wound treatment question

[marta]

my mare was attacked today by another horse in turnout. i witnessed the attack and i have to say it was horrifying to see a horse so determined to kill another. but i digress.

as a result of the attack my mare ended up with a very round and deep cut on her shoulder. it goes through many layers of tissue. it so happened that a vet was scheduled to be at the barn today and she looked at the injury. this is not my vet. by the time she saw the cut i already flushed it w/ saline and betadine. hair was clipped. she said to leave it alone, don't put any antibiotic ointments on it, don't suture it. she gave me SMZ's and said to just let it heal. i was glad she didn't think she needed sutures. but i'm a bit unsure about her advice to let it heal without an antibiotic ointment. the wound is draining now on its own. vet said that in her experience the ointments sometimes inhibit the healing process.

so i just wanted to see what others thought about letting the wound just heal by itself without ointments? it's entirely possible that i just feel a need to apply something to make myself feel better;)

[Bayou Roux]

I am not a vet; I am not a medical practitioner of any kind...but for what it's worth, it does seem to me that if the wound goes through a few layers, and is draining, that coating it with an ointment could possibly inhibit healing from the inside out.

I could conceive of a superficial surface-layer closing (or just gooing up), with the underneath layers developing infection...

So, while I'd share your concern, especially if I saw it happen, here's one vote that the vet's probably got it right. Keep your eyes on it, though, and if you don't like how it's looking, call her back out.

Jingles to your mare, though, sheesh!

[marta]

my stomach is in the knot as i sit here at the computer at home.
i'll watch it for a few days and see how it goes.
i guess the SMZ's will help w/ any infection.

[Sunnydays]

I have (sadly) had major experience with wound care. The specialist at Guelph had a motto "dilute, dilute, dilute" She espoused flushing with clean water, to remove dead tissues that build up. Scrub with a sponge or cloth with minimum of soap on a recent wound - our just a saline solution as healing progresses, then rinse and do not use ointments (unless trying to either promote or control proudflesh - depending on wound type/stage). A plastic surgeon friend said one could alternate saline solution for cleaning, with very dilute vinegar solution, as salt and vinegar are effective against different pathogens. Do not use iodine, betadine, or alcohol, as these kill the good cells too.
Good luck.

[Bluey]

Is your horse current on tetanus vaccine?
I would wonder if it needs a booster, just in case.

We had a horse open his stall door and wander around, then open another horse's door and they got in a fight in the aisle and one ended up with a big, ugly, mangled cut in his shoulder.
That opening was too big for it to be sewed up, the vet said, so he washed it good and put the horse on penicillin and his tetanus shot.

The vet had us flush it with running water from a hose several times a day, until it started healing well and then taper off.

We had a problem, best I remember, with the wound getting straw bedding in it, so we had to clean that out several times a day.
I think that today they have some artificial wound covers for such big holes, leaving drainage tracks below.

Eventually, as it was almost closed, best I remember, we started adding scarlet oil and it healed with a fine line you could not hardly see.

With those kinds of injuries, you have to take it as it heals, do whatever you have to do as it goes along.
I hope your horse heals just as well as those with similar injuries I have seen did.:)

[marta]

but i'll check my records and call the clinic on monday to confirm.

b/c of the shock she was in, i put a blanket on her and i'm going to leave her in it for a few days. forecast calls for frigid temps and i want to make sure she doesn't stiffen up on me. in order to ensure the blanket material doesn't rub on the wound i attached a piece of wound dressing to her shoulder. it's loose, so it allows the cut to drain. this evening they had to attach a second piece of wound dressing on top b/c not only is it draining down her leg but it managed to seep through the first layer.

it makes sense that ointments would potentially decrease the ability of the wound to drain. i didn't think of that.

the hole is so big. it's easily 1 cm in diameter. and then it goes through layers of tissue you can actually see. :cry:

[MoonWitch]

We just went through the same thing with my daughters OTTB who opened up the front of his leg on a drainage pipe in his paddock. Would was like a gaping mouth and you could almost see to the bond. Needless to say we don't board there anymore, but now I degress. Anyway, went to our new barn and the BM took one look at it and gasped! We had been instructed to use Furazone (I hate this stuff) and we did as instructed. Vet came and debrided the flap of dead tissue and we kept it irrigated. She had a salve that has been in her family for years. She is just starting to market it and if you want to PM me I will give you contact info as well as before and after photos.

[BeastieSlave]

When my "Bubble Boy" put a hole in his chest so big you could put your fist in it, my vet did try to stitch it up initially. Some of the tissue died (sort of melted away) and the stitches didn't hold.

I was sure he would have a massive scar. The vet opened everything up and trimmed away the dead tissue that hadn't turned into slime. Then, he had me blast the wound with the hose every day and clean out any crustiness with gauze. Doing that cleaned the hole and stimulated the tissue. He also had me spray on an enzyme treatment for wounds. It healed beautifully and you have to really look to tell where the wound was.

Good luck with your mare!

[AKB]

Twice, we have had big wounds that our vet (a surgeon) advised covering with silver sulfadiazine cream several times a day. The cream keeps the wound clean and moist, but is not so thick as to prevent drainage. It is also a good antibacterial cream. You might talk with your vet and see if she/he recommends it. You can buy it in several catalogues.

[secretariat]

There are times when anti-microbials are warranted, but they're significantly over-used. Even Betadine has some negative implications. I'm not a vet, and am not giving veterinary advice, but from a horseman's perspective remember that anything that will kill germs will also kill or stunt the cells you're trying to grow to heal the wound. As a result, if the wound is in a location that will not continue to get dirty, your best bet is usually just cold hosing. If the wound progression indicates you need more, use it -- but use it with caution and conservatism.

As my vet told me several months ago, "The best thing horse owners can do for their horses is get all of the purple and red treatments out of their tack room."

[irishcas]

Hey Marta:

I wouldn't put anything on it, except Sugardyne. That stuff is a miracle treatment. I had a horse with a HUGE wound to his tail, I just flushed it with Betadine and then packed it with Sugardyne. There is only a small scar to see now, it healed very nicely.

Do you have a picture of the wound?

Regards,

[marta]

i didn't even think of that.
imagine a whole punch 1 cm in diameter applied to her shoulder. it looks like it cut through many many layers of tissue. it's draining and looks very well today. i didn't touch it so far. it actually appears that her rump is causing her much more discomfort (she took multiple blows to the right side) than the cut.

[Bayou Roux]

i didn't even think of that.
imagine a whole punch 1 cm in diameter applied to her shoulder. it looks like it cut through many many layers of tissue. it's draining and looks very well today. i didn't touch it so far. it actually appears that her rump is causing her much more discomfort (she took multiple blows to the right side) than the cut.

I'm glad to hear it's looking better today! Continued jingles.

And, yeah, it's been my experience, both equine and personal, that the bruises hurt a heck of a lot more than the open wounds. (I'm clumsy...)

[marta]

i'm applying sore no more to her rump. just pouring it on and rubbing it in. i know it works on my bruises and it appears to make her feel a bit better, too.
i walked her for 15 minutes in the indoor just to get her moving since the paddocks are snowy and icy and horses just kind of stand around. vet said to keep her moving so that she doesn't stiffen up.

incredibly her lower legs seem to have gone unscathed. i poulticed them after the incident b/c she ran a lot trying to get away from that beastly TB. i was worried that she tore up her suspensory again but there was no heat or swelling in the lower legs at all today.

now the trick is to get her to eat her SMZ's without resorting to a dosing syringe. i think she got a total of a 4 lbs scoop of TC lite, a 3 lbs scoop of senior and a 3 lbs scoop of pennfields granola today just b/c i was trying to get her to eat all of the food w/ the meds mixed in. told the BM to try senior by itself tomorrow and see if she eats that. i even added hot water to make it more palatable.

and then, to add insult to injury the TB beast who beat her up came in from turnout with awful case of snowballs in her shoes and i had to pick them out. i had ambivalent feelings doing it and grumbled at her. i realize it's just a horse and she probably doesn't even remember the incident any more (although my mare does!) but that human tendency to get resentful and vengeful was kicking in.

[Ebvann]

I am in the same boat...my gelding cut himself, a seven inch gash in his left front leg above his knee.... around 10 days ago. vet came out, had to put him to sleep to sew it up, put about ten stitches and a drain in it, and put him on SMZ... before vet even got home Yo had already reached down and pulled the drain out... long story but after 5 days of tender loving care and stall confinement, handwalking and antibiotics... infected...vet back out, had to cut out stitches and leave the gaping hole...put him on major antibiotics for another five days (and probiotics); I have been cleaning it out, fairly strong hose to wound for several minutes, then cleaning inside wound, airdrying then applying the silver stuff someone else used in a post above me...the wound is changing daily in its appearance, vet came for first three days...so now I am looking at this wound and hoping that the metamorphisis I am observing is ok....it is still draining and looks pretty gross but I am keeping it covered to keep trash out..using puppy "wee wee" pads and ducktaping to the horse himself...but he is trying to bite me when i pull ducktape off but that was the only way to keep banadge from sliding down leg. I like the silver stuff, very light...I think used for burn victims...does allow draining and I do clean the wound completely 2 to 3 times a day...I think what I am observing is granulation and capillaries beginning to do their thing...I hope...pretty frightening after we have already had one infection....so guess I am saying my thoughts are with you, but I would be cleaning it a couple of times a day....good luck, wondering if anyone has suggestions once wound closes for strenghtening the skin on that area....

[marta]

really only so that the blanket doesn't rub directly on the wound, although it's in the area below the gussets so really no rubbing there (thankfully!).
i have the large wound dressing that opens up into a rectangle about 4 inches long and 3 inches wide. she's not objecting to duct tape. my gf said she has a wound bandage that sticks well but doesn't pull on the hair. we haven't tried that yet.

7" cut - that's HUGE! ours only seems 7" deep;) kidding. but it does seem to cut through about 7 layers of tissue:(

[Sentry Chick]

My mare was attacked on 12-14 and had to have 3 layers of stitches and drainage tube. She had somehow pulled the tube out herself a day early but it's still draining so no problems there. She was put on SMZ's too. I was not instructed to put anything on her wound either. So far it's healing fine, stilll draining like crazy but healing. She is not due to have her stitches out until later this week.

[3Spots]

I just have to throw in my favorite, Banixx. It worked better than furazone, triple ointment, alushield, etc. on all the abcesses and wounds my youngster has managed to get. Clear like water, ph balanced. Works.