Key Considerations in Wound Care
An owner asks about wound severity, the usefulness of ointments, and causes of white-hair scarring.
Q I keep several horses and am wondering—which kinds of wounds are most problematic? Are ointments ever a useful treatment? Also, why do some wounds heal with hair growing back in white?
LAUREL WISE, Durango, Colorado
A wound’s location plus the possibility of contamination and a foreign object’s being embedded are all important factors when considering the potential severity of a wound.
Location can dictate whether a wound is minor, potentially career ending, or even life threatening. Wounds that enter synovial structures such as joints and tendon sheaths are the most serious; they can have devastating outcomes and be extremely costly to treat.
Wounds that enter the abdomen or thorax (chest) can have similarly serious consequences. Wounds that don’t enter body cavities or synovial structures will generally have good outcomes if treated properly.
Contamination can play a significant role in healing. Highly infected wounds take longer to heal and can result in additional scar tissue as healing progresses. It’s therefore important that infections are recognized early in treatment and dealt with aggressively.
Foreign objects in a traumatic wound can contribute to a prolonged healing period and further the damage if not found and extracted early. For example, heel-bulb lacerations must be checked carefully for the presence of barbs or wire fragments. These foreign objects may not be apparent from the outside, requiring radiographs for diagnosis.
Sequestrums (dead pieces of bone) can result from wounds that penetrate and damage underlying bone. Typically not apparent early in the healing process, sequestrums often develop weeks after the traumatic event and should always be considered with a non-healing wound.
Many products on the market are meant to help wounds heal faster, with less scarring. The right product for a particular wound depends on the conditions addressed above and should be determined by your veterinarian. In general, it’s best to hold off on using a product on a severe wound, instead cleaning it with water and bandaging it to keep clean until your veterinarian arrives (see box).
White hair results when hair follicles are damaged by the traumatic event causing the wound, or sometimes by the resulting bandaging of a limb. Typically there’s also an area of hair loss associated with extensive traumatic wounds. Loss of hair results when scar tissue fills the space where normal skin was lost or severely damaged. Primary closure of a traumatic wound with suturing can help to minimize scar tissue’s filling a wound. Any time a wound can be closed (even if your veterinarian feels that the suture line will pull apart at some point), the scar will be less severe than if the wound cannot be closed.
LESLIE EASTERWOOD, MA, DVM
Assistant Clinical Professor
College of Veterinary Medicine
Texas A&M University