Lacerated toe pad - Page 3

**Burns** · 06-16-2008, 04:55 PM

Good thoughts - I don't know of anything else that would effectively hold the wound together with his degree of weight bearing besides sutures. The surgical glue wouldn't hold, and I don't think he'd leave his foot alone if I put any sort of contraption on it to hold the pad closed.

Healing by second intention means the wound has to heal from the inside out without surgically debriding it and closing it. Picture a V shaped cut, which would be a cross-section of the wound. The granulation tissue starts at the bottom of the V and granulates upward, healing from bottom to top. Sometimes the topmost layer of each side of the top of the V will need to be snipped off as it curls in, but theoretically, the wound should heal ok on its own, but it will take awhile.

Since he doesn't seem overly painful and seems to be leaving the wound alone for the most part, I am willing to try treating it this way and hopefully avoid anesthesia and sutures and having to worry about the sutures popping or him ripping them out.

Thanks for the reply. I think out loud myself a lot too, which you've probably already noticed by now

**dobermansrule** · 06-16-2008, 05:44 PM

Quote:

Originally Posted by Burns

Good thoughts - I don't know of anything else that would effectively hold the wound together with his degree of weight bearing besides sutures. The surgical glue wouldn't hold, and I don't think he'd leave his foot alone if I put any sort of contraption on it to hold the pad closed.

Healing by second intention means the wound has to heal from the inside out without surgically debriding it and closing it. Picture a V shaped cut, which would be a cross-section of the wound. The granulation tissue starts at the bottom of the V and granulates upward, healing from bottom to top. Sometimes the topmost layer of each side of the top of the V will need to be snipped off as it curls in, but theoretically, the wound should heal ok on its own, but it will take awhile.

Since he doesn't seem overly painful and seems to be leaving the wound alone for the most part, I am willing to try treating it this way and hopefully avoid anesthesia and sutures and having to worry about the sutures popping or him ripping them out.

Thanks for the reply. I think out loud myself a lot too, which you've probably already noticed by now

I think the challenge in your approach, obviously,is that it is the front foot of a very active doberboy which means almost constant forces on the pad, reopening the wound. Is there any chance that it would just heal itself as a split pad?

**Burns** · 06-16-2008, 06:39 PM

Quote:

Originally Posted by dobiesrule

I think the challenge in your approach, obviously,is that it is the front foot of a very active doberboy which means almost constant forces on the pad, reopening the wound. Is there any chance that it would just heal itself as a split pad?

It will likely heal with a wide scar and a slight divit - thankfully, I don't think it was quite deep enough to heal as a split pad.

I just got done soaking it and swabbing it out with a cotton swab, and it actually looks really good today. It looks less deep than yesterday, if that's possible. Maybe the collasate really helped last night. I'm going to do it again tonight. I'm very optimistic that this is going to heal just fine if it keeps up how it looks today

Poor Redders is really doped up on the buprenorphine though. I don't think I'm going to give him any more of that...

**Doberdog** · 06-17-2008, 08:17 PM

Poor Redders, how did he do today? Does it look less deep again today? I hope so. Keep us updated on his progress, we will all learn from you. Give him a kiss on his foot for me.

**Lexus** · 06-17-2008, 09:14 PM

Poor guy! When we adopted Harley back in 01 he had a lacerated pad on his front paw.

The rescue (I know now) was bad b/c he was anamic from fleas and she had never treated the injured paw, he had a piece of cloth wrapped around an infected paw

lol, not to mention he wasn't neutered.

Neither here nor there, sorry

Anyway his was severe enough to need surgery. He had a bit of pad removed and the remainder stitched together. I had a retrofitted IV bag to use for a cover on the foot anytime he needed to go outside. It was so long ago that I can't remember how long it actually took to heal up, I want to say it was nearly three weeks to a month. It seemed to heal rather slow, but then again, his was pretty ugly b/c of how long it had taken to get taken care of.

**Burns** · 06-17-2008, 11:15 PM

Quote:

Originally Posted by Doberdog

Poor Redders, how did he do today? Does it look less deep again today? I hope so. Keep us updated on his progress, we will all learn from you. Give him a kiss on his foot for me.

aww thanks so much for asking, Doberdog! I really appreciate it. You guys have all been great with all your love and support

Redders is doing ok today - the wound looks good. Nice and clean and pink, not swollen or irritated at all. I've been soaking two-three times a day, and then swabbing it out. I've been able to pull a little debris out each time and make it bleed a little, which is good, because debriding the edges of the wound and making it bleed will stimulate more epithelial cells to form and heal up the wound. Then I put some triple antibiotic ointment in it. At night, I do the Collasate instead of the triple antiobiotic and put a boot on him. But every morning, the boot is off! Even after taping! Clever boy... But it's a cheap-o snow boot that I bought ages ago, so I ordered a bootie/sock that goes up higher on his leg so I'll try that. And I'm ordering a Thera-paw boot just in case.

I'm not going to give him any more buprenorphine - the opiate made him way stoned and dysphoric, even at a low-end dose. He just stood there whining and drooling and staring out into space. I felt soo bad

It wore off after about 6 hours and he was back to is normal bouncy self. So no more of that.. but I'll keep him on the Metacam, which is a NSAID, so he should do fine on that, though I'm going to check his urine specific gravity and make sure he is still concentrating his urine normally on it. I just don't want him to be painful while I'm swabbing out the wound rather vigorously.

By the way it's looking, I'm confident it will heal ok. It's just going to take some time.

Quote:

Originally Posted by Lexus

It was so long ago that I can't remember how long it actually took to heal up, I want to say it was nearly three weeks to a month. It seemed to heal rather slow, but then again, his was pretty ugly b/c of how long it had taken to get taken care of.

These paw injuries take forever to heal because of the degree of weight bearing and the likelihood of more trauma/infection during healing. I'm anticipating a month or more before seeing it filling in appropriately. I know all about healing by second intention after my wrist slash accident and having it heal from the inside out. It takes a looong time!

robinb · 06-17-2008, 11:19 PM

I'm glad to hear that Red is doing better.

**Burns** · 06-18-2008, 11:34 AM

Here's some pics of Red's wound this morning. It doesn't look as deep to me as the last set of pics I posted. The top edges are starting to heal which isn't necessarily good because then they won't heal together, but I think it'll still be fine. It'll have to heal from the bottom-up and fill itself in.

He's such a good boy letting me treat his foot

thea2003 · 06-18-2008, 11:38 AM

Looks pretty healthy to me, looks like it is healing nicely.

Santa · 06-18-2008, 05:00 PM

Looks much neater around the edges and nice and clean. What a sweetiepie!