TECHNIQUE

Wound Management in Hedgehogs (Disease Investigation & Management)

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Summary Information
Type of technique Health & Management / Disease Investigation & Management / Techniques:
Synonyms and Keywords --
Description

 

This page has been prepared for the "Hedgehogs: Health and Management" Wildpro volume, and is designed for the needs of the following species: Erinaceus europaeus - West European Hedgehog

Before performing any clinical technique, the associated legal and ethical considerations should be consulted, knowledge of the potential complications/ limitations/ risk should be gained, and the level of expertise and qualification required must be ascertained.

Wound management should be performed by a veterinarian or under veterinary direction.

A close examination of the skin should be performed in all hedgehog casualty cases to check for the presence of wounds, which should be characterised in terms of age, size, location, degree of infection, etc.

Wound Types and Distribution:

The distribution and character of wounds typically seen affecting casualty hedgehogs often provide clues as to their cause:

Assessment & Management:

Handling and Sedation/Anaesthesia:
  • General anaesthesia is generally required for wound management, particularly in the first instance where prolonged and detailed examination is required and cleaning and debridement may be needed. (B22.27.w3, V.w26)
  • Daily wound care may be performed on a conscious hedgehog, provided that this is not too painful and that the area is accessible if the hedgehog curls into a ball. (V.w26)

Preparation:

  • Hedgehog spines should be clipped using sharp-edged blunt-ended scissors placed parallel to, and flush with, the skin surface. 
    • Clippers designed for clipping hair should not be used on the spined area. Spines should never be plucked. 
    • The wound may be protected with a small piece of damp cotton wool while the fur or spines are clipped to reduce further contamination f the wound during this process.
    • Sufficient areas of spines must be clipped to allow adequate visualisation and ventilation of the wound. 
      • However, the area to be clipped should be kept as small as possible since the spines are the hedgehog's method of defence. 
      • (see: Erinaceus europaeus - West European Hedgehog  - Social Behaviour / Territoriality / Predation / Learning).
    • Hedgehogs which have large area of spines missing or clipped may need to be kept until they grow out before they are released in order to provide protection from predation.

    (J15.21.w1, B156.7.w7, B284.6.w6, B337.5.w5, V.w26)

Assessment:

  • All wounds, particularly if long standing or/ and in warm weather are vulnerable to maggot infestation. (See: Myiasis)
  • Fully assess involvement of all local structures at an early stage. Injury to soft tissue structures and concurrent fractures may significantly alter the prognosis.
    • Use a sterile probe to investigate depth and communication of wounds as necessary. This is particularly important where maggots are present. All wounds must be checked carefully for fly eggs or maggots (see: Myiasis).
  • Severe wounds affecting the panniculus or orbicularis muscles may compromise the ability of the hedgehog to curl into a tight ball and therefore jeopardise its mechanism of defence. Serious consideration should be given at an early stage as to whether these cases will be suitable candidates for release (see: Erinaceus europaeus - West European Hedgehog  - Social Behaviour / Territoriality / Predation / Learning).
  • A decision must be made whether to manage wounds for healing by primary or secondary intention.
    • Fresh lacerations, for example strimmer wounds, which are often clean, may be appropriate for suturing.(V.w26)
    • Contaminated, chronic, flystrike-affected (See: Myiasis), puncture and pressure necrosis wounds, as well as those involving large skin/soft tissue deficits should be managed by secondary intention.(J15.21.w1, V.w26)
    • Bite puncture wounds are likely to become infected and, in the vast majority of instances should never be sutured.(V.w26)

Cleaning & debridement:

  • Dilute povidone-iodine, dermisol, or sterile saline may be used for wound cleaning as necessary.(V.w26)
  • Solutions which both cleanse and remove necrotic tissue (e.g. Dermisol multicleanse (Pfizer), Aserbine (Forley), are recommended for initial management. (B284.6.w6)
  • Salt water (one teaspoon of salt in a pint of boiled and cooled water) can be used as a basic solution for cleaning wounds. (B337.5.w5)
  • Dog-bite wounds should be cleaned using an antiseptic solution such as Savlon. (B259.w9)

Healing by Secondary Intention:

  • Rapid granulation and healing of large wounds may be promoted by the application of topical medication such as Intrasite gel (Smith & Nephew) or Orabase (ConvaTec). (J15.21.w1, B151, B284.6.w6, V.w26)

Suturing:

  • Following flushing and debridement as necessary, fresh wounds may be closed using standard suture techniques and drainage provided using fenestrated drip tubing. (J15.21.w1, V.w26)
    • Where the panniculus or orbicularis muscles are involved, the muscle layers must be identified and sutures should be placed in appropriate individual layers. (B22.27.w3)
    • Several layers of sutures are required to minimise the risk of their ripping out when the hedgehog tries to roll up. (B291.12.w12)
    • Dehiscence may result following suture of the heavy dorsalis caudalis muscle. (B22.27.w3)
  • For facial wounds in which the skin has been pulled out of place but injury to underlying structures is minor, the skin may be sutured back using fine suture material; it is essential to ensure that the skin surrounding the eyes is placed accurately. (B151)
  • Abdominal hernias (common following road traffic accidents) generally respond well to surgery. (B156.7.w7, B284.6.w6)
  • Puncture wounds should not be sutured; these should be kept open and clean. (B337.5.w5)

Dressings:

  • These may be required to prevent the patient from interfering with a wound. (B337.5.w5)
  • A non-adherent dressing such as a petroleum gel impregnated gauze may be used (or Melolin on clean wounds), covered with extra padding such as cotton wool and then bandaged in place. (B337.5.w5)

Nursing care/adjunct treatment:

  • Consideration should be given as to appropriate antibiotic, anti-inflammatory, analgesic and fluid therapy. (V.w26)
    • Strongly smelling foods may be advisable for an individual with an injury affecting the nose as the sense of smell may be reduced or lost temporarily. (B337.3.w3)
    • With nasal injuries not affecting the mouth, dry foods may be preferable to reduce the risk of continuous contamination of the wound with food material. (B337.3.w3)
    • Systemic and local antibiotics may be used to control or prevent bacterial infection. (B228.11.w11,  B259.w9)
    • Bacteriological culture and sensitivity should be performed where possible to guide appropriate antibiotic selection. (V.w26)
    • (See: Fluid Therapy for Hedgehogs)
    • Requirements for fluid therapy, analgesia and anti-inflammatory treatment should be carefully considered in burns cases. (See: Fluid Therapy for Hedgehogs)
    • Appropriate doses of analgesic and anti-inflammatory drugs are given in the pages of the Formulary.
Appropriate Use (?)
  • Full assessment of the severity of wounds and the likely prognosis should be made at an early stage and reviewed periodically. 
  • Severe wounds affecting the panniculus or orbicularis muscles may compromise the ability of the hedgehog to curl into a tight ball and therefore jeopardise its mechanism of defence. Serious consideration should be given at an early stage as to whether these cases will be suitable candidates for release (see: Erinaceus europaeus - West European Hedgehog  - Social Behaviour / Territoriality / Predation / Learning).
  • For severe wounds the option of euthanasia should be considered. See: Wildlife Casualty Euthanasia (with special reference to UK Wildlife)
Notes --
Complications/ Limitations/ Risk
  • Deep wounds may affect the hedgehog's ability to roll up. (B284.6.w6)
  • The dorsal, spined, skin of the hedgehog, which is loose fitting, heals relatively slowly, being less vascular than the furred areas.(B284.6.w6)
  • Wounds are often old, dirty and infected by the time a hedgehog presents for treatment, and may be infected by flye eggs/maggots (Myiasis).
Equipment/ Chemicals required and Suppliers
  • Appropriate cleansing solution.
  • Suture materials - various veterinary suppliers.
  • Topical preparations such as hydrogel preparations to encourage granulation and healing.
Expertise level/ Ease of Use Procedure should only be undertaken by an individual with appropriate clinical training and practical experience; for suturing of wounds this would usually be a veterinarian or someone with advanced veterinary technician training.
Cost/ Availability Costs may be variable depending on the type of treatment required. 
Legal and Ethical Considerations In some countries there may be legislation restricting the use of this type of technique to licensed veterinarians. For example in the UK: "The Veterinary Surgeons Act 1966 (Section 19) provides, subject to a number of exceptions, that only registered members of the Royal College of Veterinary Surgeons may practice veterinary surgery." (See: LCofC1 - RCVS Guide to Professional Conduct 2000 - Treatment of Animals by Non-Veterinary Surgeons).

Use of Drugs (Medication):

  • Before administration of any drug the manufacturer's datasheet must be consulted regarding operator safety, relevant withdrawal times etc.
  • Many drugs are not registered for use in particular species and care should be taken in their use, with proper regard for possible toxic effects. Consideration should be give to relevant legislation regarding the use of drugs.
  • In the UK, guidelines regarding the use of drugs are set out in the Royal College of Veterinary Surgeons Guide to Professional Conduct 2000: (See: LCofC1 - RCVS Guide to Professional Conduct 2000 - Choice of Medicinal Products).
Authors Becki Lawson (V.w26)
Referee Debra Bourne (V.w5), Suzanne I. Boardman (V.w6)
References B150.w1,  B228.11.w11,  B337.3.w3, B337.5.w5, )J15.21.w1, J138.60.w1, P8.3.w2, D92, V.w26, V.w44

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