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| | + | ==Introduction== |
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| | + | The donkey is liable to skin injury through its relatively exposed limbs and |
| | + | the circumstances of its management. <u>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.</u> 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 cases, 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. Management 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 section describes the principles of wound management under these headings: |
| | + | <big> |
| | + | '''[[Wound Management Basics - Donkey|Basic wound management]] |
| | + | |
| | + | '''[[Healing Fundamentals - Donkey|Fundamentals of healing]] |
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| | + | '''[[Wound Healing Inhibition Factors - Donkey|Factors that inhibit wound healing]] |
| | + | |
| | + | '''[[Wound Types - Donkey|Wound types and their management]] |
| | + | |
| | '''[[Maggot Therapy - Donkey|Maggot therapy for wound treatment]] | | '''[[Maggot Therapy - Donkey|Maggot therapy for wound treatment]] |
| | + | </big> |
| | + | ==Conclusion== |
| | + | |
| | + | Wound management is one of the most expensive clinical procedures |
| | + | in equine practice and decisions must be taken carefully with specific |
| | + | clinical intentions. Delays in wound healing are expensive and also result |
| | + | in significant welfare considerations for the horse or donkey as well as |
| | + | extra stable management, so it is important to repair the wound as soon |
| | + | as practicable. |
| | + | |
| | + | It is also important to remember that there is nothing prescriptive |
| | + | about the clinical management of a wound, because no two wounds are the |
| | + | same. The clinician will need to consider carefully the whole wounded area |
| | + | and carry out appropriate procedures that will encourage and speed up the |
| | + | healing process. The basics are clear. The wound care should be directed |
| | + | towards healing as early as possible and with the minimum number of |
| | + | complications. This means that at every stage the wound must be examined |
| | + | carefully and thoroughly. Management may have to change and there may |
| | + | be some circumstances when some harm has to be done in the expectation |
| | + | that it will help in the end. Promises of a rapid recovery, however, are unwise |
| | + | and almost always unrealistic. A few wounds heal amazingly well and others |
| | + | that should do so simply fail to heal for no easily defined reason. |
| | + | It is wise to keep the owner informed of the reasons for each decision |
| | + | so that disappointment and acrimony can be avoided. |
| | + | |
| | + | ==References== |
| | + | |
| | + | * Knottenbelt, D. (2008) The principles and practice of wound mamagement In Svendsen, E.D., Duncan, J. and Hadrill, D. (2008) ''The Professional Handbook of the Donkey'', 4th edition, Whittet Books, Chapter 9 |
| | + | * Knottenbelt, D.C. (1997). ‘Equine Wound Management: Are there significant differences in healing at different sites on the body?’ ''Veterinary Dermatology 8''. pp 273-290. |
| | + | * Mulder, J.B. (1989). ‘The medical marvels of maggots’. ''Journal of the American Veterinary Medical Association 195''. pp 1497-1499. |
| | + | * Pascoe, R.R., Knottenbelt, D.C. (1999). ''Manual of Equine Dermatology''. W. B. Saunders, London. |
| | + | * Wilmink, J.M., Stolk, P.W.T., van Weeren, P.R., and Barneveld, A. (1999). ‘Differences in second intention wound healing between horses and ponies; macroscopical aspects’. ''Equine Veterinary Journal 31''. pp 53-60. |
| | + | * Winter, G.D. (1962). ‘Formation of the scab and the rate of epithelialisation of superficial wounds in the skin of the young domestic pig’. ''Nature 193''. pp 293-294. |
| | + | |
| | + | Further reading: |
| | + | |
| | + | Knottenbelt, D.C. (2004). ''A handbook of Equine Wound Management''. W.B. Saunders, London. |