Horses seem to be attracted to wounds, especially on their legs. If you own one horse or several horses, you will likely encounter at least one wound at some point. Horse wounds can range from small to large and minor to serious. This article will discuss several types of wounds that can occur on the legs that should be evaluated by a veterinarian as well as bandaging techniques.
What can you, the owner/barn manager/trainer do when a wound is found? Call your veterinarian, remain calm and keep the horse calm, assess the horse and perform a physical exam, assess wound(s), stop excess bleeding if present, clean wound(s), bandage the wound(s).
There are several different types of wounds that require treatment and likely veterinary attention. Those wounds include wounds with exposed bone, wounds over joints, wounds over tendons and tendon sheaths, and wounds with excess bleeding.
Wounds with Exposed Bone
The distal (lower) portion of all four limbs has minimal protection and coverage over the bone. There is usually just skin, tendons and ligaments. The outer layer of bone is called the periosteum and can easily be damaged with wounds that have exposed bone. With excess bone exposure or damage, the formation of a boney sequestrum can form or a potential bone infection can occur. A sequestrum is a dead piece of bone that usually requires surgical removal and/or long-term antibiotic therapy. Leg wounds that have exposed bone require prompt veterinary care.
Wounds Associated with Joints
Wounds over a joint or near a joint can be small puncture type wounds or a larger wound. Regardless of the size of the wound, if it is over or close to a joint, veterinary evaluation is important. Wounds with joint involvement often can have excess clear yellow to orange drainage from wounds that may indicate joint fluid drainage. You may notice excess warmth and painful swelling around the wound and joint. Lameness is also typically present with joint involvement.
Wounds that communicate with and involve a joint require more involved treatment. If these wounds are not treated appropriately, they have a high likelihood of causing future lameness problems due to the development of arthritis that can happen after a joint infection. Ideal aggressive joint treatment usually involves surgery to flush/lavage the joint to remove any debris and bacteria, injectable antibiotic medication, anti-inflammatory medication, good bandaging of the wound and leg, rest and confinement to a clean dry stall or small pen.
Wounds Over Tendons
The extensor tendons are located on the front of the legs and are commonly injured or lacerated along the cannon bones. If the tendon becomes lacerated in a wound, the leg will knuckle over on the fetlock and the horse will be unable to “flip” the foot forward without help. The leg will need to be stabilized and supported with a good bandage and a splint to keep the leg/joint from “knuckling” until the tendon heals and scars back together. This tendon heals very well without any residual lameness or problems.
The flexor tendons are located on the back of the legs. When wounds and lacerations involve these tendons, they are considered a more serious injury compared to extensor tendon injuries. When the tendon is completely or mostly lacerated, surgery is required to suture the tendon back together. There is usually prolonged healing, and they can be associated with chronic lameness problems.
Wounds that occur over the flexor tendons may be associated with a tendon sheath (a similar structure as a joint that contains synovial fluid). There are several tendon sheaths that are located around the flexor tendons located on the back of the legs. Wounds in areas where tendon sheaths are located usually require more aggressive treatment as was discussed above with joint involvement.
Leg Wounds with Excess Bleeding
Heel bulb and pastern lacerations are commonly encountered in horses and they often are associated with excess bleeding. There are a large artery and vein located on both sides of the leg that are superficially located just under the skin. Wounds in this area may also involve the pastern or coffin joint, the flexor tendons and/or the tendon sheath. Wounds in this area require prompt veterinary evaluation. Because there is often excess bleeding, it is important to know how to properly and effectively bandage to stop active bleeding. Bandaging supplies and techniques will be outlined later in this article.
1 = Leg cotton/sheet cotton (disposable)
2 = Quilted washable leg wrap
3 = Brown gauze
4 = Elastikon (sticky tape with minimal elasticity
5 = Vet wrap (“sticks” to itself but not to the skin/hair; very elastic/ “stretchy”
6 = Washable Polo-type wrap
7 = Cast padding (soft gauze roll)
8 = Kling gauze roll
9 = Telfa non-stick pad (to put directly on the wound)
The goals when bandaging a leg that has a wound are (1) to keep the wound clean (2) to keep pressure around the wound and leg to minimize swelling and (3) to protect the wound and leg as healing is occurring. The goals for proper bandaging include (1) applying a telfa pad or similar non-stick product directly over the wound to minimize the bandage sticking to the healing wound (2) to apply even pressure with each bandage layer and product (3) to apply each bandage layer going the same direction (4) to avoid any wrinkles in each bandage layer and (5) to make sure there is adequate pressure around the wound and leg without the bandage being too tight.
Bandaging- Excess bleeding
This bandage is applied to wounds that are actively bleeding and is referred to as a pressure bandage. The goals of this bandage are (1) wrap around the wound and leg with several layers of absorptive material (2) wrap around the wound and leg very tightly and (3) remove the bandage 12 hour or less after applying. This bandage is meant to stay in place for a short period to get bleeding to stop. You will be wrapping the wound and leg as tight as you can (tighter that you would for a normal wound bandage or support wrap bandage).
Supplies needed or that are helpful include and absorptive product (terry cloth or towel, roll cotton, sheet cotton, or diapers), vet wrap, brown gauze, and elastikon.