Wound Healing Documented

In October 2002, I was called out to a ranch to examine wounds on a mare that had been run through a barbed wire fence by stray dogs sometime the day before. The rancher was concerned that she might not recover past being pasture sound. He was unable to bring the mare into the hospital for emergency care and because of financial considerations would have to be able to treat the mare at the ranch. We are fortunate to have the healing documented in photos.

As the wounds were old, and tissues were dried, necrotic (dead), and edematous (fluid-filled), there was not much benefit in attempting to suture the wounds closed. The main therapeutic plan was to give the tissues every advantage to heal efficiently on their own. Debriding the devitalized muscle, fascia (connective tissue), and skin establishes healthy tissue that can provide a new supply of blood vessels and fibroblasts (connective tissue cells). These cells create the granulation tissue platform across which new epithelial tissue migrates to form new skin. The defect fills in with granulation tissue first and allows the wound to contract and become smaller.

In this unvaccinated mare, I administered a tetanus antitoxin, then clipped, cleaned, and debrided the wounds with the mare under sedation. Because there were a few healthy flaps of skin that were not attached to underlying fascia, I placed several mattress sutures to help this healthy skin adhere to the deeper tissue and decrease the size of the wound, which would help decrease the healing time.

The mare's owner was left with supplies and instructions to irrigate these wounds daily with saline or water, use an ointment to keep the injured area moist and free of flies, apply an antiseptic/astringent spray daily, and to protect the dependent (living) tissue with petroleum jelly. It was particularly important to prevent the skin below the wounds from becoming scalded and irritated from the serum and other wound drainage.

Within one month, the left forearm was healed. Within two months the right forearm wound was one-third the original size. After one year, the mare had excellent healing with minimal scarring and no loss of function. She was back in excellent condition and performing her ranch duties without problem. The diligent care this mare received paid off in the end.

Jeff P.Goldy, DVM, practices in Aurora, Colo.

(1) OCTOBER 20, 2002: This wound and a similar one on the left foreleg occurred as this mare ran through a barbed wire fence while being chased by stray dogs. When the veterinarian arrived, the wounds were already too old to stitch closed, although some healthy skin flaps were partly stitched over the wound.

(2) DECEMBER 15, 2002: The therapeutic plan for these wounds mainly included debridement of the dead tissues (to allow better healing) and daily irrigation. The right forelimb wound was now one-third its original size, so the plan seemed to be working.

(3) OCTOBER 1, 2003: Nearly one year after the original injury, this mare had minimal scarring and no loss of forelimb function, and she was comfortably working on her ranch.

About the Author

Kimberly Peterson, DVM

Kimberly Peterson, DVM, is an AAEP member and assistant professor in the Department of Veterinary Technology at Morehead State University in Morehead, Ky. Her husband, Eric, is an equine practitioner, and their family lives in Lexington.

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