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A Peek Inside a Vet’s Wound Care Kit

By Jennifer Ryan
June, 2018
Recommendations for both veterinary and client care kits

Equine veterinarians are always prepared to address a cut or scrape – and they have to keep their clients stocked up as well.

“I was in practice for 20 years, and, unfortunately, animals don’t ever seem to have emergencies during office hours,” says Melinda J Mayfield DVM, WCSP-AH, technical services veterinarian with Innovacyn, Inc. “Sometimes it can be a while to get a hold of a vet, or get a vet to come out. Horse owners can usually do some first aid while they are waiting.”

Before a cut or scrape occurs, veterinarians should review their recommendations for wound care with their client. This also can be the perfect time to ensure clients have all the necessary supplies on hand.
          

What not to use
Veterinarians also should advise clients on what products not to use. For example, Mayfield notes that hydrogen peroxide can actually damage tissue and delay the healing process.

“Peroxide doesn’t have great antimicrobial activity,” she says. “It can actually lead to granulation tissue development, or ‘proud flesh,’ and overall set the horse up for chronic conditions. The only reason to have peroxide is to get blood out of floors.”

In the case of sutures, peroxide can dry skin edges and impede healing.
 

Horse owner care kit
Initial wound therapy involves cleaning debris from the wound. The longer the wound stays dirty, the greater the risk of infection, according to Kansas State University. Once infected, wounds are less likely to stay closed after suturing.

Mayfield recommends owners clean the wound with a topical solution like hypochlorous acid, which has antimicrobial activity. Then, protect the wound with gauze or vet wrap.

“Some areas can be hard to bandage, especially around a joint,” she notes. “Hopefully, you’re not putting on a bandage that’s going to have to last for days. Cleaning the wound and protecting it are the main things you want to do.”

In the case of a bleeding wound, Mayfield recommends putting on a compression bandage to slow down bleeding.

Experienced horse owners may need to have a sedation medication in their first aid kit as well. The first few hours can be critical to proper wound healing, and sedation can allow owners to adequately clean the injury.

“If the horse ran into some sticks, there may be pieces of wood in there,” Mayfield says. “You want to examine the wound really well, flush and clean it. The first rinsing is the most important. That’s when you’re going to get rid of the most contamination from the initial trauma.”

For owners, Mayfield recommends using xylazine or detomidine to sedate the horse and cleaning the wound with hypochlorous acid. However, owners should be particularly careful in the case of leg wounds where “phantom” kicks can occur.


Veterinary care kit
The variety of wounds – and reactions from horses – means there’s no one-size-fits-all approach to wound care.

“The exact same wound in the exact same area in two different horses are not going to heal the same,” Mayfield notes. “We have to look at the individual animal and environment they are in. Then, we have to look at the wound every day to see how’s it’s changing.”

Good healing requires healthy tissue, good blood supply to the area, and infection and inflammation control. Using cleansers with antimicrobial properties helps control inflammation. In more serious cases, veterinarians may recommend antibiotics or anti-inflammatory drugs such as flunixin meglumine. Inflammation can trigger proud flesh, which makes it important to control.

“When the initial insult happens, the body starts to react and then you get into a proliferative phase. Proud flesh occurs when the body gets stuck in the inflammatory phase and doesn’t move into the next phase of healing.”

Once inflammation is addressed, veterinarians assess the moisture balance of the wound. To achieve this balance, the specific wound must be assessed daily. If the wound is too dry, Mayfield may recommend a hydrogel dressing to contribute moisture. If the wound is too wet, she may recommend an alginate dressing to pull excess moisture away.

The final step in wound healing requires the epithelial cells to close the wound.

“These cells are very lazy,” Mayfield says. “If they hit any resistance, they will stop. If they hit a ridge of proud flesh, they will stop. Veterinarians have to address each area epithelial could get stuck on with good wound prep. Then, you can get a nice, healed wound in a timely period.”

The progress of epithelial cells changes from day to day. Therefore, veterinarians must rely on owners to evaluate the wound each day and report on any changes in color or moisture. If wound healing isn’t visible every two to three days, that’s a sign that progression is delayed. Typically, it takes about 12 weeks for a wound to heal.

“The key to wound care is doing what we can, then staying out of the way,” Mayfield says. “Often, horses heal in spite of what we do, not because of it.”

Horse owner first aid kit:

  • Topical wound cleaner with antimicrobial activity
  • Gauze
  • Vet wrap
  • Compression bandage
  • Sedation (optional)

Optimizing wound management with TIME:

  • T = tissue
  • I = infection/inflammation
  • M = moisture balance
  • E = edge of wound

Topics: Equine Extra, Equine, Wound Care

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