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Wounds - Location, Location, Location

By Jennifer Brown, DVM, DACVS

Wounds are a common injury in horses and often appearances can be deceiving.  You may be surprised to know that some of the smallest wounds can be life-threatening.  With lacerations, like in real estate, location is everything.  A small wound over a joint or tendon sheath can have catastrophic consequences.  I have lost several patients that had small, seemingly innocuous, wounds into joints or tendon sheaths that became infected because the owners did not know how serious they were at the time they occurred.  I have also attended large, horrific looking wounds that were of not of any danger to the horse but caused quite the panic for the owners.  So how do you know when to call the veterinarian?

First, a good knowledge of anatomy is important when assessing a wound.  In the limbs; joints, tendon sheaths, tendons, ligaments, bones, and blood supply are some the critical structures that can be damaged through the different types of wounds.   On the body there are few joints or tendon sheaths that are likely to be affected by a wound, but certainly they can penetrate into the chest or abdomen.  Location of some of these structures is obvious.  However, did you know that the digital tendon sheath runs from just above the fetlock down into the foot and that it is very close to the skin surface in the pastern?  Knowing the general locations of where these structures are located on your horse will help you decide how concerned you should be about any wound.  There are several good equine anatomy reference books are available to horse owners.  These are good resources to have and learn from.

Second, know the types of wounds that can occur and how serious they may be.  The most common wounds are lacerations, abrasions, punctures, and contusions.  Lacerations can be full-thickness (all the way through the skin) or partial thickness.   Full-thickness lacerations can also go beyond the skin and into deeper tissues damaging muscle, ligaments, tendons etc.  It is not always obvious how deep a laceration is and what other structures were affected.  Most full-thickness lacerations should be evaluated by a veterinarian.  Likely they will require sutures, bandaging, and additional medical care.  Abrasions are characterized by loss of the hair from the surface of the skin.  In general abrasions do not need veterinary attention unless they cover a large area. Topical treatments and appropriate bandaging will generally suffice. Contusions, caused by a hard blow, don’t cause any noticeable surface damage, but to the tissues underneath there may significant trauma to the tissues.  Usually these will be painful to the touch and there will be swelling in the area.   Most contusions will resolve without complication and may only require bandaging if swelling is present.  However, severe contusions can cause significant damage to the blood supply of the skin and underlying tissues, sometimes leading to the skin in that area dying.  This will not be immediately obvious, but if you notice a loss of hair, increase in swelling, or change in the color or texture of the skin it is time to call the veterinarian.  Puncture wounds are small wounds that are characterized by a small, but deep, penetration through the skin into the deeper tissues.  These are the trickiest of all the wounds as they will have the smallest entry site, sometimes not even noticed by the owner until problems arise.  Like full-thickness lacerations these should be evaluated by a veterinarian to assure that no vital areas are involved as well as to be sure that the puncture is opened and cleaned properly. 

Finally, when in doubt call your veterinarian to evaluate a wound.  I cannot stress enough how serious a wound into a joint or tendon sheath can be and it is essential that it is taken care of immediately.  Don’t let the size of a wound fool you and remember location, location, location. If you have any questions contact lkuebelbeck@surgi-carecenter.com.

This article originally appeared in Horse & Pony magazine in September, 2011 and is reprinted with their permission.

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