Equine Wound Healing

Equine wound healing is a complex and elegant process of rebuilding damaged, dead, or missing tissue. There are 3 stages of wound healing: inflammatory, proliferation, and remodeling. The names give you an idea of what process is predominant at the time. Simply put, the inflammatory phase, the first 2-3 days, is very early with blood vessel changes and a stampede of white blood cells to clean up and clear away debris. Proliferation can last up to 6 weeks in severe wounds, and includes new blood vessels to carry in the cells, proteins and chemicals to create scaffolds for the reconstruction activity that is the bulk of this phase. Remodeling is taking the newly made tissue and forming it into the proper architecture and functionality that it had before.

Generally, wounds progress through an orderly defined process to return the body to normal function and integrity, but there are several factors that can impair this process, and many are man made! The rest of this article will describe some things that you should NOT do when caring for a wound.

I have been called to many fresh lacerations over the years that needed sutures, and would have healed quickly and cosmetically if they had been sutured, but… sometimes the owners have packed the wound with ash from the BBQ grill. It is impossible to remove all the carbon crystals and gritty particles from such a wound – suturing over that would result in a reaction, drainage, discomfort, and sutures coming apart. It does not help us. Don’t do that. Likewise for the sand or one time, the kitty litter “to stop the bleeding”. While pickling lime may have a place on a 3-week-old wound, it should never be used on a new one. I feel that I have to specifically add that in the liquid category, used motor oil, turpentine, and alcohol are not appropriate for fresh wounds either.

In general, rinse it off, and lightly cover it until your vet arrives. If it is not deep or too traumatic, your vet may be happy for you to wash it with an antimicrobial solution or soap. If it is oozing, gushing, dripping, or pumping blood, we can usually tell you how to get by until we get there. I have walked a guy through clamping a major vessel with needle-nose pliers to save his horse, and have arrived to more than one farm to see someone with their hands encircling a badly cut leg holding the blood in. After bleeding is controlled, your vet will clean and assess the wound. Often there is more involved than meets the eye: nerves and bones can be damaged, joints can be punctured, tendons are often involved on the limbs, foreign bodies are common. It is always best to have a full evaluation so any issues can be immediately addressed, and a proper plan decided.

One of the problems we see often is people who feel the need to clean and scrub wounds several times a day despite instructions to the contrary. Those newly formed cells that need to creep over the wound from the edges are getting scrubbed away. The irritation to the wound encourages excessive granulation tissue (proud flesh). The “slime” that people want to scrub away is often protein exudate used in the healing process. Don’t get excited, more activity with the wound is often not a good thing. Another issue is what to put on the wound? Put on it what your vet tells you to put on it! Not a lot of extra stuff. The baby cells can’t move well in super thick ointments. Hydrogen peroxide kills them. Most of the little bottles of wound care liquid from the feed store contain a lot of alcohol – not good for the baby cells or blood vessels. The irritation/inflammation caused by alcohol can encourage proud flesh.

What kind of bandage do you need? The kind your vet wants! There are different reasons for having a bandage, and the type of bandage is decided by the reason you need it. We change the frequency of bandage changes as the wound changes. There may be drains to allow or encourage drainage, there may be different types of sutures, but be sure to remove them how and when you have been told. Leaving these things in another week ” just to make sure” causes a foreign body reaction that can make drainage just by having it there, or lead to scarring.

Horses like to grow excessive granulation tissue over joints and other moveable areas, and there are many ways to deal with that as well. The fact that there are many remedies is an indicator that none of them work exceptionally well, so we may have to try a few to see what works best on any given wound.