New page: {{review}} '''Definition: a wound that has components of one or more of the other types that is complicated '''by factors that either preclude simple [[Healing Fundamentals - Donkey#Pr...
{{review}}

'''Definition: a wound that has components of one or more of the other types that is complicated
'''by factors that either preclude simple [[Healing Fundamentals - Donkey#Primary or first intention healing|primary union]]
'''or are likely to result in serious delays in healing.'''

[[Image:Facial injury.jpg|left|thumb|250px|<small><center>This facial injury was complicated by severe damage to the facial nerve resulting in facial paralysis and an oro-cutaneous-nasal fistula (direct communication between the skin wound and the mouth and nasal cavity). The wound had been in existence for some 10 days before presentation and the bone underlying the wound was necrotic. There were therefore significant complications and reasons why the wound was likely to heal slowly, if at all. (Image courtesy of [http://drupal.thedonkeysanctuary.org.uk The Donkey Sanctuary])</center></small>]]
[[Image:Facial injury 2.jpg|right|thumb|250px|<small><center>Oro-cutaneous-nasal fistula (Image courtesy of [http://drupal.thedonkeysanctuary.org.uk The Donkey Sanctuary])</center></small>]]

Complicated wounds are commonly seen in equine practice. The
management of complicated wounds is always problematic. Some require
careful anatomical reconstruction and others require various other
techniques. In all cases the wound management procedure must be followed
carefully.

Initially the wound must be protected from further damage until
a detailed exploration can be performed. For this reason it is common
practice to apply a hydrogel and a dressing while the animal is moved to a
suitable facility. Involvement of other organs or structures may be more
significant than the skin injury itself. One of the most critical factors is a
full exploration of the wound. In some cases this can be performed with
the sedated standing animal but in others a general anaesthetic is advisable.
The extent of the injuries may mean that the skin wounds are insignificant
(e.g. compound fractures of the limb bone, open body cavities, etc).

Healing depends on the extent of damage and ability of the structures
involved to heal.

==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


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