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Wound Management - Donkey (view source)
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==Introduction==
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]]
'''[[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.