In summer, it seems that less time spent munching grass or going to competitions means more time for mischief and misadventure. This combined with some horses’ nervous, flighty disposition can result in bumps, grazes and sometimes cuts.
When a cut occurs on a part of the horse which is well covered with muscle or other soft tissue, complications with healing after veterinary treatment are not common. However, if a significant injury breaks the skin on the lower part of the leg, then the chance of complications with healing increases significantly.
There are two main reasons for this:
- The lower leg of a horse has much less muscle under the skin, mostly just bone, tendons and joints. This means when skin is cut and shrinks from the wound site, as skin tends to, stretching the skin so it joins normally is more difficult. This is because muscle under the skin is more flexible than bone and tendons.
- This area has a lower blood supply as bones and tendons need relatively little blood compared to muscle. This blood supply is closer to the skin surface and easily damaged when horses are injured.
So, the combined difficulty getting the skin to join and getting optimum blood supply for good healing makes for a challenging recovery for the horse, carer and vet.
What first aid can you apply?
Apart from your vet’s phone number, it is important to have a plentiful supply of wound protection on hand. After identifying a cut or graze, your first priority is to stop the bleeding. Next, clean and cover the wound. For this, you’ll need some sterile gauze which won’t stick to the wound. Then, it's necessary to apply some good disinfectant like Betadine or Hibitane. You will need to protect the wound with some gauze-covered cotton wool roll, which you can hold in place with good-quality elastic bandages. Once the wound is well bandaged, get the horse in a clean safe area, while you wait for your vet to arrive. While you wait, it's a good idea to recall your horse’s tetanus vaccination history. Horses are more sensitive to tetanus through wounds than any other species.
When is veterinary care required? The initial treatment of a wound, particularly of the lower leg can have a profound effect on the long-term outcome for your horse.
A vet is urgently required when:
- The wound involves a blood vessel or a joint
- The wound edges won’t easily join
- The wound is contaminated with dirt or other material
- You can see underlying structures such as joints or 'white bits'
- The horse is lame as well as a laceration
- The main issues your vet can address quickly are stopping blood loss, infection management, and strategies to improve wound healing, which can include suturing, skin flaps and/or grafts to fill gaps in skin coverage.
Post-Surgical Management The management and care of these sometimes-complicated wounds is often a shared responsibility between horse, carer and vet. Vets need skills which go far beyond surgical skills. A vet and the owner will team up and discuss so that they can decide what level of responsibility the owner can safely undertake to change dressings, assess how the wound is healing and redress the wound.
The vet will then decide how much instruction to give the owner verbally and in writing to ensure these important tasks are carried out effectively. The vet can then decide how often they need to visit the horse to check and re-bandage the wound.
Sometimes blood supply to the healing wound is compromised and the outcome is not ideal. For example, a poorly healing wound may result in surrounding skin dying, which then necessitates a secondary healing process such as a red area. The formation of a red area, sometimes called granulation, involves covering the underlying structures with tissue that is rich in blood vessels until the skin heals from the outside in. Although not ideal aesthetically, the red area will ultimately be covered with skin scar tissue. This scar tissue is not as flexible and may restrict some movement, so this treatment should be avoided if at all possible.
Your vet, diligence and patience are your best friends when it comes to complex wound healing. |