How To Heal An Open Wound

How To Heal An Open Wound

by Elisa Black-Taylor
(USA)

Sealys Head Injury

Sealys Head Injury

Sealys Head Injury Sealy posing Another of Sealys wound

I feel I've had a crash course in how to heal an open wound in dealing with our car fan blade injured cat Sealy. I want to share some of what I've learned with the readers at pictures-of-cats.org.


Looking cool. Photo by Elisa.

The reason I want to share what I've learned is we've made a lot of mistakes and near mistakes while dealing with his very horrific injury. His original story can be found here: Treating a Cat with a Car Fan Blade Injury.

It's been difficult dealing with the time frame it may take for Sealy's injury to heal. Slow progress is very hard to watch. He was injured by a car fan blade two months ago and we're still dealing with a very exposed wound. In this instance, this is how it must remain in order for it to heal properly.

The vet measured it over the weekend and the size at this point is 3cm. X 4cm. It had crusted over just a tad and Sealy hadn't knocked that part of his scab off. As it turned out, Sealy has been properly caring for his wound on his own. There was a bit of infection under the scab and on top of the wound. It was so minute as to not be a major concern.

An open wound must remain open in order to heal. If it scabs over, infection may form under the scab and on top of the wound. Scabs are there for a purpose - to protect and allow the skin underneath to reform and heal. But in Sealy's case infections formed under the scab so the wound has to be open and the environment kept sterile (which protects the wounded area).

Infections can't be allowed happen in as serious an injury as Sealy has. It would be a large area for infection to gather and it could prove dangerous for a wound of that size. I looked at several diagrams online of how an open wound heals. First tissues build up and repairs itself at the bottom of the wound. This isn't seen by the eye and there are a lot of long words to describe what the cells are doing to repair themselves.

After the wound has healed from the bottom, it will begin to heal from the sides. In other words, the circle will become smaller and smaller over time.

I read it can take months (and months and months) for a severe injury to heal. The main thing we must do, we are advised, is to keep the scab picked off and to keep Sealy in as sterile an environment as possible.

Sealy's still living in his large cage at night. We do take him out and hold him for several hours a day. He also lays on his blanket on the couch. Please don't think us cruel for continuing to keep him in a cage. Any bacteria that gets into the wound could cause serious problems. His bedding is changed as soon as it's soiled. Everything is washed in hot water. The white sheets we use are washed in hot water with bleach. Liquid fabric softener is used with each load to ensure his bedding is soft so as not to scrape his open wound.

By the way, his favorite thing is ear rubs behind his good ear.

Sealy's vet told us to put Preparation H on his wound twice a day. I thought this was a stupid way to heal an open wound. Why not use triple antibiotic or hydra cortisone or burn cream? The Preparation H has turned out to be an excellent cream for a open wound. This keeps it moist and also cuts down on any itch. We believe Sealy suffered a lot of nerve damage because he doesn't even flinch when we drop the ointment onto his ear wound. The ointment is cold and should get a reaction out of him if he had any feeling in the area.

In my opinion, this remedy is very valuable information for cat owners as it doesn't cause the wound to become infected. If you read the instructions on most first aid creams, they all state "do not use in open wounds."

It's almost comical some of the ways we tried to protect Sealy from himself before the vet explained why the wound shouldn't be allowed to scab over. I cringed every time I found Sealy had knocked his scabs off while grooming. Since the injury would be severely irritated by an Elizabethan collar, Laura and I both got really creative in protecting the area. Here are some of our efforts.

- Bandaged left front and left back paws with gauze and surgical tape. Sealy pulled it off.

- Placed infant socks on left front and left back paws and secured with duck tape. Sealy pulled it off.

- Placed a hooded flannel garment on Sealy and pinned hood under his chin to make it tighter and protect the wound from his unwrapped paws. He managed to push the hood back and scratch anyway.

- Placed the hooded flannel garment on Sealy. Then placed infant socks on front and back left paws and pinned socks to underside of flannel garment using very large infant diaper pins. Sealy slipped out of the socks.

After those failed attempts, we finally gave up and returned to trying to keep his left paws wrapped. I worried because the tape and the gauze could both knock off the scabs while he was washing up. Our goal became to keep him from drawing blood when he groomed himself.

So for the past week we've had a cat who would groom himself and knock the scabs off each time.

Which turned out to be exactly what was supposed to happen in order for it to heal. Sealy knew best after all!

As of this past Saturday, his left paws have remained wrapped. We have to change the bandages every few days when they begin to look soiled. His wbc (white blood cell) count has dropped from 64000 to 16000, which is excellent. The vet had never seen such a high count and at the same time the cat not be on deaths door. His weight has climbed from 5.5 pounds two weeks ago to 6.0 pounds over the weekend. And his temperature has dropped from 104.5 to 102.5F. His antibiotic was changed from Baytril to Clavamox due to the wee bit of infection dripping from under the one scab Sealy had missed knocking off.

Sealy will continue to visit the vet until he's healed. His inner ear still has a lot of infection. A lot of people have asked me if he can hear out of that ear. We don't know and we don't care. We do know Sealy can hear out of the uninjured ear. He perks up whenever I say his name. Our main concern isn't his hearing ability. Healing the open wound is our main priority. The rest will just have to fall into place.

We're also not going to have a bunch of tests run to find out if there's brain damage or nerve damage or whatever. These tests would be very expensive and wouldn't change how Sealy is. We love him regardless and he's been through enough. Most of the tests people have wanted us to do would require anesthesia and would also place him under more stress than he's already experienced. Sealys just Sealy, missing ear and lopsided head and all the rest that goes along to make him a very special cat.

He's a survivor. A very hungry one, if I do say so myself. I don't know how much of his food is going into repairing his body, but Sealy has convinced us human servants that five packets a day of his favorite food - Whiskas Purrfectly Fish - is a good start. This is supplemented by baked shredded chicken breast.

I never knew how to heal an open wound until Sealy came along. Now I feel I've had to become an expert on the subject.

Do any of you have any tips to offer me? We still have a long road ahead of us until he's healed and I just want to do what's best for my baby.

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How To Heal An Open Wound

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Apr 18, 2012
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products changing
by: elisa

You've got to be careful with products changing. Kaeopectate was once used on cats but now has the bismuth which I think is bad for cats. My drug vet didn't know that.

I'm really glad the wound is to heal open. His skin is getting thick there. Can you imagine a full scab forming and then gettting knocked off multiple times. Each time taking a large hunk of tissue with it. Now that would be dangerous. You'd have infection and blood and everything else to deal with


Apr 18, 2012
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Tiny retraction
by: Anonymous

Ignore my FB comments -- it seems that the ingredients of Preparation H have changed over the years. It now contains these active ingredients: Hydrocortisone, for itching; phenylephrine, a vaso-constrictor (narrows blood vessels, calms swelling) and pramoxine, a local anesthetic for pain.

Inactive ingredients: benzoic acid, butylated hydroxyanisole, corn oil, glycerin, lanolin, lanolin alcohols, methylparaben, mineral oil, paraffin, propylparaben, purified water, shark liver oil, thymus vulgaris (thyme) flower/leaf oil, tocopherols excipient, white wax

I know that Thyme oil is a very powerful anti-microbial.

I posted on the FB page about the yeast because at one point in time, many years ago, I [TMI WARNING!] was using it for its typical usage at the same time I was being treated for a vaginal yeast infection. It honestly felt like someone detonated an IED inside me! I had to go back to the doc, who explained that my body was not only fighting the yeast in the front parts, but now also the back. It ended up being two of the most miserable days of my life!!

Anyway, my original point still stands: Prep H makes a lot of sense as a wound care product, so I am happy for Mr. Sealy and the fantastic care he's getting all around!!


Apr 18, 2012
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Vet Techs
by: Ruth (Monty's Mom)

Elisa would make an excellent veterinary assistant, but in the USA that job would undoubtedly include assisting in some way with declawing cats. There isn't one vet in my area that doesn't do it at all. I thought too that I'd enjoy working in a vet's office if I got tired of other things-- I do thrive on variety. I'd never do it now that I know what I'd be required to be a part of. Do vets realize how many excellent people they will never be able to employ until they stop declawing?

I learned about wound healing studying to be a physical therapist assistant. I remember learning how it closes from the outside in and we learned how to measure wounds. I have not had to measure any wounds working as a PTA and probably never will unless I am part of a wound care team. For the most part, physical therapy is nursing without the pus, which is fine with me. Changing bandages is boring. I'd much rather help people walk. It's great to know what you like and what your calling is. Elisa certainly has a calling to work with animals-- it would be nice if she could get paid to do it somewhere, but not be asked to do anything unethical either.


Apr 18, 2012
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Cool pic
by: Michael

Sorry I added the Mr Cool pic late (Sealy in bandana). Nice photo. Good idea.


Apr 18, 2012
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size
by: elisa

I believe it has more to do with how large the wound is. It leaves the possibility for a lot of infection to form. No vet tec for me. I'm too squeamish. At least I used to be...


Apr 18, 2012
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Interesting
by: Michael

You nurse him with great commitment. Impressive. I would have thought, though, that there would come a time when you allow a scab to form. Scabs are natural and serve the purpose of protecting the body where the wound is so that the skin can heal over.

Scabs normally speed up the healing process. I guess in the case of Sealy, there is the increased danger of infection forming under the scab so you have to remove it.

I wonder if the risk of infection forming under the scan is because Sealy had or has an infection inside the ear canal that is a separate medical health problem.

Thanks for posting Elisa. You have acquired so many skills. You must be employable as a vet tech by now! Just a thought.


Apr 18, 2012
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for the record

by: elisa

In the side view you can see bits on scab caught in his fur. These are what we have to remove after he grooms himself. He was washing up as I took that photo.



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