It seems that horses are always finding ways to injure themselves, so it's a good idea to familiarize yourself with the types of wounds you may encounter, and their treatment.
There are four basic types of wounds:
1. INCISION- This wound is a cut with reasonably straight edges and is caused by sharp objects. In general, incisions are the easiest wounds to heal. Even if they are deep enough to be stitched, there are usually no complications.
2. LACERATION- This is a tear in the skin, caused by a blunt instrument, such as a fence post or another horse's teeth. A laceration usually has a jagged edge, possibly with a loose flap of skin. There is usually some damage to the deeper tissue. The risk of infection here is generally greater than with an incision.
3. PUNCTURE- This is a hole in the skin, caused when a sharp pointed instrument enters the flesh. Punctures have small surface openings, but can be quite deep. These pose the highest risk of infection.
4. ABRASION (sometimes referred to as a CONTUSION)- This is a wound with bruising, and in general is the hardest wound to heal. Falls on pavement generally cause this type of wound. A rope burn is another example of an abrasion.
GENERAL WOUND CARE
For all types of wounds, the first thing to consider is, how serious is it? If it is very deep; if it may involve your horse's internal organs; if it involves the eye, eyelid, or is very near the eye; if it is near or on a joint, tendon or hoof; or if it has arterial bleeding (this will spurt in time with your horse's heartbeat), call your vet IMMEDIATELY. Organ involvement and arterial bleeding can be life threatening injuries. Wounds to joints, tendons, and feet, while not immediately life threatening, can quickly become so, or become career ending, due to infection. Injuries involving your horse's eye can cause blindness. If your horse is due for a tetanus shot, one should be given right away. If your horse has not had his yearly booster, or you are not sure when he had his last shot, talk to your vet about giving your horse a tetanus antitoxin along with the tetanus toxoid. Tetanus is a very serious bacterial infection that thrives in wounds and is present in the soil where horses are kept. Tetanus can kill your horse, so be sure your shots are up-to-date.
If none of the above conditions are present, but the wound is fairly deep, it may need to be stitched up. If there's a loose flap of skin, this will certainly need to be stitched up, or cut away (depending on location and age of the injury). Stitching will help keep out infection and will help cut down healing time in a wound. It may also lessen scaring. While having a simple wound stitched is not an actual emergency, the quicker after the injury it's done, the better. Prompt stitching will speed healing time and cut down on any complications, such as infection, stitches pulling out, etc.
Whether the vet is needed or not, there are 5 main objectives to treating any wound:
1. ARREST BLEEDING
2. CONTROL INFECTION
3. ENCOURAGE CIRCULATION TO THE WOUND
4. ENCOURAGE HEALING FROM THE INSIDE OUT
5. DO ALL THE ABOVE WITHOUT DAMAGING THE SURROUNDING TISSUE
Although a small amount of bleeding is beneficial since it will wash the wound clean, you will want to stop any excess bleeding as soon as you discover the wound. Direct pressure, hosing with cold water, or applying sugar to the wound will halt or at least slow down the bleeding. (Salt will work in place of sugar, but I would use this as a last resort, since it will be painful).
Once the bleeding is under control, you will want to clean the wound. A sterile saline solution is probably the best thing to use for this, but hydrogen peroxide, or clean, running water may also be used. (Do not use a power sprayer) If there is dirt or grass caked to the wound, be as gentle as possible. Use your liquid liberally to soften and loosen the foreign matter. Doing this will minimize tissue damage. If your vet is coming out, most prefer for you to not use any soap on the wound. Ask him or her what they would prefer you to wash the wound with. DO NOT PUT ANY MEDICATION ON THE WOUND. If the vet is not needed, you can clean the wound with a medicated wash. The vet I worked for preferred Novlasan. Betadine is another common one. You should use a clean soft material to wash the wound. Gauze squares work well. Cotton may leave fibers in the wound. Sponges (unless they've been sterilized in your microwave) should not be used. If the wound was exceptionally dirty, or if the injury was not discovered in the first few hours, infection may be a problem. Consult your vet about a round of antibiotics. The vet may not need to come out for this since many antibiotics can be placed in the horse's feed.
Once the bleeding has stopped and the wound is clean, your next problem is how to keep it clean. Except for the horse's lower legs and feet, it is not possible to cover their wounds with bandages. So you will need to have a dressing that will cover the wound. Aluspray and Blu-kote are two good ones. You will also need a good fly repellant to keep the insects off the wound. Besides landing on manure and then flying over to land on your horse and spreading germs, some insects will lay eggs in the wound, causing summer sores. So you definitely want to keep the bugs off.
FACES- While in general, you want to apply a drying wound cover that will help a scab form, faces present a different problem. Since much of their facial skin needs to stretch while they're eating, a moist dressing is needed here. Sprays are not recommended for faces. Most horses do not like being sprayed in the face, and even if they will stand still for it, you're still much more likely to get medicine in their eyes. If the wound is near their eye you must make sure that the medication does not drip into their eye. If the wound is very near the eye, consult your vet for the best choice of medication. In general a cream or oil based salve is the best choice on a face wound. Scarlet oil, daub-on blue kote, Furacin, Novalsan cream or Corona, are all good choices, along with a roll-on fly repellant. Swat is a wound cream which also repels flies.
HEELS- This is another area that needs to be kept moist. So you need a dressing that keeps the skin moist, but that dirt doesn't stick to. Almost any of the moist wound dressings will work well. Furacin, Corona, and Novalsan cream are three good ones. (Scarlet oil and Blu-kote may not be quite moist enough here.) The trick is to softly massage the ointment into the wound so that there isn't a large excess for the dirt to stick to. If the wound is deep, it's best to keep it wrapped as well. Once the skin begins to heal, the wound is best left open, since the bandage may rub slightly and actually hinder the skin's healing.
PUNCTURE AND DRAINING WOUNDS- The main concern with a puncture wound or one that is draining, is to heal them from the inside out. If the skin heals before the deeper tissue heals, abscesses can result. Also many bacteria (like tetanus) thrive in an airless environment. So infection becomes more likely if the outside heals before the inside. Punctures in the foot need veterinary care, so follow your vet's advice here. In all other punctures or wounds which are draining, hosing the wound with cold water for 10 or 15 minutes once or twice a day will help slow the skin closing up too quickly. The drainage may burn the skin, so applying a wound cream to the skin below the wound will be helpful.
If you follow the rules set above, wounds are more of an annoyance than a danger. However, if any wound becomes hot or swollen, it means infection has set in. Your horse will need to be put on antibiotics. Call your vet as soon as you notice this. The quicker you get the horse on antibiotics, the quicker he will heal, and the less expensive it will be for you. It's better to spend a little money now and be safe. If you wait, it could end up costing you a lot more, and you might even lose your horse. So if you're ever in doubt about any wound, call your vet. Better to be safe than sorry.
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