Download Wound Therapy Presentation: Acute deep laceration extending from

Wound Therapy
Presentation: Acute deep laceration extending from the anterior and medial aspect of the third
phalange to the anterior and medial aspect of the fourth phalange (left forelimb) with devitalized tissue
flap extending to the metacarpal pad on the underside of the affected foot acquired when patient
exuberantly entered river water when in training.
Patient: “Puff”, 5 year old, intact female, working/field trial Labrador Retriever, 57 pounds
Procedure: Surgical closure of deep traumatic laceration and use of Class IV laser therapy in
conjunction with medical and surgical treatment to promote wound closure and manage pain and
inflammation. The initial goal was to promote wound healing from surgical closure and manage pain
and inflammation. Upon wound dehiscence, abscessation, and sloughing of devitalized tissue, the goals
were modified to promotion of granulation tissue, wound healing, pain and inflammation management
through Class IV laser therapy, bandage treatments, and medical treatment with antibiotic, antiinflammatory, and pain medications.
Companion Laser Settings: The surgical site and surrounding tissue was initially treated daily for a
total of 8 sessions of the “Pain/Trauma” protocol (6.0W, 2 minutes and 45 seconds, 762 Joules). At the
time of and following the 5th daily treatment (when the wound dehisced and progressively sloughed
devitalized tissue for the next 2-3 days resulting in complete sloughing of the third phalange),
“Wound” protocol (2x2 area treated, 2.0W, 1 minute and 32 seconds, 124 Joules) was initiated in
conjunction with the “Pain/Trauma” protocol. Daily treatments were continued for a total of 15
sessions then decreased to every other day treatments using the “Wound” and “Pain/Trauma” protocol.
Figure 1: Day 7 when toe
sloughed tissue prior to
surgical debridement.
Figure 2: Day 7 prior to
surgical debridement and
laser therapy.
Figure 3: Day 7 after
surgical debridement
prior to laser therapy.
Figure 4: Day 15 . Exposed
bone still present but healthy
bed of granulation tissue
forming.
Figure 5: Day 15 . Underside
of foot with granulation tissue.
Figure 6: Day 22. Boney
tissue now covered completely
with healthy granulation tissue.
Figure 7: Day 22 . Almost
complete wound contracture
on underside of foot.
Figure 8: Day 24. Wound
contracture and significant
decrease in size of wound.
Figure 9: Day 60 from original
injury – pet has returned to
competition/field trials.
Overall Treatment Plan: Upon presentation, the patient was sedated with Dexdomitor and
Butorphanol to close the wound. Wound closure was difficult due to the amount of contaminated and
devitalized tissue. Her wound was aerobically cultured and antibiotics chosen based on culture results
(Amoxicillin trihydrate/clavulanate potassium and Enrofloxacin). Pain control was accomplished by
the administration of Carprofen, Tramadol and Class IV laser therapy. Bandage applications (wet-todry with the application of granulated sugar initially followed by a silicone patch) were performed
daily to every other day. A total of twenty one Class IV laser sessions were performed prior to the
patient being discharged back into the care of her trainer.
Results: Within 7 days of the sloughing of all soft tissue structures holding the third phalange in place
and the initiation of open wound management, the patient’s lameness had improved and the wound
contracture with healthy granulation tissue growth was significant. Overall, her wound healed much
faster than anticipated and the patient has returned to work and competition/field trials with no
significant decrease in function to the affected foot/limb. She is no longer maintained on any oral antiinflammatory medication or pain medications.
Testimonial:
“Puff, a 5 year old black Labrador female, working dog, suffered a severe laceration to her left front
foot on January 21. The injury resulted in the loss of her toe and the foot was a bloody mess. Rocky
Point Animal Hospital kept her as an inpatient. They were unable to simply sew the wound up due to
the extensive damage to tissue and had to manage the foot as an open wound. She was treated on a
regular basis with their Class IV laser therapy machine. I can only say that the proof is in the pudding.
Her healing rate was spectacular. She was released just over 4 weeks later, went back into training
wearing a boot for protection a week after that, and is today running competitive field trials less than 8
weeks after the accident. With the extent of the initial injury I was concerned that she would never run
again and would need to be retired. Her speedy recovery is miraculous, and clearly the laser therapy
played a huge part in that recovery.
I can’t say enough good things about Rocky Point Animal Hospital, their veterinarians, and the staff.
In their state of the art facilities with all the latest equipment they repaired, treated and loved on Puff as
if she was one of their own.” – Mark Menzies, Owner of “Puff”
“Throughout my years of working as a small animal practitioner, I have had the opportunity to manage
numerous wounds where simple closure was not an option due to the decreased viability of tissue,
infected tissue or the plain lack of tissue to perform closure without grafts. I have had the most success,
with the shortest recovery times, when using Class IV laser therapy in conjunction with bandage
therapy, antibiotics (as necessary), and anti-inflammatory/pain medications. This technology has also
made our patients significantly more comfortable during the healing process.
Aside from wound management, the opportunities to use Class IV laser therapy are countless – I have
numerous patients that flourish under the anti-inflammatory/pain and healing effects of our Companion
Animal Class IV laser. I feel it has been nothing but a positive modality of treatment for so many
patients in our hospital.” – Dr. Johanna Burnette
Case Study & Testimonial: Johanna Burnette DVM, Rocky Point Animal Hospital, Rocky Point,
North Carolina. Photographs provided by Johanna Burnette DVM. Class IV laser sessions performed
by Sarah Drake, Alicia Bullard, Ashton Creech, Kara Bush, and Charman Vincent.
HOURS:
Monday-Friday 8:00am until 6:00pm
Saturday 8:00am until 12:00pm
Rocky Point Animal Hospital
Rocky Point, NC
910-602-6633