How to care for minor wounds

Most horse owners are comfortable treating minor** scrapes and wounds on our ever-accident prone horses. But the myriad of available topical products can be overwhelming – what is best to use and when?

**As always, if you have ANY concern over the depth of the wound, if it’s a grossly contaminated wound, a wound near a joint, a puncture, or there’s a potential need for sutures, ALWAYS check with your veterinarian BEFORE applying any topical product.**

What is ‘Minor’?

First, let’s review what can be considered a minor scrape or wound. Most superficial wounds over areas of dense muscle (such as side of shoulder) or far from joints/tendon sheath/other sensitive areas (such as scrape over front of cannon bone) and only partially breaking the skin can be doctored at home.

Avoid application of caustic or potentially painful options, such as alcohol and hydrogen peroxide- these can be damaging to exposed tissue. Look for products that contain a list of ingredients- if you don’t know what’s in it, why would you apply it to your horse?

Superficial Wounds

For superficial abrasions and areas that cannot easily be bandaged, a liquid bandage product such as Alushield or Aluspray is a great option. In its aerosol form, it is easy to apply, allows necessary airflow to promote healing, and protects against wound irritants.

bandage on the leg of horse

Bandaged Wounds

For wounds that are protected with a bandage, the ideal topical product depends on the stage of wound healing. Large fresh wounds that tend to leak large amounts of fluid will not benefit from an ointment- they are too wet (and should be evaluated by your vet!) Less exudative bandaged wounds can benefit from topicals such as Neosporin (triple antibiotic), silver sulfadiazine (SSD), or manuka/medical grade honey. All of these options have anti-microbial properties and preserve a moist healing environment while promoting epithelialization of the wound.

Dealing with Granulation (proud flesh)

In later stages of wound healing, horses commonly produce excessive granulation tissue, also known as proud flesh. Proud flesh can be identified by its appearance as lumpy red tissue that may bulge over the margins of the wound and bleeds very easily.

Proud flesh is especially common on slow healing wounds of the lower limbs that require prolonged bandaging. The good news is that while it has impressive blood flow, proud flesh lacks sensation, allowing your veterinarian to debride and flatten this extra tissue if needed. A combination antibiotic and steroid ointment such as Panalog is often used over proud flesh to help smooth out the granulation tissue so that the wound can continue to contract and heal. Once the granulation tissue is flat and healthy, it is not necessary to apply panalog. Some wounds alternate between proud and healthy granulation tissue during the healing process, so we may alternate applications of panalog or manuka honey depending on how the wound looks at each bandage change.

Ensure your first aid kit is well stocked with a thermometer, clean bandaging material, and a few of the topicals previously mentioned. When you discover a wound on your horse, take a minute to assess its location and depth. And if in doubt, a phone call and photo to your vet is always a good idea to determine best treatment and optimum healing.

Proud Flesh- What is it and how can you treat it?

As horse people, wounds and wound management are unfortunately a common part of our lives! A common complication of wound healing in the horse is “proud flesh”.

“Proud flesh” is the common term for exuberant granulation tissue that may develop in relation to a wound. Granulation tissue is the body’s natural way of filling in defects left behind after an injury. While granulation tissue is a normal and beneficial part of the wound healing process, if there isn’t appropriate pressure from the surrounding skin or if the wound area is being irritated or stretched during healing, it can overgrow the bounds of the wound. We often see this as pink, lumpy tissue that is elevated from the level of the skin. This makes it very difficult for the skin edges of the wound to contract down and properly close.

So, how do we manage proud flesh? The biggest component of proud flesh management is debridement, or removal of the extra tissue, then placing an adequate bandage. There may be several rounds of debridement and bandaging before the proud flesh contracts enough to let the skin close over it. Keep in mind that since granulation tissue is a part of the healing process, it has a lot of blood flow and bleeds like crazy! But don’t worry, there is very rarely nerve supply in proud flesh, so the horses do not feel a thing. We also have several dressings and materials that we can use to help with the reduction of the proud flesh, such as steroid cream and antimicrobial dressings.

If you are dealing with a wound with proud flesh, it is important to prevent the horse from over using the area where the wound is, which may mean no riding while the wound is healing. Excess motion may lead to irritation, which will lead to more proud flesh.

If a wound is not healing, there are a number of other things that may need to be considered, such as a potential foreign body or metabolic disease in the horse. If there is no progress in the healing of a wound for a couple of months, consider calling your veterinarian to pursue further diagnostics.