Horses often get injured by foreign objects such as barbed wires, nails, fences, gates, glass or metal. Proper wound care is an important responsibility of any horse owner or veterinarian. For proper wound care, there are an endless number of wound ointments and salves, cleansers and dressings. But not all of them are backed by evidence of safety and efficacy. Thus, it is prudent for a horse owner or veterinarian to know what effect an ointment or dressing will have on the wound before using it.
The process of wound cleaning involves removal of the dead tissues and foreign bodies from the wound, while also reducing the bacterial load. However, in this cleaning process, the techniques you use to clean the wound will cause some trauma to the wound. Thus, a horse owner or a veterinarian should analyze the risks, benefits and cost of various techniques before using any approach.
Here are some ointments and cleansers that we apply to wounds with which ones are safe to use:
A moderate flow of saline helps to clean all sorts of cuts, tears or abrasions. Hypertonic saline, in particular, helps in removing surrounding dead, damaged or infected tissue while reducing bacterial concentration in the wound. Thus, it is important for horse owners to have saline in their first-aid kit. Saline is the best way to heal the wound, but it can also damage healthy cells. So, it is best to use it only in infected wounds.
2. Povidone Iodine (PI)
Povidone iodine has been popularly used in equine wound care. However, numerous studies indicate that PI causes tissue necrosis and impairs healing leading to bacterial infection. Moreover, PI does not appear to be more effective than saline in reducing bacterial concentration. Thus, PI should only be used around the wound over intact skin and never in the wound itself.
Chlorhexidine is commonly used as a wound cleansing agent. Despite its low toxicity, studies show limited evidence of its effectiveness in reducing bacterial concentration in the wound. Similar to PI, chlorhexidine causes tissue necrosis and should only be used over the intact skin.
4. Hydrogen Peroxide (HP)
Hydrogen peroxide is widely known for its effervescent activity, which gives users the impression that it is effective. However, hydrogen peroxide lacks antibacterial effects. Even though hydrogen peroxide has few benefits or side effects, it is not enough to warrant the use of HP.
5. Acetic Acid (Vinegar)
Common distilled vinegar is highly effective against pseudomonas infections. The low pH of the acetic acid creates an environment that certain bacteria like pseudomonas, cannot tolerate. This cleansing agent should be used as a 15-minute soak or compress. Remember to rinse the wound with saline after treatment with acetic acid. Moreover, discontinue the use of vinegar once the infection is in check.
6. Surfactant-Based Cleansers
Surfactant-based cleansers are less commonly used as they are considered slightly toxic and irritating. But they are highly effective on mildly to moderately contaminated wounds. While using these surfactant-based cleansers, let them sit for 1 to 2 minutes, then rinse off, and reapply as required.
7. Topical Antibiotics
Topical antibiotics help to inhibit the growth of bacterial numbers, but their overuse can lead to bacterial resistance. Thus, topical antibiotics should be used for only one to two weeks. There are different kinds of antibiotic that kill different types of bacteria. So, the antibiotic you choose should be sensitive to the bacteria that is found in the wound.
Following are some common topical antibiotics for equine wound care:
- Silver: Silver is an extremely effective antimicrobial agent. It is generally used in the form of silver sulfadiazine cream (SSD), but it is also available in a dressing form. A recent study shows that silver sulfadiazine cream reduces overgranulated tissue than other ointments. Newly formulated silver dressings also helps in reducing bacterial concentration in the wound. According to a study, use of silver dressings decreases the rate of wound infection, inflammation and use of analgesics when compared to SSD cream.
- Nitrofurazone: There is no single positive study that validates the efficacy of nitrofurazone ointment. In fact, there are several studies that show that nitrofurazone retard healing. Thus, it is highly recommended to avoid using it in open wounds.
- Triple Antibiotic Ointment: The triple antibiotic ointment has been used widely as an effective agent for bacterial reduction. This product has been used since the 1950s, and yet it has a good bacterial susceptibility. Various studies have confirmed its efficacy when compared to other topical antibacterial or antimicrobial agents. These antibiotics have synergistic effects on bacterial reduction in wounds. Along with silver, the triple antibiotic ointment becomes an excellent choice for topical wound treatment.
- Honey: Honey is an ancient remedy that promotes healing in topical wounds. But honey derived from the flowers of the Manuka bush can effectively eradicate more than 250 types of bacteria. Manuka has a unique substance that gives it its extraordinary antibacterial activity. This novel substance is still unknown to the scientists. So, remember that not all types of honey are equal and to use ones that have antibacterial effects on wounds.
Different types of dressings serve different purposes. However, it seems that no single dressing will be beneficial throughout all the stages of the wound healing process. Debridement dressings, for instance, are used in the initial stages of wound care. This type of dressing helps in removing bacteria and dead tissue from the wound. Gel dressings add moisture to dry wounds and encourage healing in dry wounds. Granulation tissue dressings are used to encourage granulation tissue formation and wound contraction, which helps in the wound healing process. Finally, epithelialization dressings are used to finish off the healing process.
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