut surface before being sewed or bound up, and then kept applied to the raw surface, both to prevent inflammation and to promote healing, and to hasten the process of cicatrisation, or the skinning over of the wound. Apply the Veterinary Oil twice per day. Should the granulations rise above the surrounding skin, or “proud flesh” appear, Veterinary Oil is still the best application, and will soon reduce the unhealthy growth and induce a natural healing.
Punctured Wounds
Definition.—These have small openings externally, but are usually deeper and of a much more serious nature than others. Because from their depth they are liable to implicate blood-vessels, nerves, viscera, and other deep-seated parts of importance. And because the parts which they traverse are stretched and torn, and consequently disposed to inflame and suppurate. And because matter, when formed, has no free exit, and is liable to burrow extensively. Finally, because foreign bodies may be carried into great depths without being suspected, and create long continued irritation, and because they are most liable to be followed by Tetanus.
Causes.—These wounds are caused by any sharp pointed instrument, such as a pitch-fork, nail or scissors, or by stabs or thorns, bayonet or sabre thrusts.
Treatment.—Our first object is to remove all foreign bodies, such as splinters, thorns, or balls, should it be a gun shot wound. Should the puncture not be in the neighborhood of a joint, or penetrating a tendon or bursal cavity, it is then generally advisable to enlarge the orifice of the wound by passing a sharp knife to the bottom of it, and convert the punctured into an incised wound, when it must be treated by injecting Veterinary Oil in all cases where it is possible to do so, and in all cases by keeping the Oil applied to the open wound or sore until it is entirely healed. Give also A.A. morning, noon and night; after which give I.I. morning and evening.
When a tendon is punctured and the thecal fluid escapes, the nature of the injury in no way differs from an open joint in the mode of treatment to be pursued, which will be found fully explained in the Section on open joint, page [44].