Wound-Assessment Q&A

Here’s how to evaluate the relative severity of a wound while you wait for your vet to arrive.

Your horse has what looks like a nasty gash. You’ve left a message for your veterinarian, but in the meantime you’d like to have a better understanding of how serious this wound might be.

Credit: Photo by Caroline Fyffe Cold-hose a wound to clean it before you try to assess its depth. Hosing will also help to reduce any related swelling.

Here, we’ve asked H&R’s consulting veterinarian, Dr. Barb Crabbe, to discuss the relative severity of wounds. She shares the five critical factors you should consider when evaluating any wound, explaining which situations are most critical.

Where is the wound?
A gash over a well-muscled area of the upper body, such as the chest or croup, is likely to heal well, even if it’s large and deep. That’s because there’s a good blood supply in those locations, and few critical structures to complicate healing.

Wounds on the head also heal surprisingly well, even if they look scary at first, as long as they’re carefully sutured if need be and don’t involve the eyeball itself.

Lacerations on the lower legs, however—especially those below the hocks and knees—are more difficult to heal. The blood supply is more limited, and there’s little extra tissue between the skin and more critical underlying structures. A wound directly over a joint or tendon sheath is the most serious of all, as infection in one of those closed-off structures could be life-threatening.

What other factors pertain?
The following special-circumstance scenarios are likely to require special care from your vet.

Heavy bleeding indicates a large blood vessel is involved. Bright-red blood that comes in spurts is the most concerning, as it means a high-pressure artery is likely involved.

Accompanying lameness also ups the seriousness factor. It may indicate that a joint, tendon, ligament, or even bone has been damaged.

If the wound is on your horse’s face, squinting or tearing may mean his eye’s been damaged. Blood from his mouth, or difficulty chewing, could mean an injury to his teeth or jaws.

How deep is the wound?
To determine depth, hose the wound clean, then try to separate its edges by putting pressure on either side. If the wound is fresh and you can pull the edges apart, it’s likely to have penetrated the full thickness of the skin and will heal best with sutures.
A very deep wound, even if it’s small (such as a puncture wound), can be the most serious of all because of the risk of infection to deeper structures. That means a tiny but deep wound over a joint can be a bigger problem than a huge abrasion over a well-
muscled area.

How large is the wound?
All other factors being equal, size does matter. A wound less than half an inch in length typically won’t need sutures, even it it’s full-thickness-deep through the skin. A wound between one-half and one inch might heal best with a stitch or two, and a wound longer than an inch will almost always heal better if sutured.

Again, though, location is important. A longer wound on the well-muscled upper body will probably heal even if it isn’t sutured, while a shorter one on the lower legs can be problematic if left to heal on its own.

How old is the wound?
Fresh wounds that you attend to immediately are much less likely to be complicated, as compared to wounds that are days or even hours old. Excessive swelling or drainage of a thick, yellowish/brownish substance are two signs that a wound is older and likely in need of special care.

Be aware, too, that even a wound that’s a day or two old often may still be sutured, and will heal much better as a result.

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