Appendix A: Class VIII Medical Materiel

K9 Wound Management: This is intended to be a resource for CPG-directed wound care (initial lavage/debridement, bandaging, dressing changes, culture collection, and advanced therapies)

#### Basic Cleaning & Irrigation

Sterile normal saline (0.9% NaCl) or Lactated Ringer’s Solution (LRS) - multiple liters

Bulb syringe(s)

Large-bore gravity irrigation tubing/bags (IV tubing adapted for gravity irrigation)

Optional: Pulsatile (battery) lavage device & spare batteries

#### Wound Preparation & Clipping

Water-soluble sterile lubricant (surgical lubricant) - liberal use to protect wound bed during clip/clean.

Electric clipper with sterile blades.

Surgical scrub solutions (chlorhexidine or povidone-iodine)

#### Debridement & Minor Operative Supplies

Scalpel handles & blades (various sizes) - sharp debridement.

Metzenbaum/mayo scissors - dissection and debridement.

Hemostats/forceps (Brown-Adson, Debakey, mosquito) - tissue handling.

Sterile drapes/impervious drape material

Monofilament suture (2-0 and larger) for tie-over bandages

Umbilical tape/surgical mask ties

#### Bandage Materials & Dressings

Sterile gauze sponges (4x4 or similar)

Laparotomy sponges - for large wound primary packing

Non-adherent dressings (e.g., Telfa pads).

Topical agents:

- Moisture retentive dressings (e.g., calcium alginate, polyurethane foam, hydrocolloid, hydrogen)
- Triple-antibiotic ointment (bacitracin/polymyxin/neomycin)

Roll cotton/cast padding (soft roll)

Conforming gauze/elastic conforming bandage

Adhesive tape (paper/waterproof surgical tape)

Sterile gloves (various sizes), gown, masks

Adhesive spray/skin prep (optional) (e.g., DuraPrep™)

#### Advanced Wound Care & Adjuncts

Negative pressure wound therapy (NPWT) device kit (e.g., WoundVac) and canisters. CPG recognizes NPWT as viable but requires training and frequent sedation; recommended to consult veterinary staff.

Splinting materials (if wound requires immobilization) and padding.

#### Analgesia, Anesthesia & Sedation (for Debridement/Bandaging)

Analgesics/sedatives appropriate for MWDs (opioids, alpha-2 agonists, ketamine, benzodiazepines, reversal agents where applicable) - per CPG advise to provide effective analgesia/anesthesia based on severity. (See K9 Analgesia and Anesthesia for more detailed anesthesia guidance.)

Local anesthetics (lidocaine 1% or 2%) and syringes/needles

Airway & oxygen supplies if general anesthesia/sedation is used (oxygen, ET tubes, laryngoscope)

#### Systemic Antibiotics & Other Medications

A formulary of systemic antibiotics appropriate for dogs and dosing references. (The CPG states systemic antibiotics are indicated for moderate/severe wounds and recommends continuing at least 7 days; consult Table 3 antibiotic guidance). Do not administer without veterinary oversight.

#### Miscellaneous & Patient Protection

Elizabethan collar alternatives (bucket collar, “cone” or improvised plastic bucket with bottom cut out) to prevent chewing at bandage.

Towels/blankets for positioning and to minimize patient movement during procedures

Sharps containers and biohazard waste bags

Documentation forms/wound tracking flow sheets (for daily evaluation and bandage change tracking)

For additional information including National Stock Number (NSN), please contact dha.ncr.med-log.list.lpr-cps@health.mil

DISCLAIMER: This is not an exhaustive list. These are items identified to be important for the care of combat casualties.