Page 79 - Veterinary Laser Therapy in Small Animal Practice

Pointing light at soft tissue: clinical applications 65

(a) (b) (c)

Figure 7.6 (a, b) A 3-week-old bite
wound in a Greyhound presented with
dehiscence and some necrotic tissue.
(c, d) After five LT treatments with 5
J/cm it was debrided and granulated,
2
ready for suturing. The wound was also
lavaged and covered with a bandage,
using alginate as primary dressing.
When alginate is saturated and ready
to be changed, it has this jelly-like
appearance, which should not be
(d) (e) mistaken for infection. (e) The sutures
were removed 12 days later.

tool, tissue healing is going to be enhanced. Well, of rule, wounds are better if covered; moist wound care
course wound care is at least as important as LT. has been proven better for a long time in humans, and
• If you do moist wound care and you do not want is gaining ground in veterinary medicine, as opposed to
to remove the primary dressing, would the light the old paradigm of “let it dry and breathe.”
be absorbed in the same way through alginate, a For highly exudative wounds, especially if some
hydrogel, or a transparent film? The answer is no: debridement is needed, one of the best contact layers to
some material will transmit much more light to the choose is an alginate dressing, either with plain calcium
underlying tissue and we will discuss this here. alginate or silver-impregnated. It is also hemostatic; but
remember you do not want to laser an active hemor-
Appropriate dressings and bandages prevent trauma rhage though. This is more often used whenever there
(including self-trauma) and contamination. When is still some debridement to do and a higher amount of
properly used, they contribute to patient comfort and exudate to evacuate. Bandage changes are performed
can help remove exudates and create an optimal envi- every 24–72 h, depending on how fast the dressing
ronment for wound healing. The selected type of dress- saturates. When it is ready to be changed, it looks like
ing depends on the amount of exudate you expect and jelly and comes off very easily, making the change com-
the phase of healing the wound is at, but as a general fortable for the patient (Fig. 7.6). If the alginate dressing

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