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  Discussion on Deep wound care questions
Author Message
Member:
chrism

Posted on Wednesday, Apr 25, 2012 - 10:41 am:

Unfortunately, my 12 year old dressage horse, Shadow, is at the vet school, horspitalized.

We believe she got cast in her stall and managed to bend a very thick and wide oak plank enough to get her hind leg past it and caught/pinched, and then managed to extricate herself after much struggle. (We found the salt block holder and water buckets kicked all around and off the wall. Lots of scrape marks on the wall. The holder was in the aisle - I guess it was launched like a missile.) All this occurred in about 1 hour of unsupervised stall time on Monday morning. She is normally out 21 hours a day and comes in for breakie and a nap for about 3 hours. Bad, bad luck.

In any case, she is at the vet school for 7-10 days, getting antibiotics, fluids (she was shocky), daily deep wound care, pain relief.

She has 3 major wounds, one on either side of her left hind cannon, each about 10 inches long and several inches wide with a fair amount of exposed bone. The other wound is just above the hock, on the inside of the leg, approximately hand sized and exposing some more bone. I get sort of ill just thinking about her wounds.

In any case, she seems fairly perky and is behaving well for the team - she is so sweet and gentle, that it is hard not to fall in love with her.

Her vets tell me that if she had to get wounded like this, her wounds seem to be in the best places possible. They were concerned re ligaments, tendons, joint capsules, fractures, etc. but could not find problems with these structures. The wound is draining well. She is weight bearing and walks as well as you'd expect with wraps well past her hock. While there are all sorts of complications possible, she is responding well to treatment and a chance of a full recovery.

The road to recovery sounds fairly long (6-8 months!), and will require a lot of care from me, so I've been researching and prepping, and pulling up my big girl pants and telling my gorpy stomach to get over it.

I have a few questions re deep wound care and will likely have many more:

1) What are good priced sources and names/types of bandages? If my memory serves, they are packing the wounds with 4x4 gauzes (sponges?)and gauze perhaps soaked in something, then wrapping with a cotton pillow (gamgee?), then wrapping with white then tan gauze (the white may be before the pillow), then what looks like coflex and finally finishing at top and bottom and down back with an elastic type bandage. Whew. The bandaging seems to take as long as the debridement, irrigation with saline, etc. Where does one buy all this stuff at reasonable prices? I've checked Jeffers, Valley Vet and Smartpak. Prices seem to vary - Jeffers may be cheapest, but none of them have the exact stuff. So tips here are needed.

2) Dr. O's articles reference chlorhexidine cream and nitrofuran spray - I don't think these are available any more, so am curious re alternative recommendations.

3) Are there descriptions re the bandaging process that would help me understand what I am watching and that could be a check list when I am home with her?

Of course any and all suggestions are welcome. I keep telling myself to breathe deeply and take one day at a time, but it is hard not to worry.
Member:
frances

Posted on Wednesday, Apr 25, 2012 - 12:50 pm:

Bad luck indeed. Just wanted to pass on my commiserations and wishes for a full recovery amazingly quickly.
Member:
dres

Posted on Wednesday, Apr 25, 2012 - 4:42 pm:

shoot .. horses are just plain fragile .. i had to treat a wound for many months and found the supplies i needed on medical sites and Walmart ..
good luck , your mare sounds like she is worth the price of all your time and troubles..

On the first day God created horses, on the second day he painted them with spots..
Member:
vickiann

Posted on Wednesday, Apr 25, 2012 - 5:09 pm:

I think that you will be able to find those wound products but that Dr. O has used the generic names for the items.

Good luck treating this wound. It is good news that it looks as though you should have a good outcome given the effort.
Moderator:
DrO

Posted on Wednesday, Apr 25, 2012 - 5:16 pm:

Hello Chris,
Sorry to hear about your horse. With time it is amazing what you can get healed up to good as new.

For information on and description of bandaging different areas of the horse see HorseAdvice.com » Diseases of Horses » First Aid » Bandaging Horses. The above description is way more complex than needed even if pressure bandaging is trying to be achieved.

I am still able to find both chlorhexidine cream and nitrofurazone based ointments. However if I could not find them I would use a povidone ointment possibly with 4 oz sugar added to the pound of ointment.

Why not attend some of the bandaging sessions before your horse leaves and then actually doing the bandage change a few times under the watchful eyes of the clinician?
DrO
Member:
chrism

Posted on Wednesday, Apr 25, 2012 - 8:08 pm:

Thanks, all.

I've attended all three wound sessions, and I guess I am noticing more each time. At least it is desensitizing me to the gore.

Today we started the negative pressure wound treatment, so that is planned for 48 hours before rebandaging.

The good news is that my horse is behaving well, making her a good candidate for the negative pressure wound treatment. It is essentially what they do for people with diabetes and wounds that won't heal well - the suction stimulates the healing process. In horses it is supposed to stimulate granulation.

I think she has a more than a few more days at the vet school, but I am just trying to get my ducks in a row. (Did you know that "ducks in a row" is a phrase left over from shipbuilding? They used to us metal ducks to position wooden splines when drawing the ship's hull lines - you wanted to use the stiffest wood spline that the ducks in a row would hold ... sorry, I should have posted geek alert.)

Anyway, Shadow seems bright, compliant and may realize we are trying to help her heal.

Off to read the bandaging article.
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