What to do before the vet arrives?
Wounds on horses, especially to their legs, are common. Being a ‘flight’ animal and choosing to run from danger, they are often involved in tangles with fences. Their long legs have little cover over the bone, meaning skin will easily be ripped, exposing any soft tissue structures below as well as the bone itself. Luckily most leg injuries occur on the front surface of the legs which don’t have as many important vital structures (like tendons) as the back surface. When veterinary assistance is called for a leg injury, we try our best to get to these types of injuries as soon as we can. But an immediate response is not always possible and wound cleansing is a good thing for owners to do while waiting for us to arrive.
Wound contamination vs wound infection.
At the time a wound occurs, the skin is often torn or cut allowing foreign material like dirt and grass to contaminate the wound. This foreign material contains bacteria and in the warm moist environment of a wound, bacteria will multiply and the wound then becomes infected. Fresh wounds are thus ‘contaminated’ while older wounds will be ‘infected’. In the early stages of a wound, removal of any wound contaminants will greatly decrease the chances of subsequent infection. Once the bacteria in a wound multiply and incorporate themselves into the tissues involved, they are much harder to remove. For this reason early decontamination by wound cleaning is something that should be attempted as soon as possible.
Four hours is the time interval quoted for a contaminated wound to become an infected wound. In a lot of instances, owners don’t know when an injury occurred, as many leg injuries are simply ‘discovered’ by the owner. A lot can occur over night or possibly during the day when no one is around. Aging a wound is not an exact science but if the leg or area involved is swollen or the exposed tissues dry, then this is an indicator the wound is an old one. Cleaning a wound is best for a fresh wound but it is still very helpful to perform on what looks like an old wound.
Wound decontamination/washing.
Washing the wound out and removing any grossly visible foreign material is not easy for many people, especially if you are squeamish about injuries to your horse. We understand if you would prefer not to do this, but if you are able, here are a few tips on the right way to do this. Washing the wound with copious amounts of salty water or saline is best. Tap water is better than nothing but use sparingly as it can water-log the tissues and the non salty nature of pure water can be detrimental. You can make up a simple saline solution by adding a heaped teaspoon of salt to a litre of clean water. Don’t add disinfectants like Savlon, Dettol or Jeyes fluid.
These are ok for small, shallow wounds but can be caustic to most open wounds and damage the tissues – especially if used in higher concentrations (most people add more than needed!) Use saline solution liberally to douse and sluice the wound rinsing out any contaminants. If you notice any large foreign material like straw, grass heads, small leaves, gravel, rust flakes etc then; after washing your hands well, and pick these out.
Putting ‘stuff’ into or on the wound.
Exposed tissue is delicate. After cleansing, resist the urge to put something onto or into the exposed wound. Don’t put wound powder, blue stone, thick ointments or kerosene into the wound. If you want to put something into the wound use something natural, like honey. Washing the wound out well with saline solution is all that’s needed to decontaminate a wound.
Keep the wound moist.
Exposed tissue, including exposed bone, needs to be kept moist. Letting wounds dry out, damages tissue. After washing the wound liberally, bandage the wound to keep it moist. Close the wound up as best you can, place any tissue sticking out, back into the wound. Upward facing flaps tend to hang down with gravity so replace these where they are supposed to go before bandaging. Don’t use dry bandaging against the wound, it often sticks to the wound surfaces. Dampen the bandage padding material that goes against the wound, with saline solution. Don’t skimp make sure your bandage is big enough to cover all the wound. Don’t bandage too tight as damaged tissue will swell. Bandaging should keep the tissues moist and dark till the vet arrives.
Minimise movement.
Keep the horse calm and quiet till the vet arrives. Put the horse in a box or clean yard. If these aren’t available, tie him up if he’s used to this. Minimising movement until the veterinary assessment, can give a better chance of a faster heal.
Stitching wounds up.
In many instances, wounds, especially leg wounds, are not stitched up. The decision to stitch a wound depends on many factors like position, area involved, time since injury, type of injury, tissues involved, contamination and tension on wound edges. Following a few basic first aid measures like those outlined above will often give a better chance for a wound to be stitched. A stiched wound will make a smaller wound and heal faster.
- Brendon Bell
