Infection Control Protocols for Wound Management

Wounds are presented almost daily within practice, whether a surgical wound, a laceration, an abrasion, puncture or degloving. Depending on the nature of the wound, our treatment protocols will vary; however, the way we approach a wound from an infection control standpoint should not.

Thinking About Protocols

Are there any standard protocols in your practice with regards to how wounds are handled? It would be worth asking if you are unsure, and if there are protocols in place, it is worth checking that all staff members are aware of them.

Considerations for Infection Control Protocols

Whether a protocol is in place or the practice is looking to implement a new set, the following points should form part of your Wound Management protocol.

• Before handling a wound, hands must be washed
• Correct PPE must be worn, including gloves, aprons. Where there is a risk of aerosols contamination, eye and face protection should be worn
• The area where the patient is being examined should be covered, ideally with an absorbent clean inco-sheet, especially for flushing and lavage
• Equipment should be within easy reach and cleaned prior to and immediately after handling, for example, clippers (see Clipper Maintenance in the resources area), scissors, stethoscope etc
• Prepare the environment with any dressing materials that are expected to be used placed within easy reach
• If the situation arises that a staff member needs to leave the area to collect any materials required, then all PPE must be removed and replaced on return

Dealing with Infectious Cases

Occasionally in practice, a wound will be presented, which gives everyone a bit more cause for concern. It is not uncommon for some wounds that are ‘stuck’ in the Proliferation or Granulation stage, to be contaminated with bacteria. Laura RVN, Pioneers’ wound care advisor, has dealt with cases where wounds are confirmed as positive for MRSA or Pseudomonas. These wounds must be managed much more stringently, and having appropriate biosecurity protocols for effective infection control is paramount.  

Protocols for Infectious Cases

• PPE for every interaction with the animal to include: Gloves, Full Protective Gown, Overshoes, Face and Eye protection for aerosols if appropriate
• Ensure all hair is tied up, and no elements of uniform/personal wear are exposed to the patient

Examination Protocol

• The animal should be examined at the end of the day, after all other patients have left the building
• Minimal members of staff should be handling the animal, ideally only two
• All PPE to be worn
• The animal should be examined in a room that is not in a thoroughfare, and ideally has limited use during the day
• Inco pads ideally should be placed on the examination table and floor mats or inco sheets again on the floor, to collect and retain any fluid whilst flushing the wound
• A clinical waste bin should be ready so that all waste can be disposed of immediately
• Any dressings that are opened and not used to be disposed
• Once treated the animal should be returned immediately to the owner, without being placed on the floor

Cleaning Protocol

• Dispose of all waste immediately, and waste bags sealed and placed for incineration
• Wearing clean PPE, the room should be thoroughly disinfected using Clinell wipes. Every surface needs to be disinfected – if not using Clinell, then check contact times and dilution rates of disinfectant
• Ideally, an 'Air bomb' such as Airgene, Airstell or ProXL should be used as well after each treatment
• Personnel should consider laundering their uniforms at the practice, changing before they go home, and using Persil Professional washing powder