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In a Nutwell - Wounds

This week I wanted to talk to you about wounds with one of our cases to show you how severe they can be.  Just warning,the below photos show some graphic content. 

Wounds may appear insignificant and can be unassuming, but this can be misleading. The overall aim of treating a horse wound is to avoid infection and to promote a healthy healing environment.  Some wounds are much more severe than others, but the basic principle for treating the wound remains the same. Small wounds can be more complicated than the larger more gruesome ones, and sometimes it’s the smaller ones that can be deep, such as a puncture and can have multiple complications if not dealt with correctly.

Wound healing and the final outcome greatly depends on its initial management. “A job worth doing is a job worth doing right”, is very applicable to horse wounds and by investing in appropriate veterinary care in the first instance can greatly speed up wound healing and avoid lengthy complications and delayed healing, (DVEP, “Wound care”).

This patient has been one of our most visited this year due to a nasty wound to his right hind leg which he caught on wire fencing. Not all wounds heal like we want them to and there can be complications along the way.The wound was very deep with the bone being visible, making it more complicated and very difficult to heal. It was going to be a long road to recovery and the chance for wound breakdown was very high. Despite the poor prognosis, he made a full recovery with thanks to his very determined owner,along with the expertise and dedication of our vet Robert. 

Below I have put together a time line of the wound recovery.

Day 1: Our patient has caught his right hind leg on wire fencing which caused a deep wound.

Under anaesthetic, the wound was cleaned and sutured and he was kept box rested until the wound healed. 

Three weeks post stitch up:  

This is the wound with a healthy bed of granulation tissue, the yellow is protein rich transudate which is normal. It is important here to maintain both pressure and cleanliness and avoid further trauma of the delicate cells around the wound edge. At this stage, the wound dressing was being changed twice weekly.

This is a week on from the photo above – notice how much narrower the bottom of the wound is becoming, and compare it to the photo from two weeks prior. 

Excess granulation tissue has been trimmed back here to aid healing. 

This is two weeks after trimming of the granulation tissue, the white discolouration at the wound centre is residue from the dressing used that week and is very normal. If you notice the point at the bottom of the wound has almost healed. 

This is two weeks later. The hair is growing back on the leg and the wound is significantly smaller in size. The dressing was no longer being applied. Unfortunately, this was moments after he had caught his leg on a sharp edge and re-opened the wound. 

Topical skin spray was applied to help dry the remainder of the wound. 

Present: The wound has now completely healed and he is back to being ridden again.

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