Case Study – Wound
Charlie is a two year old bay gelding that was treated by our clinic last summer following sustaining bilateral wounds to his right fore pastern region when out at grass. It was thought he had got his foot trapped in the wire mesh fencing and in his struggle to free himself, he ripped his shoe off, caused a deep laceration to the medial pastern region as well as a tore off a large area of skin on his lateral pastern.
The wound was fresh on assessment having only occurred a few hours previously and had minimal contamination. The hair surrounding the wounds was clipped and the area cleaned with dilute hibiscrub solution. The wounds were then irrigated with saline prior to digital exploration with a gloved sterile finger. Ligamentous tissue was clearly visible through the medial wound, fortunately it was not lacerated and no other vital structures were affected.
The wounds were managed by second intention healing which means that granulation tissue must fill the base of the wound before the skin can grow across (epithelialization). This involved regular dressing changes and application of a Robert Jones bandage. The principal of this is to prevent further injury and contamination, immobilize the wound site, minimise oedematous swelling, as well as absorb excess exudate and maintain a moist wound environment, all of which promote wound healing. He also received a course of antibiotics and anti-inflammatories as well as an injection of tetanus antitoxin serum on the first visit.
Steadily over the following 4 weeks the wound filled with healthy granulation tissue followed by wound contraction. He was kept on box rest with walking out in hand during this period.
Charlie is doing well and enjoying this summer at pasture.