Wounds

Incised wounds: These are made by a sharp object such as a knife or a piece of broken glass. They will have clean-looking edges and may bleed heavily if blood vessels are cut.

 Lacerated/Tears: More jagged edges. These kinds of wounds are often caused by barbed wire. They are very unlikely to bleed as badly as an incised wound because the wound is usually created by a pulling or pushing action against an object. Blood vessels, being elastic, are often able to stretch or slide with the foreign object and then spring back into position.

Puncture wounds: Caused by the likes of a stake or nail. Will usually not bleed heavily because of the elasticity mentioned for tears, but if the object does manage to puncture a major blood vessel then the outcome for the unlucky horse may be fatal.

Abrasions: Caused by friction. A rope burn is a typical abrasion. Most abrasions normally involve only the skin and hair, but sometimes they can go deeper. Abrasions will often seep blood or body fluids and can look very messy.

Contusions: Essentially, an internal wound. The tissues have been damaged and are bleeding, but the skin is not broken. Usually, there will be swelling at the site and the horse will show discomfort.

Most wounds can be treated by the horse owner unless they involve the eye, or deeper tissues such as tendons, muscles joints, and, of course, bones. In these cases, the risk is that the horse may not fully recover unless proper treatment is given, so it is recommended the vet be called.

Aside from major blood loss, the greatest threat your horse will face is that from tetanus. This is a serious disease caused by a bacteria living naturally in the soil. Ideally, horses should receive long-term immunisation against tetanus, but even so, a vet will probably recommend a booster or protective dose in the case of injury. Many horse owners will naturally not want to pay the cost of a vet visit for every wound or scratch. However, they need to recognise there is a risk, which can be minimised with immunisation. The risk is also considerably greater in wounds that receive large exposure to soil, such as fall that cuts the knees, or if it is a puncture wound. These can provide the airless conditions in which tetanus spores thrive best. A tetanus booster in these circumstances is strongly recommended.

The first issue in the treatment of any wound is to control the bleeding. If the blood is spurting from the wound, an artery has been damaged and a vet must be called. Usually, however, pressure applied directly to the wound site will be enough to stem the bleeding within a few minutes. If this fails to stop the bleeding, a vet should be called.

Remember that some bleeding can be a good thing, as it helps flush the wound and remove any foreign matter.

If the blood flow is life-threatening and cannot be kept in check, you may have no choice but to apply a tourniquet above the wound. The tourniquet will stop the bleeding, but it will also starve the area below the tourniquet of blood and oxygen, and you run the risk of killing tissue. A tourniquet MUST be released every few minutes to allow some blood flow, and, if it needs to be put back, should be moved a little higher or lower on the limb. A vet must be summoned immediately.

Once bleeding is under control, the next step is to ensure that the wound is free of dirt and other foreign objects. Never use disinfectant and the use of an antiseptic is probably not necessary. The best way to cleanse a wound is to use a moderate flow of clean water. If you remain concerned, you could use a mild soap and water, but use clean water to thoroughly remove any residue afterwards.

A clean wound provides you with the best opportunity to assess the damage and decide whether veterinary intervention is necessary. Is there muscle or tendon damage? If the wound is over a joint, is the joint capsule intact?

Generally, dry powders should not be applied to fresh wounds, as this can interfere with granulation, which is the first step in the wound closing over and healing.

You must now decide whether a bandage is appropriate. There are several benefits: it prevents dirt entering the wound area and keeps flies at bay. They can also restrict movement, which may speed the healing process. A bandage can also bring the edges of the wound closer together.

Generally, bandages are only an option for the lower body parts. Dressings should be changed regularly to keep them fresh, and it provides an opportunity to check on the healing process. They'll need to be firm to stay in place, but never apply them so tightly that they restrict blood flow. Bandages also discourage the formation of proud flesh (see below).

If wounds are left open, they can be given a gentle flush each day with about 600ml of sterile water with a teaspoon of salt to keep the wound clear of any debris or fluids oozing from the wound.

Generally, dry wounds will heal faster.

Stitching is always an option for bigger wounds, particularly incisions, but the location of the injury will very much determine whether this is sensible. In some areas, particularly around the legs, the stretching of the skin is such that it is unlikely the stitching will ultimately hold. Your vet will recommend the best course of action.

Contusions - bleeding beneath the skin - can be painful for a horse. They are usually caused by a kick, a fall, or a bad knock. Applications of cold-packs immediately after the injury will help with the discomfort and minimise the amount of bleeding into the issue. Once you're satisfied the bleeding has stopped, warm-packs will encourage healing.

Lacerations, with their ragged nature, probably carry a higher risk of infection and need to be very thoroughly cleaned.

Hydrogen peroxide at the right concentration (read the label) is good for cleaning puncture wounds, as it allows oxygen into the injury. The big risk here, as mentioned above, is tetanus, so call the vet and arrange for a booster. Some vets may even open up a puncture wound to get air to the base of the injury and to ensure the cut heals from the inside out.

Bigger wounds run the risk of developing proud flesh, which is excessive granulation. This needs to be dealt with when it appears, to prevent bigger problems later. The wound will need to be dressed daily with a mildly caustic solution that your vet can provide. This needs to be used until the wound surface is back level with the surrounding skin.

Keep a record of such injuries and the paddocks in which they occur. Do your best to identify the cause and, where possible, remove it. Invest some time in checking your fences regularly for any nails, bolts, or wires that can cause injury. Replacing a top strand of barbed wire is not expensive and will not only save you vet bills, but also the cost of repairing and replacing horse covers.

Introduction
The purpose of first aid is to minimize the damage done by disease or injury and prevent infection, so that healing can proceed as rapidly as possible. Sometimes first aid is all you need, other times it is a temporary measure until further help arrives. First aid can remarkably affect the outcome. Once principles are understood, common sense must be applied. Remember, if you are in a panic, you will not be able to help anyone, so step back from the situation and gather your wits before you tackle the problem. You may not be the only animal who is excited. The injured horse will also be confused and excited which makes him dangerous. If you cannot safely approach him: do not.
The Rules are as important as the first aid.
RULE ONE: Keep calm.
RULE TWO: Do not let the horse hurt anyone.
RULE THREE: Get the horse to a quiet familiar location to work on him. Actively assess: "can this horse be worked on safely?". What can I do to make it safer for the horse and me.
Profuse Bleeding
People tend to overestimate the severity of bleeding. Remember that a 1000 lb. horse has over 7 gallons of blood in his system and he can loose one gallon without serious effects. Of course, if a laceration has profuse bleeding, steps should be taken to slow it down.
Bleeding can be markedly slowed by applying pressure over the source of the blood. This should be done with a clean cloth, if available. Fold the cloth several times on itself to create a thick pad and apply a stretchy tape, Vet Wrap like material is excellent, firmly over the bleeding wound. This type dressing must be dry to adhere to itself so you must keep pressure on the bleeder as you apply the first few layers of the wrap. You can slow down the bleeding considerably using this method.

Too much padding or too loose will prevent you from getting adequate pressure. For instance towels wrapped around the bleeder are not going to help, though I see this done frequently. If the tape is very tight around the leg, change it every 10 minutes to allow circulation to the rest of the leg. If the location of the bleeding is such that you can not tape it, hold the bandage firmly in place until the bleeding stops.


Lacerations
Deep Cut in the Skin Versus A Full Skin Thickness Cut
Many horse owners have trouble differentiating a deep cut in the skin and a full skin thickness laceration. From a treatment standpoint they are very different. Whereas deep cuts in the skin do not require stitches and antibiotics, full skin thickness lacerations do. The deeper layers of the skin can be white to pink resembling the tissue under the skin. One of the easiest ways to tell is that cuts which do not penetrate the skin all the way cannot have the edges of the wound separated. You cannot pull the edges of the wound apart because at the bottom the skin is still connected. How deep can a partial thickness wound be? In some areas where the skin is thick it may be 1/4 to 3/8's of an inch deep on the other hand in some areas the skin is as thin as 1/8 inch.
Cuts Which Do Not Penetrate the Skin
Clean with soap and water and twice daily apply a nitrofurazone based spray. Antibacterial ointments are OK but do not last as long. If the area will be subjected to dirt like the lower legs a clean bandage kept dry is good. These wounds do not require suturing but a careful examination is in order to be sure there are no punctures (see below).
Full Skin Thickness Wounds
Wether this type wound should be sutured or not depends on many factors: age of the wound, location, contamination, blunt trauma, and even the first aid care all factor into the equation. Many people misunderstand the dynamics of serious infection thinking suturing insures this will not happen, when the opposite is true. Contaminated or badly traumatized wounds are safer left open and cared for properly than when sutured. The reason is drainage. Proper drainage helps insure the prevention of ascending infection. Obviously a sutured wound cannot drain. Before a wound is sutured it is imperative that it be clean, free of contamination, and badly traumatized tissue.
Open wounds that will not receive medical attention for several hours
or more should be flushed out with clean water and bandaged, using an antibacterial ointment such as Neosporin. A garden hose with the nozzle set on a firm spray is ideal for flushing.
If a wound is to be stitched,
flushing and bandaging will help minimize infection until the wound can be sutured. Avoid applying medications to the wound, as they may interfere with healing. If medical help is more than two hours away ask the opinion of the vet as to what you might dress the wound with. I like petroleum based triple antibiotic ointments, Furacin ointment or Nolvasan creme. A spray with diluted (somewhere between the appearance of strong tea or coffee) Betadine is good also.
If the wound is badly contaminated
with dirt, it should be gently cleaned with a antibacterial soap, thoroughly flushed, then bandaged with ointment. Seek professional help with contaminated wounds, as these may have life threatening complications like tetanus or gangrene.
Avoid peroxide or blue wound sprays,
as they will kill healthy tissue. The one exception would be a contaminated sole wounds. Peroxide can be used to clean these out initially.
What Deeper Structures Are Injured
With all wounds and particularly with full skin thickness lacerations you must consider what other structures are traumatized. With lower limb injuries penetration into a joint capsule or tendon sheath can turn a routine laceration into a lifetime performance compromising injury. Deep injuries to these areas should always be examined by a veterinarian.
Punctures: the worst of all wounds
Punctures can really fool you. They frequently look like minor wounds, but depending on the depth and contamination they can rapidly become infected. The first signs of problems are usually pain and swelling 24 to 72 hours after the accident. The puncture seals up rapidly, so the infection has no place to go and will spread to surrounding tissues. When in doubt about how deep the puncture is or you doubt that it is draining well have it examined by a vet. Punctures need to be open and explored for foreign bodies, thoroughly cleaned and may be left open or sutured.

Bruising
If your horse receives a hard blow that does not break the skin consider ice compresses for a minimum of 30 minutes and oral bute (1 gm. per thousand lbs. twice daily for 3 days) to limit swelling and pain. Bruised tissues are far more susceptible to serious infection so penetrating wounds with a lot of bruising are more serious. While hot and swelling is present cold compresses or hosing will help.
And area where bruising is particularly serious is to the back of the thigh. These large muscle masses are prone to forming scars from deep bruises. These scars contract and will effect the gait of the horse for life. These horses cannot reach forward as far with the effected limb and slap the ground during the anterior phase. Special care to get the inflammation out as quick as possible and keeping the horse moving with controlled exercise during the next 60 to 90 days is imperitive.

Taken From Horse Talk

The Equine

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