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If you have owned a horse for any period of time, you know that horses and wounds go hand in hand. It really is not a question of if but when. You also know that horses have an amazing ability to heal and to heal quickly.
For new horse owners, the first time this happens on your watch will cause you great angst. The outward appearance of the wound or the amount of blood being lost can make owners panic, so it is important to have a simple game plan in place.
If you’re anything like me, I obsess over each little bump and bruise. I recall getting my first horse after being away from them for 20 years. The very first weekend my new horse was injured in the cross-ties so badly that it required attention of the vet.
When your horse gets a wound, remember the four Cs: stay Calm, Clean the wound, apply a Compression bandage, and Call the vet. Following these simple steps will ensure your horse has the best prognosis possible and save you from the frustration of dealing with a non-healing wound.
Wound Care Supplies
To prepared for this eventuality you will want to keeping some wound care supplies on hand. Here is a list of some of the more important items to keep in your first aid kit:
- Vet Wrap
- Polo or leg wraps
- Cotton Sheets
- Gauze
- Povidone-Iodine (dilute with water until it resembles weak ice tea)
- Triple Antibiotic ointment or Neosporin
- Baby Diapers (work great in a pinch on horses legs)
- Sanitary Napkins (make great pads to cover wounds)
Leg Wrap Supplies
Types of Wounds
“Wound” is a general term that can encompass a wide range of injuries including minor scrapes to punctures to injuries where the horse’s skin is peeled away from the body.
When you first discover the wound, you will want to determine the severity of the injury. In most cases, you can probably manage your horse’s minor injuries yourself.
If you have any doubts do not hesitate to call your veterinarian. It is far better to get healing on the right path early on than to try to fix it later once complications have developed.
Call the vet if you notice a:
- Deep laceration
- Damaged joint
- Damaged muscle, ligament
- Exposed bone
- Profuse bleeding
- Infection
- The wound needs stitches
- Very dirty contaminated wound
- Development of proud flesh
More important than the outward appearance of the wound is its location. A small inconspicuous puncture wound or a laceration over a joint or tendon can be far more serious to your horse’s health and soundness than the most horrific wound on the hip or shoulder.
When it comes to wounds, there are two very simple rules to keep in mind.
- RULE ONE– All wounds want to heal. If the wound is healing with what you’re doing, don’t change anything, As long as it’s going well, leave well enough alone.
- RULE TWO– If a wound isn’t healing right, something is wrong. That’s when you need to call your veterinarian.
Wounds are generally divided into two types.
Type 1 – Wounds that can be sewn up.
These include wounds created at surgery, as well as wounds that occur from horses just being horses.
If a Type 1 wound has been properly cared for and sutured shut, you generally don’t need to spray it, soak it, or put anything on it..
Type 2 – Wounds that can’t be sewn up.
There are several reasons why a wound may not be able to be stitched back up:
- There’s not enough skin to close over a wound. There’s been tissue lost, and the edges of the wound can’t be brought back together.
- The wound wasn’t recognized quickly enough. If the wound is older than 6 hours, the vet may not be able to stitch it back together. Wounds on the face may have a bit more time because of the density of the blood vessels. If the wound is dirty, you may have even less time.
- When there’s been too much damage to the skin. Heavily damaged skin won’t heal, it will just die. Even if you sew it back together, dead skin will come apart and leave you with a Type 2 wound to deal with.
- When the wound is located near a joint where movement keeps it open. If the wound is located on the lower leg near the knee, for example, keeping the sutures together will be difficult as the horse moves.
Even in Type 2 wounds, there’s still one thing working for you; the horse’s body wants to heal the wound. All you really need to do is work with the horse’s body to make sure that healing gives you the best outcome possible, both cosmetically, and functionally.
Type 2 wounds will take a little longer to heal than Type 1 wounds. Instead of the skin cells joining back up, and the wound healing relatively quickly, healing Type 2 wounds is bit more of an involved process. This process occurs in four basic steps:
- Filling the wound with granulation tissue.
- Covering of the wound with the epithelial cells of the skin
- Wound contraction.
- Formation of a scar.
What To Do When You Discover a Wound
Control the Bleeding
If bleeding is excessive, apply direct pressure with a small pad of clean gauze to help stop the bleeding. Infant disposable diapers or sanitary napkins work well, or take eight to ten 4-inch-by-4-inch gauze pads, and fold them in half. Hold for at least five minutes to ensure that the bleeding has stopped. If blood is still flowing freely, repeat.
In severe cases, you might have to simply sit tight with direct pressure applied while waiting for your vet to arrive.
Clean the Wound
As soon as you’ve controlled the bleeding, rinse the wound well. Clean dirt and debris from the wound by running it under a cold hose. Cold water has the added benefit of helping to reduce swelling and inflammation.
Keep the wound clean until your veterinarian can assess the injury. This is a very important step because the longer the wound stays dirty, the greater the risk of infection.
Inspect the area closely to make sure it is completely clean. Once infected, the success rate of suturing a wound closed and having it stay together is decreased.
Flushing a clean wound with a dilute antiseptic wash, such as Betadine or Povidone Iodine can reduce the risk of infection even further. When you dilute it, it should resemble weak ice tea. If you choose to apply a wound ointment, use a triple antibiotic ointment such as neosporin.
Bandaging (if appropriate)
Apart from superficial scrapes, almost any wound on the lower leg will benefit from bandaging to keep it clean while it heals. You’ll want to cover the exposed tissue with non-stick gauze or other wound dressings that won’t adhere to the wound.
Wounds above the legs can often be left open to heal. The relative immobility of the horse’s torso means the healing tissues won’t be disturbed as often, and these areas are likely to remain cleaner. You’ll want to change the bandage at least daily while healing progresses.
Once the wound is completely covered by a layer of granulation tissue, bandaging can be discontinued. The granulation tissue is a natural barrier to bacteria and debris that keeps everything underneath this layer healthy and clean.
If left alone, a scab will form over the granulation tissue and the skin will move across the granulation bed at a rate of 1 millimeter a day.
Our job as an owner is to sit and wait, which is the most difficult step. If we tamper with the wound by taking off the scab, placing topical medication on the wound, or keeping the leg wrapped, we could be deterring the normal wound healing process and can create problems like proud flesh.
How to Apply a Bandage
Bandaging is an important part of wound care. Not only does it help keep the wound clean, it can hold topical medications in place. It’s important to do the job carefully. A bandage that is too loose or too tight can slow healing or even make a wound worse.
Before you start, you’ll need to choose the best dressing for your horse’s wound. Sterile non-stick gauze squares were the primary choice for covering the wound surface before applying the wraps to cover it—and these will still get the job done.
However, there are now newer products designed to keep the healing tissues moist, such as calcium alginate or foam pad dressings. Although it was once believed that the best way to promote healing was to let a wound dry out, recent research has shown that open wounds will close faster and with less risk of infection if the surface remains evenly moist.
In addition, specialized dressings are now available that can help debride infected wounds or restore moisture to wound surfaces that dried out before the injury was discovered. If you’re unsure of which type to use, ask your veterinarian for a recommendation. As with any product, read the labels carefully and follow the instructions.
Steps to Bandaging
- Wrap the rolled gauze just above the wound, pulling it just tightly enough to remain in place but not so hard as to stretch out the weave. Make sure it lies smoothly and that each layer overlies the preceding layer by about 50 percent. The highest risk of injury to healing tissues comes from shifting or slippage of this gauze layer.
- When you reach the level of the wound, place the gauze pad or other dressing over the exposed tissue, holding it carefully to ensure it lies flat with no wrinkles. Then continue with wrapping the gauze roll down the leg to cover the dressing and extend beyond its lower edge.
- Wrap the cotton padding around the leg, taking care that it lies flat.
- Apply an additional layer of rolled gauze to help hold the padding in place as you continue wrapping.
- Start the self-adhesive wrap about a half-inch below the top of the padding and work downward, taking care to overlap it by about half with each turn and to prevent it from bunching up or wrinkling. Also leaving about a half-inch of padding exposed at the bottom, continue wrapping back up the leg for a total of two layers. You want to finish with a smooth, snug covering.
- To help secure the bandage more firmly, apply two or three rounds of elastic bandaging tape at both the top and bottom, overlapping both the horse’s leg and the bandaging material by two or three inches.
For more information on how to wrap a bandage, you can check out this video How to Apply Equine Standing Wrap Bandages.
Keep Your Horse Still
Depending upon the severity of the wound, your veterinarian may recommend that you stall your horse. Too much motion in a wound that is healing pulls at the tissues and can prevent the skin from closing over it.
Seek Help Quickly if Healing Halts
Signs of trouble:
- Persistent swelling
- Heat
- Pus
- Wound edges separate and dry out
- Stitches pulling apart
- Stitches buried into swollen tissue
- Foul smell
- Bubbling under the skin
- Fever
- Depression
- Excessive proud flesh
What is Proud Flesh?
Proud flesh is a pink cottage cheese like flesh that grows over an open wound. It forms a natural barrier and lays the foundation for new skin growth as a normal part of the healing process.
Proud flesh becomes troublesome when it grows profusely. Horses are very enthusiastic healers, especially when lower-leg wounds are involved. The developing bed of granulation tissue must stay below the level of the surrounding skin margins to enable the skin cells to successfully “crawl across” them.
If granulation tissue protrudes above the skin edges healing can’t progress, because skin cells can’t crawl “uphill.”
Left unchecked, it can become an unsightly mass of flesh that bleeds and weeps.
To discourage the growth of proud flesh, keep the wound covered in antibacterial wound dressings under the protection of bandages until the skin can grow back.
When the wound is ready to go un-bandaged, apply a small amount Wonder Dust to dry and discourage proud flesh. Some people discourage the use of products like Wonder Dust, but I have had great luck with using it.
If at any point in the wound healing process you feel proud flesh is growing too much, call your vet.
How Are Scars Formed?
Scars are formed after the healing process. If the dermis layer of skin is damaged, a scar will form. The dermis is the deepest layer of skin. The collagen that your body forms in a wound turns into the scar tissue. It has a different texture as surrounding tissue, and it won’t be as strong as the original tissue.
The size of a wound and the length of healing time can influence scarring. Large wounds and wounds that have longer healing times are more likely to scar. On a horse, the location of the wound also contributes to scarring.
Wounds on a horse’s legs often scar much more than a wound on a horse’s torso. Wounds over joints and legs often break open as the skin stretches when the joints move, delaying healing time.
Wounds that end up contaminated with bacteria, dirt, shavings, etc. will take longer to heal and increase the chance of infection and scarring.
Proud flesh can be a huge problem if left unchecked and can contribute to delays in healing more scarring.
What Can You Do to Minimize Scarring?
A Type 1 wound that was stitched will have less scaring than a similar wound without stitches. It’s always a good idea to have your Vet take a look at any wound to determine the need for stitches.
A wound that is stitched closed will still have a scar, but it’s usually much smaller and sometimes only at the microscopic level.
There is no magic formula to preventing scars, but you can do a few things to help your horse heal with minimal scarring.
- Keep the wound clean. You don’t want to over-do it so much that the wound gets irritated, but you need to keep contaminants out of it. Flushing with water or saline daily is a good idea.
- Wounds may do better if they are covered in the initial stages of healing. This is key for most leg wounds, as they fill with footing, dirt, shavings, etc. easily. Standing wraps, cotton bandages, Vet Wrap, Elastikon, and even bandages taped on can help with this.
- Keep a wound moist. It will crack when it becomes dry and scabby. The easiest way to do this is to use a Vet approved ointment once or twice or more a day.
- Once the wound has laid down a layer of granulated tissue, wounds do better if they are uncovered. It really depends on the stage of wound healing.
Will the Hair Grow Back?
One of our biggest concerns is how the wound will look after it has healed. Will the hair grow back? The answer is maybe. It boils down to how much damage happened to the hair follicles in the skin. Lots of damage means the hair is probably not coming back.
What Causes White Hairs to Form Over Wounds?
There are cells in your horse’s skin that produce pigment as your horse’s hair grows. These production cells, as they are called, are responsible for the color of your horse’s coat. They are also delicate and love to get damaged. After damage, you might have a wound where the hair grows back, but the pigment doesn’t, which gives your horse a white patch.
Conclusion
No one ever wants to deal with an injured horse, but being prepared and knowing what to do in the event of an injury will help alleviate the anxiety. I hope you found this article helpful and that you have great outcomes with any wound you may have to deal with.
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Enjoy the Ride!