Best Open Wound Treatment for Horses
No one wants to find their horse with an open wound, but we all know how good they are at getting themselves into trouble. Be it a cut from a stray, sharp stone or branch during a vigorous roll, a run-in with the fencing, or a kick from a field-mate, the sight of a nasty gash is enough to get most horse owners´hearts racing! Some horses seem prone to wounds no matter how much we wrap them up in cotton wool, regardless of how many pairs of brushing boots or overreach boots we put on, or whether they´re stabled rather than field-kept, they can still manage to get a decent wound somewhere.
Thankfully, most of the time wounds are superficial and can be managed at home. If they don´t involve structures such as tendons, joints, bones, eyes, and orifices (the mouth, anus etc) and if they don´t extend any further than the skin then normally all that´s needed is good wound care and patience.
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First things first
If you find your horse with a nasty gash but he´s otherwise OK, then get to work trying to clean it up. If you´ve got any doubts about other injuries, or if the wound seems severe then call the vet right away and in the meantime, you can clean it up. To get rid of contamination and dirt flushing with copious amounts of sterile saline using a syringe to apply it under pressure. For a decent flush, you´ll need at least 100mL in most small wounds, and liters more severe ones. If you don´t have saline in your first aid kit then tap water is OK but overflushing with it can damage the tissue, so once the wound looks mostly clean then stop. If your horse won´t tolerate the wound being flushed this then try to apply a sterile dressing and wait for the vet.
What can I put on an open wound?
If you´re faced with a wound that´s not serious, but it´s fresh, sore and unsightly then you can manage it well with a few basic steps and a bit of understanding about wound repair.
To give the wound the best chance of healing well, there needs to be no contamination, although flushing well will do most of this work, normally it´s best to then try to get rid of the surrounding hair so that it´s not poking into the wound and stopping healing from progressing. First applying a generous amount of a protective sterile gel to the wound is recommended, then you won´t undo all of the hard work you did in flushing it out! These hydrogels are great because they help to get rid of damaged tissue and debris, cleaning the wound out even more without you having to do the leg work, and in wounds that just don´t seem to be clean after the first flushing, applying the gel with a dressing to keep it in place, and then flushing it out the next day can help to get rid of the rest of the debris.
Next, let’s consider the stages of wound healing. Initially, for up to 5 days after injury, we have the inflammatory phase. As a result of the trauma, blood and inflammatory cells are drawn into the wound, these help to fight infection, to stem the bleeding and to provide the precursors to start the healing process. If the wound isn´t bleeding but is fresh and probably still contaminated then one of the best things to apply áfter flushing it, is medical grade honey! This is applied to fresh wounds because the action of the honey helps to prevent bacterial infection and provides the right environment for healing in early stages, it´s also available in the form of impregnated dressings that can be bandaged over a wound where appropriate. It can be reapplied until the next stages of healing are underway: granulation and epithelialization.
After about 3-5 days wounds start to granulate, this means that healthy blood vessels and connective tissue are deposited leaving a pink shiny looking tissue, in many cases, this will be covered by the start of a scab so it won´t be visible. The granulation tissue is actually really resistant to infection so normally we only have to protect and support it whilst the skin stars to epithelialize over it and a scar forms.
Granulation tissue can be protected by keeping it a bit moist using the hydrogels mentioned above, or a wound spray but if a scab is present then the tissue will be granulating and protected underneath so there´s no need to put anything on or remove the scab. When the scab falls off and leaves a fresh scar then healing´s nearly complete – apart from the remodeling that happens over the following weeks to months which we normally can´t appreciate.
A bit of knowledge goes a long way…
The next time your horse comes in from the field with an open wound, you´ll have the knowledge to hand to give it the best chance of healing. Despite the plethora of topical products advertised for wound care, there are few products that will actually help healing, in fact indiscriminate use of iodine, disinfectants and inappropriate topical products can damage wound beds and slow down healing.
The main things to remember to have to hand are saline, some form of hidrogel to help debride and protect the wound, medical-grade honey to support it and prevent infection in the early days, and a topical moistener to care for the fragile granulation tissue that will provide the framework for the scab and scar formation. Remember that horses can be quite prone to proud flesh, where there is overexuberant granulation tissue, so monitoring open wounds carefully for protruding tissue is important, if this happens it´s best to give your vet a call.