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EQU INE WOUND
SUMMER 2015 ISSUE
EQUINE MATTERS
8
Figure 2: Sometimes it is obvious when
a wound requires intensive treatment.
The swelling of this wound prior to
treatment meant that the treatment
period was considerably lengthened
Figure 1: Wounds overlying joints
should be examined by a vet;
fortunately for this horse the knee
joints were not affected and he made
a full recovery
How can we help wounds to heal?
1. Cleaning the wound and
removal of damaged tissue
All traumatic wounds are contaminated with
foreign material, such as dirt and bacteria,
from the hair coat, environment and in some
cases the item that caused the wound.
Thorough cleaning removes the debris, pus
and discharge therefore reducing the risk of
infection and promoting wound healing. It is
essential that any product used during this
process does not inhibit wound healing.
Whilst cleaning a wound it is essential to
wear gloves to prevent bacteria transferring
into it from your hands.
Whilst water is satisfactory for removing the
gross contamination it should not be used
beyond this point as it can damage cells
and cause swelling of the tissues; ideally a
large volume of warm saline (2tbsp salt in
1 litre of water) should be used. Antiseptic
solutions e.g. chlorhexidine (Hibiscrub
®
)
can be added to provide additional action
against bacteria.
Removal of dead or dying tissues is essential
for efficient wound repair. The presence of
unhealthy tissue means that the healing
response is focused on removing this as
opposed to healing and it increases the risk
of infection.
2. Anti-inflammatory medication
Anti-inflammatory medications, e.g.
phenylbutazone not only provide essential
pain relief for the injured horse but also help
to reduce inflammation and swelling.
3. Antibiotics
Once the protective barrier of the skin has
been damaged the tissues beneath are
considered to be contaminated and there
is a risk of infection establishing. Whilst
antibiotics are important to help control
established infections they are often not
required for wounds that are treated quickly.
Your vet will decide whether antibiotics
are required.
4. Suturing wounds
Wounds that are most suitable for suturing
(stitching) are those with clean, healthy edges
and are free from infection
(Figure 3)
. As a
general rule, a vet should see a wound within
6 hours to determine whether suturing is
possible, however this can vary with the
type and location of a wound
(Figure 4)
.
5. Bandaging
Bandages consist of several layers each of
which help to provide a regulated, moist
environment ideal for wound healing.
Bandaging a wound also prevents further
contamination, protects from additional
trauma, helps to reduce or prevent swelling
and when necessary immobilise the wound.
The wound product and dressing pad
selected should depend upon the type of
wound and the stage of healing. In many
cases a hydrogel and a non-adhesive,
absorbent dressing pad are ideal and these
should be kept in any first aid kit. Other
products available include medical grade
manuka honey, silver-impregnated dressings
and ketanserin however it should be stressed
that prior to using any product it is best to
seek advice from a vet.
Layers of cotton wool or gamgee held in
place by conforming bandage help to
ensure the bandage applies an even pressure
and absorbs blood and discharge. The
thickness of the absorbent layer can vary
significantly and is quite considerable when
immobilisation of a limb is required. The
final layer, a cohesive or elastic adhesive
bandage, helps to support the overall
structure of the bandage and makes it
harder-wearing.
Figure 3: Wounds suitable for
suturing have clean, healthy
edges and are free from
infection
Figure 4: The wound in
Figure 3 after suturing
Conclusion
Whilst the majority of wounds that horses
suffer heal in a straightforward manner
this is not always the case. Having a
well-stocked first aid kit can help to reduce
the stress when needing to perform first
aid. If you are ever uncertain whether your
horse needs to be examined by a vet
calling for advice is essential; sending a
photograph can be very helpful at this
time. There are many factors that can slow
the rate of wound healing which can be
addressed through a combination of
wound management techniques.