Wound Care is not for the faint of heart!

You go to the pasture to catch your favorite pony and he and his herd run for the far back corner. To your horror, as the herd thunders back toward the barn your pony slips on a mud-covered ice patch and falls. His leg scrapes down a steel fence post in the fence line and he comes hobbling and bleeding to the barn.

What next?

• Do a calm assessment of the wound. There’s a flap of skin hanging down the cannon bone with the extensor tendon showing.
• Does it need veterinary attention? This is a full skin thickness wound so yes, call the veterinarian. Wounds have a “golden period” of ~8 hours to be sutured. After 8 hours, the body has begun the process of healing the wound and the edges may not hold together even if stitched together.
• Is the wound dirty or bleeding profusely? Spurting or rapidly pooling bright red blood indicates an artery has been severed. Apply pressure bandage. NOT appropriate, in most circumstances, to use a tourniquet. Any kind of padding will work—quilts, cotton, rub rags, bathroom towels. In this scenario, no artery is involved but mud is everywhere so gentle cleaning is indicated. The best cleaning solution is Saline (0.9% Normal Saline), if available, otherwise lots of low pressure water (do not blast with a hose as this drives the dirt into the wound).
• Apply a clean wound covering. Non-stick gauze, padding and bandage for an extremity (Specialty Bandages at the HA come into practical use!). Could involve a fly sheet or blanket. Do not apply any ointment or sprays as they can complicate the suturing and healing process.
• Be sure the horse is otherwise unhurt, warm and safe. Sometimes we see the big, ugly wound and miss that the horse is wet all over and shivering. In this scenario, he needs a toweling off from his mud bath.
• Veterinarian arrives, sedates and sutures and leaves a to-do list. Is his tetanus vaccine up-to-date?
• Systemic antibiotics are often prescribed. Use them as directed.
• Anti-inflammatory drugs (like phenylbutazone or “Bute”) may help with pain and swelling. Use as directed.
• Bandaging—particularly on a leg. Change daily or more often if wound has a lot of discharge. Use washable padding and wash in hot water and bleach. Can cut up old mattress pads for padding. Become expert at applying stable bandages!
• Watch for wound dehiscence (the skin edges gape apart) and report to your veterinarian.
• Watch for exuberant granulation tissue (“proud flesh”)—red, bubbly-looking and bleeds easily. May need veterinary visit to remove the proud flesh so the skin can advance over the wound surface and close it up. At HA level, should understand the stages of wound healing in the Integumentary System.
• Be diligent and patient. A whole season of riding is lost in this scenario but the wound heals completely with minimal scarring.
• Exceeds Standards on HA bandaging is a bonus result. Practice does make perfect!