Lacerations can be among the most alarming horse injuries that you’ll ever face. Since wound treatment is such an extensive field, we provide you with an overview here. You can find veterinary books with more complete information on lacerations.
There are three main types of open wounds: Superficial Lacerations, Deep Lacerations, and Puncture Wounds; treatments for each have commonalities, but also some specific differences. When you discover that your horse has sustained an open wound, your first responsibility is to determine the location, nature, and extent of the injury. Here are some guidelines:
If the wound is spurting bright red blood, an artery has been severed and you must stop the bleeding as quickly as possible. Do this by applying pressure directly to the laceration. Pressure bandages and wraps can be used on limbs, but if the laceration is on any other part of the horse’s body, you’ll have to elicit some help to keep the animal still while you apply pressure to the bleeding. If the bleeding is not excessive, you’ll have to make a judgment as to whether or not to stop it. Remember that some bleeding is helpful to cleanse the wound.
Once bleeding has been addressed, it’s important to clean the laceration in order to determine the nature of the wound. Dried blood and debris can be cleaned off using towels or washcloths and warm water with a mild antiseptic such as betadine soap. If flaps of skin have been dislodged from their blood supply, you should try to reorient them and keep them in place by means of warm compresses until the vet arrives. Please also refrain from applying any ointments or powders to lacerations that will be treated by a vet, as they may impede her examination.
If the skin is torn and separated but there does not appear to be extensive damage to the underlying muscle tissue, it’s considered a superficial laceration. A deep laceration involves torn muscle tissue and may also include damage to tendons or ligaments. Deep lacerations should be examined by a veterinarian within an hour. When you call the vet, be prepared to describe the nature of the injury, the degree of separation of tissue, and its location. Consult an Equine Anatomy Chart so that you can accurately inform the vet of the location of the horse’s injury.
Puncture wounds are the most dangerous and most troublesome because they are characterized by a small entry wound which does not allow easy examination as to the injury’s depth and extent. Puncture wounds on the animal’s body may involve damage to internal organs and on the limbs can indicate tendon or suspensory injury. All puncture wounds should be examined by a veterinarian as soon as possible.
Once the vet has arrived, you can relax a bit and allow her to do her job. Here are some things to expect: In the case of a deep laceration, she may need to flush the wound in order to examine it more fully, and if damage has occurred to tendons, tendon sheaths, or other suspensories, surgery may be required. Your horse will then need to be transported to an appropriate location to perform x-rays and surgery.
Puncture wounds are problematic. Upon examination, your vet may decide that x-rays or radiographs are necessary to determine the extent of the injury. Surgery may also be required if there has been damage to internal organs. Certainly, she’ll make sure that your horse’s tetanus vaccination is up to date, and if the wound is deep and contaminated, she may flush it and then arrange for drainage. This might be achieved by leaving the wound open, or by installing a plastic or latex drain that will exit through a secondary incision.
If your vet determines that suturing is necessary, she may choose to use either individual sutures or a continuous suture. Individual ones are more secure, but a continuous suture can be put in place more quickly. For larger areas of skin and ones under some tension, the vet may use buttons to spread the tension out over a larger area and keep the sutured skin from tearing.
Cases where the skin is displaced and missing or if suturing is difficult, as on the limbs, can be more challenging. In these cases, the healing process may result in the formation of excessive granulation tissue. Some granulation tissue is necessary for successful healing and the photo at right shows healthy granulation tissue. It is velvety and rich in blood vessels, but if it becomes excessive, (proud flesh) it tends to impede the growth of new skin cells across the open area. Some small and seemingly insignificant lacerations to the limbs may take an inordinate amount of time to heal due to the formation of proud flesh.
Excessive proud flesh can be removed by means of additional surgery, application of caustics like copper sulfate or silver nitrate or use of low energy phototherapy (LEPT) . LEPT also promotes the formation of fibroblasts, which are the next step in the healing process after the formation of granulation tissue. Prompt formation of fibroblasts will naturally reduce the possibility of proud flesh, so the use of LEPT is recommended right from the start.
Once the vet has completed her treatment, it will be up to you to make sure that the wound and dressings are properly maintained. Follow your vet’s instructions for changing bandages and wraps. If antibiotics are prescribed, be sure to use the entire course in order to completely eliminate any infections. Once healing has commenced, use LEPT regularly to enhance the body’s own healing properties.
Finally, there are some neat tricks to use to help the cosmetic aspects of healing: Keep a bit of Neosporin or other antibiotic ointments on the closed wound to ensure the hair grows back fully, and if you apply meat tenderizer to the closed wound, it will tend to heal without scarring.