Wounds and Lacerations. Jennifer Brown DVM, DACVS Clinical Assistant Professor in Equine Surgery and Emergency Care

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1 Emergency Care for Equine Wounds and Lacerations Jennifer Brown DVM, DACVS Clinical Assistant Professor in Equine Surgery and Emergency Care

2 Be Prepared!

3 Being Prepared Know what is normal for your horse Behavior Temperature, pulse, respiration, gum color Have veterinarian contact readily available Along with a back up Have a complete first aid kit And know how to appropriately use its contents!

4 What to do Don t panic Control the scene Don t panic Call your vet Don t panic Apply appropriate basic first aid until the vet arrives

5 Horse Surroundings Others Controlling the Scene Remember your safety first! It does not do your horse any good if you are seriously injured trying to help it!

6 Contact the Veterinarian Have the number posted on the stall and near the phones Have a back up in case your veterinarian is not available Know what your nearest referral hospital is Phone numbers Directions

7 Information for your veterinarian What, where, when: What is the injury/problem Be as specific as possible Report any physical exam findings Where the horse is You should not move horses with certain injuries When did it happen

8 THE FIRST AID KIT

9 First aid kit contents Digital Thermometer +/ Stethoscope

10 Bandaging Material Non stick pads Kling gauze

11 Bandaging Material Absorbent padded material for pressure bandage Gauze pads Diapers Feminine hygiene

12 Bandaging Padded bandage Disposable Quilts

13 Bandaging Material Bandage Vetrap, Coflex, Petflex, etc. Polo Wraps Standing wraps

14 Bandage Kits Kits available commercially

15 Wound Cleaning Antiseptic solution Betadine Nolvasan (chlorahexadine) Not scrub! Diluted for wound cleansing/lavage

16 Misc Items Latex gloves Duct tape Flashlight h and batteries Hoof pick Pliers Bandage scissors Wound ointments (Neosporin)

17 Available at most horse supply stores and websites Not complete so you Not complete so you will have to supplement them Commercial Kits

18 BANDAGING

19 Bandaging Objectives Prevent further damage Soft tissue Nerves Vessels Bone ends Decrease contamination Stabilizing limb decreases horse s anxiety

20 Compression Bandage Used to: Stop hemorrhage Decrease or minimize swelling Protect wounds Stabilize fractures and severe eee soft tissue injuries ie

21 Components Non stick pad (Telfa, Release, Adaptec) Gauze sponges Kling roll (soft white cotton roll) Heavy padded bandage Brown gauze Vetrap Elastikon

22 Clean any wounds Preparation If heavily contaminated place a wet to dry until vet arrives Sterile saline on gauze Do not spray or scrub any wounds over joints Clean off surface debris only Wear gloves until wound is covered Especially important if open joint or bone exposed

23 Bandaging Place non stick pad over oe wound and secure with Kling gauze If there is significant hemorrhage then place absorbant padding over this layer and secure with a second roll of gauze From: Wound Care Management for the Equine Practitioner; DA Hendrickson

24 From: Wound Care Management for the Equine Practitioner; DA Hendrickson

25 Bandaging Place thick cotton roll (combine) bandage or quilt Secure cotton with bandage (Vetrap, standing wrap, polo) Always have some cotton showing above and below

26 Bandaging Can place full limb bandages by stacking wraps If more immobilization is needed then add If more immobilization is needed then add an additional layer

27 Splint Materials Splints are sometimes needed for severe limb injuries be prepared for when the vet arrives and decides a splint is necessary.. Wood Boards PVC Pipe Metal Be Creative!!! Essentials: Must be stiff and long enough for appropriate use Always place over padded bandage (e.g. Robert Jones)

28 Splinting Don t splint without the veterinarian present A poorly placed splint can do more harm than good

29 WOUNDS AND LACERATIONS

30 Like in real estate. Location is everything

31 Assessment Horses may be frantic and distressed following injury Use appropriate p restraint to keep you and your horse safe during assessment

32 Anatomy Knowledge of anatomy is critical to evaluation of wounds and lacerations Appropriate identification of affected structures Determines necessity of immediate treatment

33 Anatomy From: Spurgeons Color Atlas of Large Animal Anatomy

34 Anatomy Skin Muscle Vascular and nerve Tendon/ligament Synovial structures: joints, tendon sheaths, bursa Bone

35 Anatomy Location, Location, Location Small wounds in the wrong location can be life threatening Based on location some fractures cannot be repaired

36

37

38

39 WHAT CAN BE INJURED?

40 Vasculature Laceration of large vessels can result in severe blood loss Damage to major blood supply to the limb can result in loss of the limb

41

42 Nerve Injury Nerve injury Loss of sensation Can return over time Loss of function Can lose function of a limb which is life threatening Examples: suprascapular, radial, or femoral nerve paralysis

43

44 Tendons and Ligaments Major supporting structures of the lower limb Injury can be life and performance threatening

45 Tendons and Ligaments Transection results in loss of stability of joints and other soft tissue structures Severe injury can result in joint dislocation They can look like horses with a fracture

46

47 Synovial Structures Joints, tendon sheath, bursa Contamination of synovial structures can be life threatening Infection can be difficult to treat Causes severe lameness due to inflammation i and infection M il t t fi i l d Many synovial structures are superficial and easily penetrated

48 From: Wound Care Management for the Equine Practitioner; DA Hendrickson

49 Bone Injury Exposure of the bone Disruption of the outer covering (periosteum) Trauma can lead to death of a portion of the bone Makes it susceptible to infection Fractures

50 Exposure of Bone Biggest risk is development of sequestrum Sequestrum is a piece of infected dead bone Leads to a chronic draining wound

51

52 Fractures Ability to repair or treat depends on location and size of horse Your veterinarian and veterinary surgeon will Your veterinarian and veterinary surgeon will help decide if a fracture is repairable

53

54

55

56 WOUNDS AND LACERATIONS CASE EXAMPLES

57 Should we have any Should we have any concerns with this wound?

58 How about this one?

59

60 Lower Limb Laceration Injury involved Vessels Superficial digital flexor tendon (transected) Branch of the suspensory ligament Fetlock joint Tendon Sheath

61

62 Laceration to Trunk

63 Good cosmetic Good cosmetic outcome in the end.

64 Laceration to Hock What are your concerns? What can be done?

65

66 Questions?

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