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Who ever coined the phrase “Don’t sweat the small stuff” surely wasn’t an equine veterinarian. Without much hesitation my important tip is that when it comes to wounds it is the small ones that most often lead to the biggest problems. More often than I care to recall I have had the sinking feeling of impending disaster when a horse owner calls to say that their horse is dead lame or that the leg is severely swollen after receiving what is they describe as only a small scrape a few days earlier. The reason small wounds can result in major disasters often results from the hole in the skin being like the tip of the iceberg. The major wound is under the skin. On multiple occasions that small wound resulting from a kick, a scrape or a puncture has penetrated into an important underlying structure. Any wound that is anywhere near a joint or tendon/ligament must be carefully explored to ensure that these important structures have not been penetrated. Nothing strikes terror into the hearts of veterinarians more than the sickening feeling that results from sliding a probe through a skin wound and ending up touching bone or tendon/ligament. On many occasions I have explored a small kick wound on the skin only to find that the underlying muscle belly had been torn on impact resulting in a large pocket deep in the muscle tissue that had become contaminated and severely infected. Big wounds drain well, small ones don’t. If wounds can drain chances are they will not become severely infected. Small deep wounds don’t drain well, bacteria get trapped deep inside and after smoldering for a day or two often blow up into a huge disaster.
If your horse gets a big wound — don’t panic, but call your veterinarian for advice, quite likely a visit will be required. If you get a small wound over a joint or tendon/ligament area, especially if it weeping amber coloured fluid it is OK to panic. Panic will surely elicit an immediate call to your veterinarian. If you have not called your veterinarian and 1-3 days later the horse is dead lame or the limb is blown up like an elephants leg then panic is also order. To avoid panicking, treat all small wounds as potential disasters.
A few points to remember about small wounds: If possible clip the hair from around the wound opening, hair and wounds don’t mix well. If it appears in any way that the skin has been penetrated then your veterinarian should be called. Cleanse the wound with saline and a surgical scrub such as Betadine or Hibitaine. Don’t go poking into the wound without it having been properly prepared for exploration, leave that to the veterinarian. Don’t cover the wound in some magic powder, wound grease or spray. Remember your veterinarian may need to culture the wound, if you have flooded the wound with antiseptic or antibiotic then a culture may not be able to be performed. Try to cover the wound with a clean bandage. Keep the wound from sealing over, drainage from a contaminated wound is a good thing. Draining wounds must be able to heal from the inside out. Take the advice of your veterinarian as to the proper choice of antibiotic and wound management.
I have dealt with many ugly big wounds in my career but it is amazing how big ugly wounds often heal without major intervention. I have seen many major DISASTERS from small wounds that were ignored until it was too late. Without hesitation I can report that I have seen far bigger vet bills that have resulted from small wounds that were ignored until it was too late than from the big ugly ones that resulted in the panic call to the veterinary office.
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