Wounds in horses – how can we do better?
ONE of the most common injuries in equine practice is a wound. Indeed, it seems that of all the species dealt with by vets, the horse is particularly prone to wounds.
Wound healing is an orderly biologic process of repair that restores continuity to injured tissue.
Whether the wound is created by the surgeon’s scalpel, a kick from another horse, or from a rusty bit of wire, the process is the same.
What to do and when to call the vet?
When assessing a wound, the priority is to determine whether veterinary attention is required. The following information may be important. When and how did the wound occur; how big it is, and which part of the body is affected; and is the horse lame? If the wound is recent, is it still bleeding heavily? If the wound is old, is there much swelling or pain around it? Is it discharging?
Tips to help you deal with a wounded horse.
■■ DO NOT PANIC. No matter how bad a wound may look initially, most do very well if they receive the appropriate treatment early on.
■■ Assess where the wound is – small wounds over a joint or tendon sheath can be far more serious or life-threatening than larger wounds in other areas. Don’t forget that absence of obvious lameness does not rule out penetration of a joint or tendon sheath.
■■ Bring the horse to an area where it can be assessed. Then wash the wound with water to remove contamination. A running hose is one way to do this, or a garden sprayer filled with warm tap water and salt to make a saline solution (two teaspoons of cooking salt per litre of water makes saline).
■■ Don’t apply anything to the wound other than a clean, dry dressing – resist the temptation to apply wound powder, purple spray, or oily creams as these will often impede healing. Surprisingly, skin wounds are not very painful and should not cause much lameness. If the horse is very lame, it is very likely there is damage to some underlying structure or infection in the tissue.
■■ If the wound is still bleeding, a clean, dry bandage applied with some pressure should be used.
To close or not to close – that is the question?
Until quite recently it was believed that there was little point in closing wounds, particularly limb wounds, in horses as they would almost certainly reopen or ‘break down’. Consequently, wounds would commonly be managed open to heal by ‘second intention’.
This method of healing is effective but slow and can be costly in terms of bandaging and time out of work. The most common reason wounds were left open was due to contamination.
A new way of washing wounds – hydrosurgical lavage
The most exciting advance in wound healing for horses has come from the treatment of human wounds following traumatic injury. The technique known as hydrosurgical lavage utilises a jet of sterile saline solution which is capable of removing and sucking the debris away. The energy of the vortex can be altered depending on how contaminated the wound is. Wounds that in the past were certain to become infected can now be cleaned quickly and effectively such that they can sometimes even be closed.
Vacuum-assisted closure (VAC) – yes you read that correctly – a vacuum, but not a hoover! VAC of a wound is a type of therapy or dressing to help wounds heal. Used in ancient times, the technique has recently been reintroduced with a modern upgrade.
During treatment, a special foam dressing is placed onto the wound and an adhesive film then covers and seals the wound. A drainage tube is stuck over a hole and connects to a portable pump. This pump creates
a continuous suction on the wound, which can help wounds heal more quickly. A wound vacuum system helps healing by: draining fluid; reducing bacteria; keeping the wound moist; helping draw together wound edges,;increasing blood flow; and decreasing inflammation.
Like many aspects of veterinary medicine, wounds heal more quickly
with fewer complications if they receive the correct treatment quickly. New technology including hydrosurgical lavage and vacuum-assisted wound healing reduce the time it takes wounds to heal, the time the horse is out of work, and the overall cost.
These technologies are available in several of Scotland’s specialist equine hospitals.