WOUNDS
Goulburn Valley Equine Hospital, Victoria, Australia
FIRST AID OF
WOUNDS
One of the first
decisions to be made in dealing with a wound on your horse is to
assess it and decide if it is something that your vet needs to
attend to, or if you can manage it effectively yourself. If the
wound is very large, very deep, the horse is very lame or the wound
is near any joint or tendon, it probably needs to be seen by a
veterinarian.
In the interim period
between the initial laceration and the vet arriving, the aim of
first aid is to prevent further injury, stop any bleeding and
prevent further contamination. Ideally one would gently clean the
wound (ideally with saline, or small amounts of clean water if not
available) and cover it with clean gauze and some kind of covering
bandage. If the wound is bleeding badly, the most effective method
of stopping the bleeding (haemostasis) is firm bandaging.
VETERINARY ATTENTION
Your vet will assess
the wound and advise on the most appropriate treatment. If the wound
is able to be cleaned sufficiently and is a fresh laceration, they
may be able to suture the wound shut (a primary repair), either in
the field or by taking the horse into hospital facilities. An
example of this might be a laceration to a cannon bone occurring
within the last few hours.
If wounds are only
superficial, or are very contaminated, or are in an area of much
movement they may elect to leave them open (which allows drainage of
any fluid accumulating) and the wound will heal itself (second
intention healing). An example of this is might be a stake wound to
the pectoral muscles.
Occasionally, with a
contaminated wound, it may be possible to suture the laceration
several days later (a delayed primary closure) when any swelling at
the site is reduced and the wound is sufficiently cleaned and
debrided.
The last kind of
wound repair, called a secondary closure, is the suturing of older
or chronic wounds once a healthy bed of vascular tissue at the site
of the wound has been achieved.
Regardless of the
method used to repair or manage the wound, veterinary attendance
will allow you to be more sure of the involvement of any surrounding
structures (tendons, joints, nerves and blood vessels), and can
provide antibiotic cover, anti-inflammatory and analgesic (pain
relieving) medication and tetanus cover.
AFTERCARE OF WOUNDS
Regardless of the
repair method employed to manage a wound; whether a wound has been
sutured closed or left open to heal by secondary intention, it will
benefit from bandaging to protect it, keep it clean and reduce
surrounding soft tissue swelling. For the majority of limb wounds a
similar bandage will suffice, namely a sterile non-adherent
dressing, followed by cotton wool or gamgee padding and held in
place by gauze and/or adhesive elastic bandages, and secured in
place with tape.
Adherent dressings or
poultices can be used in initial stages of contaminated wounds when
trying to debride them.
There are a host of
topical preparations, which people advocate for every type of wound.
Some of these are suitable only for certain wounds at a certain
stage of healing; if in doubt consult your vet, as the majority of
fresh wounds healing satisfactorily will require no special topical
preparations.
When monitoring wound
repair, it is important to consult your vet if your horse goes
acutely lame, if the wound appears to become infected (swollen and
painful with a malodorous discharge, or excessive granulation tissue
(‘proud flesh’) is noted. The two biggest factors aiding wound
healing will be immobility and control of infection.
WOUNDS INVOLVING JOINTS
Wounds that are
situated around joints must have veterinary attention, since
infection into a joint or a tendon sheath is of serious concern.
Generally horses with a septic joint will be extremely lame, unless
the joint fluid is leaking out of the wound. If there is any doubt
of joint involvement your vet may take a sample of the joint fluid
or inject fluid into the joint to see if it exits the wound. If the
wound does enter the joint, prompt and aggressive treatment is
necessary, usually flushing the joint on one or more occasions and
antibiotic medication.
WOUNDS INVOLVING TENDONS
Some tendons have a
synovial lining around them, and infection of this sheath follows
the same principles as joint involvement.
The most common
tendons involved in lacerations are the extensor and flexor tendons
on the cannons, often due to wire wounds, or kicking sharp objects.
If the extensor
tendons on the front of the leg are completely severed, the horse
may be unable to bear weight and will knuckle on the limb. If the
tendon is only partially severed, it may not knuckle. A proportion
of these tendons can be repaired, and can return to full athletic
function.
Flexor tendon
lacerations also have a variety of presentations depending on which
tendons and how severely they are affected, where the fetlock may
appear dropped, sometimes with the toe in the air. Generally, flexor
tendon lacerations have a poorer outcome compared to extensor tendon
lacerations, and surgical repair is almost always the only option.
