Any disruption of the hide, or surrounding body surfaces, is known as a wound. Most wounds are classified as being open, with a break in the hide through which ichor may escape. This, however, disrupts the normal impenetrable barrier to infection, as germs may enter via the route of injury.
How the wound is created determines the type of the wound and also influences the treatment given. Incision wounds are made by a clean cut from a sharp edge, such as a knife. There may be profuse ichoring because the edges of ichor vessels are cut straight across. Generally, this type of wound is rare in a dragon, and is usually the result of some surgery on the part of the dragonhealer. Lacerations are rough tears caused by crushing or ripping forces, generally from another object/dragon. Lacerations may ichor less profusely than clean cut wounds; though there is more tissue damage. Contamination risk from germs and subsequent risk of infection is high. These may happen during a mating flight when talons may shred the hide of an opponent. Abrasion wounds are superficial wounds in which the top layers of the hide are scraped off, leaving a raw tender area, and are caused predominantly by a sliding fall or a friction burn. They often contain foreign particles that may cause infection. In dragons these can occur from brushing against rock, bad landings on hard dirt, etc. Puncture wounds are caused by the entry of a sharp foreign body into the hide, such as stepping on a needlethorn. They are characterized by having a small site of entry but a deep track of internal damage. As dirt and germs can be carried far into the body risk of infection is high. Generally, because dragon hide is so thick, these injuries are extremely rare, but may occur in the frenzy of blooding with sharp bone fragments from the herdbeasts and wherries. Threadscore is similar to an incision wound in tissue damage, but with the complication of a burn. Depending on the resultant damage, threadscored wounds may ichor profusely or ooze slowly.
Several of these wound types can cause serious ichoring, and it is imperative that a dragonhealer learn to recognize the various types of ichoring from the various types of vessels. With arterial ichoring, the ichor is dark green and under pressure from the pumping hearts. Therefore, ichor is spurted from the wound in time with the heartbeats. A severed artery may produce a jet of ichor several feet high and can rapidly empty the circulatory system of ichor. These are extremely rare since arteries are found deep under a dragon hide, but may be encountered in wing injuries where the tissue is much thinner. With venous ichoring the ichor is a brighter green in coloration. It is under less pressure than arterial ichor, but since the vein walls are capable of great distention, ichor may pool. Thus, ichor from a severed major vein may gush profusely. Capillary ichoring can be characterized as oozing and occurs at the site of all wounds. Although capillary ichoring may at first be brisk, ichor loss is generally negligible. When the ichor vessels are severed or torn, their damaged ends constrict and retract in order to minimize ichor loss. At the same time, the ichor that escapes from damaged vessels begins to clot. However, the physical condition of the dragon will deteriorate exponentially to the amount of ichor lost. At first, the heartbeats will increase in tempo, the gradually the skin will grow gray, as the hearts divert ichor to the major organs. Eventually shock will become evident, which will be followed by the dragon becoming unconscious and life eventually failing.
One of the greatest dangers with any wound is that of infection. Wounds should always be cleansed with redwort, and care should be taken to remove all dirt and other foreign objects.
Assess the situation: If the dragon is in pain, then ask a Gold to 'dampen' the pain and still the movement. Involve the rider. Ask the rider for details of the injury. If this is the result of a mating flight, make sure you start handing the rider skins of wine. Take control of the situation, but never forget to ask a rider first for permission to approach their lifemate - big dragon, in pain, equals a dangerous combination.
Determination: What type of ichoring do you have? Is the ichor gushing, oozing, or spurting? Is this a slight, moderate or severe injury?
Treatment:
1. Clean wound with redwort.
2. Slather with numbweed. Remove any dirt, foreign articles etc.
3. If ichoring has not stopped, apply a pressure bandage to the wound. A pressure bandage is merely a pad of bandaging material that is applied over the wound and pressed tightly in place. If this soaks through, it should not be removed; instead, a second bandage should be applied on top of the first. In most cases, this will be enough to stop ichoring.
4. If ichoring is severe and does not respond to a pressure bandage, or if ichor is gushing/spurting from a wound, stronger measures are needed. Apply pressure to the vessel feeding blood to the area if possible. This may entail having an assistant physically clasp the vessel and stopping ichor from escaping in such large quantities. If not, quickly (time is of the essence here), use surgical clamps to restrict the flow/loss of ichor.
5. The vessel then needs to be sutured to the severed end as quickly as possible. The longer the tissue is without ichor the less healthy it will become. However, this is no excuse for rushing and making mistakes!
Sutures:
a. Do caution anyone that's distressed by the thought of stitches to look away.
b. Using a steel needle, and the treated thread (soaked in a redwort and hot wax solution), make small, neat stitches. Take care in making sure the edges of the wound are drawn together, but not tightly. Tight stitches will cause puckering of the surrounding hide, and may become impossible to remove. Always make as few stitches as possible but make sure the wound does not gape. You need this to be a barrier to infection.
c. First stitch in one side of the wound and then in the other with the same piece of thread.
d. Loop one end twice over the other and tighten, this will form a knot.
e. Clip the excess and start of the next stitch.
f. Apply more numbweed.6. Remove the clamps slowly, check for any formation of ichor. You may have to clear some of the numbweed away with oil-soaked pads to see clearly.
7. Reapply numbweed.
8. Suture any wounded muscle together and then finally the hide.
9. Apply more numbweed
Recovery: For minor injuries usually a day or two is all that is required. Numbweed will help clot the ichor, and so the wound will heal quickly. For more moderate injuries, usually no more than a sevenday is required. Obviously, if the injury is in a place that would be exacerbated, such as under the straps, on the wingsails, they will need to rest longer. Severe wounds are likely to keep the dragon out of the air for several sevendays. It is important during this time to replace lost fluid by making sure the dragon drinks. If the amount of ichor lost is great, then a transfusion may become necessary. A wound that has been stitched needs to be kept moist to avoid further scarring. Stitches should be removed by a dragonhealer approximately a sevenday after they have been placed. Generally when the dragon begins to complain of itching, sufficient healing has taken place to allow the suture removal.
Removing Stitches from a Wound:
a. Cleanse the area with redwort and apply a light coat of numbweed.
b. Again, ask the rider to look away, if necessary.
c. Clip the threads with scissors, or cut them with a sharp knife, being careful not to cut the hide.
d. Using small tweezers, remove each of the threads from the hide.
e. Apply a light coat of numbweed over the punctures left by the threads, this will help to seal them.
It is important to keep wounds clean and protected from further injury. The rider should be cautioned about the signs of infection and urged to seek a dragohealer if they notice any of these signs:
Increasing pain and soreness.
Swelling, redness and a feeling of heat around the wound.
Pus within, or oozing from, the wound.
Faint trails leading away from the wound.
If the infection is advanced, signs of thirst, gray hide and lethargy.
Dragons are warm 'blooded' even though their body temperature seems to be a little cooler than humans. This can be determined through their reactions to hot and cold temperatures. Their 'blood' is called ichor, and is dark green in color. Similar to blood, ichor is based on a metal element, but is in this case copper and not iron. Injuries, therefore, that release ichor will have a metallic smell associated with them.
Ichor circulates around the dragon in a continuous cycle, pumped by the rhythmic contraction/relaxation, or beat, of the heart muscles. The typical lub-dub of the heart is due to first the atria (upper heart chambers) filling with blood, and then the contraction of the atrium muscles filling the ventricles (lower heart chamber). This, however, is further complication in a dragon that has multiple hearts, and it takes a trained ear to identify an irregular beat in one heart. Since dragon carcasses are not readily available the exact number of the hearts is unknown. The reason for multiple hearts has never been discerned, but it is thought that this may be due to the effects of altitude and exertion during mating flights and threadfall. The ichor circulates within a network of flexible tubes known as ichor vessels, of which there are three types. Arteries are strong, muscular, elastic-walled vessels that carry ichor away from the hearts and towards the tissues. Veins are thin-walled and carry ichor back to the heart. Ichor is squeezed through the veins by the action of the surrounding muscle and is kept flowing towards the hearts by one-way valves. Capillaries are the smallest ichor vessels and bridge the gap from arteries to veins. The force, with which the hearts pumps the ichor through these vessels, and around the body, is known as the 'ichor pressure'.
Cardiovascular problems sometimes occur in older dragons, or in those dragons who's hearts are under terrific strain from other injuries or circumstances. As a dragon ages, the hearts often weaken and may develop problems, such as an erratic beat, or incorrect ichor pressure which may cause loss of feeling, or a tingling sensation, in extremities. Exertion, such as in a mating flight, may also cause a sudden onset of cardiovascular problems, such as a heart attack. This can result in a dragon going *between*.
Assess the situation: Reassure the dragon, get a gold to calm the dragon down if necessary, and ask questions of the rider about other signs.
Determination: Is there severe pain or weakness? Does this extend down one wing/forelimb or the other? Is there general lethargy? Are the hearts beating regularly?
Treatment:
Dragon should be pulled from a fighting wing, and allowed only light exercise, but daily. They should be closely monitored, and kept in low stress situations where possible.
Recovery: A dragon will never fully recover from any cardiovascular problem of this nature. Symptoms may be managed, but exertion should be avoided at all cost.
The lack of adequate body fluids for the body to carry out its normal functions and operate at an optimal level (by loss, inadequate intake, or a combination of both) is a classic definition of dehydration. In dragons it can be caused by diarrhea, usually after a constipated dragon has been purged, from consistently flying at high altitude for long periods of time, desert climes, and also from loss of ichor.
It is imperative that dehydration is treated as soon as it is identified. Mild cases are often cured by oral rehydration, but for moderate to severe cases of dehydration, intravenous fluids will be required.
Assess the situation: If the dragon been treated for an illness or injury recently, then you may need to look for further complications resulting from this, and leading to dehydration. For example, veins that have not been sutured correctly, or that have not been identified as ichoring. Has the dragon been recently purged? Have they been doing sweeps in the desert? Flying high altitude sweeps?
Determination: Is there decreased urine output? Does the hide lack its normal elasticity? (You can test this by pinching the hide into a fold, and watching it return - does it sag? If yes, then they have poor hide turgor). Is their hide graying? Do their hearts seem to be beating faster? Do they have a dry mouth? Does their stomach hurt?
Treatment:
1. If dehydration is mild, then ensure that the dragon starts drinking a lot of water, and continues to do so until they are recovered. Water should always be provided for a dragon after any treatment by a dragonhealer as a mostly precautionary measure.
2. If the dehydration is moderate, try treating with water, and watch for 3-4 hours. If there is no sign of improvement, treat as severe dehydration.
3. For severe dehydration, you must try transfusing the dragon with ichor from another dragon. Following the steps for removing ichor, and then inject this into a vein. You must inject slowly, or you risk having the vein collapse. Needless to say this is very bad. If this does happen, you need to inject ichor at a lower point on the vein to where you were injecting, and hope that you have the same vein. This is a very delicate procedure, with a lot of inherent problems and should only be carried out by experienced dragonhealers.
Recovery: Depending on the severity, recovery may take a couple of days to upwards of a month.
The displacement of a bone at a joint can be caused by a strong force wrenching the bone into an abnormal position, or sometimes by violent muscle contractions. Additionally, there may also be tearing of the ligaments associated with this injury. The most often affected are the hip, shoulder, digits and the jaw bones.
Dislocations can usually be differentiated from fractures by severe, 'sickening' pain, when the injury site is touched as compared tenderness.
Assess the situation: If the dragon is in pain, then ask a Gold to 'dampen' the pain and still the movement. Involve the rider. Ask the rider for details of the injury, and keep them with you (don't get them too drunk, you need to ask them questions!). Take control of the situation, but never forget to ask a rider first for permission to approach their lifemate - big dragon, in pain, equals a dangerous combination.
Determination: Is the injury bent at an impossible, or distorted, angle? Is there any swelling? Is mobility restricted? Was a cracking noise heard? Is it tender over the area? Is that pain 'sickening'? Ask, as many questions as you can think of, as soon as possible, while both dragon and rider are still conscious because both are likely to be distressed. If the answers are: Yes, it's a 'sickening' pain, there was a popping noise heard when the injury occurred, there is difficulty moving the area affected, there is distortion and swelling; then you are dealing with a dislocation.
Treatment:
1. Immobilize immediately, get weight off area and support if possible, use tables, or other dragons.
2. Pull steadily in a line with the bone, keeping it as straight as possible. You will have to have assistance from a larger dragon. You will have to exert quite an immense amount of force to get the joint to re-align.
3. Splint with tree-trunks. There are always tree trunks available for this purpose in the dragon infirmary.
Recovery: Full recovery will take approximately two-four months. Soaking in the lake/ocean and doing gentle exercise in the water can reduce the swelling and help promote recovery. Dragons should be careful of repeat dislocations to the injury site, as this area will now become prone to this type of injuries. Please do note that dislocated joints are relatively uncommon among dragons, although they can and do happen.
Advanced Wound Care | Cardiovascular Complications | Dehydration | Eye Problems | Talon Loss
Unlike humans, dragons do not have eyelashes. Instead their eyes are protected both by prominent eyeridges that protrude out over the eyes, and by three sets of eyelids. The inner lid is transparent, with the middle lid thicker and more opaque, and the outer lid seemingly part of the actual hide of the dragon.
Dragon eyes protrude outwards from their eyesockets, and as such provide peripheral vision that extends to the airspace above them, an extremely useful tool in threadfall. Their eyes are multifaceted, and are said to be 'whirling' with expression of emotion. However, this is actually an optical illusion provided by the facets. The eyes change color with emotion. Hues of green and blue signify contentment; yellow indicates fear; red-orange signals anger; red expresses hunger, white denotes danger and purple suggests love and/or mating urges. Additionally, dragons, like their Watchwher cousins, can see in the dark. Watchwhers, though, while having excellent sight even in total darkness, are photophobic, and have poor focal length. Dragons on the other hand have good focal length, being able to see objects on the ground from at least several dragonlengths above ground, if not further.
Dragons can, if the pairing between the rider and dragon has been sufficiently developed, use their rider's eyes to see something if they are not present themselves. This bond, usually developed in weyrlinghood can be strengthened by forcing the rider to rely on dragonsight, and likewise with dragon to rider.
Whilst rare, eye loss can, and does, happen. It is always the result of a serious accident, often this being the consequence of a mating flight, either pre-flight blooding when talons are bared in an relatively small area (the feeding grounds), during the flight itself when jockeying for position becomes a problem. Occasionally, eye loss may happen as a result of threadfall. The loss of a single eye will not completely disable a dragon. Their balance may be affected, but they should be able to compensate for most of this once the loss becomes accepted. However, this injury will always retire them from the fighting wings, since they will be blind on one side. It is unknown how the loss of two eyes would affect a dragon, though it is postulated that they would go *between* at this stage, since it would essentially ground them, and make hunting/eating a near impossibility.
Assess the situation: If the dragon is in pain, then ask a Gold to 'dampen' the pain and still the movement. Involve the rider. Ask the rider for details of the injury. If this is the result of a mating flight, make sure you start handing the rider skins of wine. Take control of the situation, but never forget to ask a rider first for permission to approach their lifemate - big dragon, in pain, equals a dangerous combination.
Determination: Is the eye absent? Is it ichoring? Is it damaged? Is it just the socket, or is it the eye as well?
Treatment:
1. First, slather the injury with numbweed, and let it soak in to take effect.
2. Clean ichor away, and check that it's not damage to an eyelid, or to the eyeridges blinding their vision.
3. Clean injury with redwort as there is a high chance of infection from this injury.
4. If the eye is damaged, but not severely so, then suture eyelids shut, coat with numbweed. It may be that the tissue will regenerate.
5. If the eye is damaged beyond what is treatable, then remove the damaged tissue with a sharp, sterile knife, and coat with numbweed. If other structures look damaged you may have to suture the eyelids closed.
Recovery: Obviously some of this injury may or may not heal. Use judgement to determine whether or not to remove the stitches in the eyelid for the complete eye loss, this will take around six to seven sevendays to heal. For the eye damage you should remove the stitches after about a sevenday. The dragon may have some loss of sight, or may not. Make a determination on their fighting capacity based upon their sight loss.
Dragon talons are similar in nature to canine claws, and even our own fingernails. They are made of keratin, and grow out from a talon bed, which is situated in the foot pad. Thus, the talon itself has no nerves associated with it, and therefore no feeling, until it reaches the point where it grows from the talon bed. There it is nourished with ichor and nerves. However, that's not to say they cannot feel by association through their talons, though it is more correct to say that they feel the connection through the talon to the talon bed.
Talon loss becomes quite common when young dragons are learning to fly. However, it remains a risk throughout life, especially in those dragons that are injured or sick, or otherwise impaired. It is then that take off and landings can cause a talon to break off, either fully or partially, particularly on hard surfaces, such as rock and compacted dirt.
Though much rarer, talon loss can also occur in mating flights, whereby talons are lost by fighting males. Hunting may also result in the loss of a talon, particularly when the captured beast is of a sufficient weight that a wrong move will wretch the talon from the bed of the foot.
Assess the situation: If the dragon is in pain, then ask a Gold dragon to 'dampen' the pain. It's likely that the pain will be fleeting, with the wrenching occasionally accompanied by nausea, which will then lessen to a throb. Ask the rider for details of the injury. If it's a flight injury, give the rider a skin of wine unless you want their affections coming your way (not advised until *after* you've dealt with the dragon), otherwise the rider should only be affected a little, with an uncomfortable feeling predominating.
Determination: Is there any talon left? Is the talon hanging at an awkward angle? Is there dirt associated with the remaining/lost talon? Is there ichor pooling around the talon bed?
Treatment:
1. Clean the area around the talon bed with redwort if infection seems likely. If there's some ichoring, then use apply numbweed immediately.
2. If the talon is torn, determine whether it would be more fortuitous to remove the complete talon, or remove the damaged portion. If you decide to remove the talon, make sure that the talon bed is fully numbed. The talon is mostly dead, you do not need to numb this, only the bit near the bed is bed is living tissue.
3. The assistance of another dragon may be required to remove the talon, depending on how severe the injury. If it is hanging from the talon bed at an angle use a sharp, sterile knife to remove it, severing through as little tissue as possible so as not to damage the talon bed.
4. If the talon can be saved, remove the part that is damaged with a sharp knife. You will need to numb the talon bed with numbweed, otherwise the dragon will feel uncomfortable pressure in this area during the procedure.
Recovery: The talon should eventually grow back, taking between four and eight sevendays to do so. However, any injury site will close within a day or two. Occasionally a talon may not grow back if the talon bed is sufficiently damaged. However, this will not impair the dragon in any way, as they will quickly learn to compensate for the missing talon.
