Treating wounds is one of my favorite things to do as a veterinarian. It is often a very demonstrable way to appreciate the healing capacity of the body. Especially when we provide an optimal environment for healing to take place. If your horse has the misfortune to have a wound that needs attention there are a few points that are probably worthy of your consideration.
Location of the wound
This is probably the single most important consideration in determining how concerning any particular wound is. Wounds on or around joints or other synovial structures need to be thoroughly examined to make sure they do not involve the joint or synovial structure. Wounds, either from a puncture or laceration, are the most common cause of infected joints. For the uninitiated, infected joints are a very serious and potentially life threatening problem in a horse. These wounds always need to be evaluated by your veterinarian as quickly as possible because you really don’t want to wait around if there is a possibility of joint involvement. Lacerations around the eye or eyelid would be another area that should always be treated as an emergency.
In my opinion the severity of a wound is very closely tied to the location of the wound. A wound that may not require much or any treatment on a horse’s chest may be much more problematic and fraught with complications if it is over a canon bone or joint. Other things that determine the severity of a wound besides location are the degree of contamination, degree of tissue trauma and timing.
The decision on whether or not a wound can or should be closed with suture or staples is based on location and extent of the wound, the degree of contamination and the amount of time that has passed since the wound occurred. Generally, anything that has been open for greater than 12 hours will need to be treated as an open wound or additional steps and precautions will need to be made to optimize success of the closure. Primary closure of a wound, when possible, is ideal because it shortens the duration of time to resolution, results in less scarring and in general seems to be more comfortable for the horse.
Even if a wound will not need to be extensively treated, tetanus prophylaxis is a good reason to call your veterinarian. He or she can help you decide if your horse needs a toxoid booster or if he may need anti-toxin.
Bandaging is one of those skills that can only be mastered with practice (see below). The following are the 5 P’s of bandaging:
At the risk of opening myself up to scrutiny, many of the salves, creams and ointments marketed for wound care are unnecessary, ineffective or scientifically unverified. Some of them have merit and have been studied and can be used effectively for a specific purpose. However, in my opinion, there is no topical that is superior to good bandaging (if needed), cleanliness and fly control. I use many other topical on occasion but these are the ones that for one reason or another I seem to use most often:
Obviously, wound care is a broad topic and no two wounds are exactly the same. Treatments will vary and it is always a good idea to invite your veterinarian to examine the wound to initiate an appropriate treatment plan. If you have questions about wound care or how you can be prepared or if you find yourself in the unsavory position of having to deal with a wound on your horse give me a call and I would be happy to help you out!