Horse Wounds Can Seem Devastating
WARNING The graphics in this blog may be too strong for some of you in my audience. By profession, I am a burn nurse. I worked for the Trauma/Burn ICU at the University of Michigan. This is a level 1 Trauma center and I have seen it all. No one likes a bad accident, whether it is a human or a horse, and our barn was devastated when this horse became injured last summer. After one day in an emergency vet clinic, this horse returned to our barn where the young owner and I embarked on the wound care together. We are amazed at how well she healed. Her recovery is just short of a miracle when you compare the before and after photos that were taken.
I have taught many horse owners how to treat their horse’s wounds by using the nursing principles of the burn unit. These principles are based on the research we did at the U of M hospital on wound care. I am not a vet! I strongly suggest all wounds be seen by your veterinarian before you take on the responsibility of the wound care. Your vet will prescribe all of the necessary topical or systemic antibiotics and advise you on bandaging techniques. This information I am going to provide may help you feel ok about what you can do to be sure the wounds heal really well. This advice is based on fact and how we treated humans when they had trauma or burn related wounds. Above all be safe. As you try to do what is best for your horse don’t put yourself in harms way.
Wound care theory #1
You can not hurt good tissue. This means that in the effort to clean a wound we have to get a bit aggressive, or, call it thorough. In the hospital we called it debridement or eschar removal. These are fancy words that mean: take all the scab and dead tissue off as you clean it. Yes, you should pick the scab off and make a very clean wound that is cherry red and slightly bleeding. When my clients worry about this step, I tell them we were taught that this is just as ok as if you scraped your healthy skin with a brush, only the dead tissue would be removed, the good tissue is left behind to heal. The bleeding is proof of good healthy circulation and not to be worried about.
Wound care theory #2
Deep wounds will heal nicely from the inside out, if you keep them open and draining. A wound that closes too early will trap debris and bacteria inside that will complicate the healing process. It is very hard to secure sutures/staples in a horse wound that has moving parts, therefore it is common to have a large wound that will not hold the sutures for very long. This theory allows for wounds that cannot be sutured to still heal well. Keep the deep wounds open (don’t allow scabs to form) and don’t be afraid to flush them out. Start with a syringe of soapy water into the wound, then follow with a clean rinse from the hose that uses pressure to really drain any microbes out of the area. We call that step irrigation and you can flush it for as long as a couple of minutes. My students are sometimes taken aback when the ole burn nurse in me gets really thorough as I dig in to be sure the wounds are super clean.
Wound Care Theory #3
Use simple soap and water to keep your wounds clean. After the vet has done the initial antimicrobial scrubs, the follow up wound care should be done with the least caustic agent possible. Things like iodine, peroxide and alcohol can actually inhibit new cell growth. At the U of M hospital, we did a big study on this fact and found that any soap will act as a good antimicrobial agent and we did not use any particular brand in the everyday care of the wounds. My personal favorite for horse wounds is the green palmolive brand dish soap. Back in the day, it was recommended for all kinds of things like scratches and rain rot, so I just keep using it on everything with good results.
The wounds we treated on this horse could have had a completely different outcome if they had become infected. The wound care I describe in this blog is to be accompanied by applying the medicine and the bandaging that your veterinarian prescribes. We did not have any significant proud flesh and what little bit we had was easily remedied. If you didn’t know that this horse was so badly injured last summer, you’d never know she ever had a wound!