Successfully treating skin wounds in horses takes days to weeks. It also requires attention, luck and a great deal of co-operation on the part of the patient.
The severity of the skin wound greatly depends on its location. Even the most gaping and extensive wounds above the knees and hocks can be coaxed to heal with minimal scarring, but those below the knee are more serious.
This part of the leg has little of the muscle and fat that protects the more delicate nerves, blood vessels, tendons and ligaments.
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These important structures are close to the surface in the lower leg, making them extremely vulnerable to injury.
For example, some of the blood vessels in the leg are so superficial that the two common places to feel for a horse’s pulse are the inside of the knee and the back of the pastern.
As a result, there is a great chance that something important will suffer injury when trauma occurs below the knee.
I once saw a horse strike its hind leg on a farrier stand, severing one of the important tendons that run along the back of the leg. The horse had to be euthanized.
Wounds on the lower leg are prone to proud flesh during the healing process, which is overgrowth of the granulation tissue that initially fills in the wound.
In normal healing, the skin cells can slowly migrate across this granulation tissue to join in the middle and close the wound.
With proud flesh, the granulation tissue gets out of hand and over-grows to extend above the level of the skin, making it impossible for the skin cells to migrate across.
This is why one of the mainstays of treating proud flesh is to surgically remove the excess flesh to allow the skin to close across it.
Whether a wound can be successfully sutured depends on the shape of the wound, the location and how long it has been there. Wounds older than six hours are usually not sutured.
Skin that has been cut will contract away from the wound, and it is sensitive about how tightly it can be stretched.
Not only are bacteria much more likely to infect the wound after six hours, but the edges have pulled away, which makes it difficult to close without excessively stretching the skin.
The lower legs have less skin to stretch over a wound.
Skin grafts are an option for large defects or those that just won’t heal. Veterinary surgeons are continuing to improve the success of skin grafts, with healthy skin typically taken from the neck.
Consult a veterinarian for wounds below the knee, large wounds, those that continue to bleed excessively and swelling or concern of infection if there is associated lameness.
For minor wounds, thoroughly clean the wound with mild antiseptic soap and flush with water or sterile saline.
Every horse owner has his or her personal favourite topical wound dressings, most of which lack scientific proof that they work.
Generally, a topical agent should keep a wound clean and moist, be easy to apply and clean off and not interfere with normal healing. Wrapping keeps a lower limb wound clean and maintains a topical product on the wound.
It can also be harmful if done incorrectly so consult a veterinarian if there are questions about wrapping.
Clip around the edges to keep the longer hair outside the wound margins, and apply petroleum jelly to the hair below the wound to prevent serum scalding and allow for quicker cleaning.
Treating skin wounds in horses is an art and a science.
Adequate cleaning and sometimes suturing sets the stage for healing, but the microscopic cells that make up the skin must do their part by dividing and growing to fill in the defect.
