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  Discussion on Deep wound care
Author Message
Member:
Paix

Posted on Friday, Nov 7, 2003 - 5:46 pm:

OOPS - HERE IT IS....}

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Hi,
I was reading the information on deep wound care and proud flesh avoidance/care. It said not to use H2O2 on open wounds. I always use it even if it is to be wrapped. I use it first and flush the wound with water as well. Then I apply a triple antibiotic or different if vet has supplied or suggested. I usually let it soak up a bit of the salve (in my presence so no flies, etc get on wound), then apply it again generously. I then apply a "spray" type wound dressing (those nice and colorful ones) and begin to wrap.

Please advise me on my steps - I am very diligent and it seems to always turn out great and no scar.

I have another question - somewhat related to this topic as well.

I rescued a PMU DraftXPaint. The people I TOOK him from (abusive/negligent) said he had a fall about 300 feet down a very step hillside full of trees.

His forehead had a larger skin flap hanging down (this is all as described to me) and they, without a vet involved, sewed it back together.

I have had him now for 6 mos - he is 3.5y/o (and huge and healthy! - I love him!).

My question is about all the dead skin, kind of loose, too. Enough so that I clean out all the dirt and whatever that gets in there under the (appx 1.5" protruding skin WITH normal hair growth, I might add). Another area has no hair and is just dark, even though he hs a lot of unpigmented skin on his bald face.

It doesnt seem to bother him - It seems to be an area that itches a lot, though. He really likes it rubbed a lot and cleaned out with scratching the area lightly with my fingers or a soft brush.

Is there anything I can do at this point to either get the hair to grow where there is none, or flatten the area and lose the extra skin?

Could he suffer headaches from this past very serious injury? That opens a whole new discussion - how to know when your animal has a headache and what to do???

thanks for your time and energy - This is my first post, but I read and learn a great deal.

Thank you.
Member:
Paix

Posted on Friday, Nov 7, 2003 - 5:49 pm:

Sorry, the injury happened to Chester when he was about 2y/o.

Thanks again
Moderator:
DrO

Posted on Sunday, Nov 9, 2003 - 8:00 am:

Dina since you are treating wounds open and no scar results you are referring to partial skin thickness wounds and not deep wounds, however the peroxide is still not indicated (though not as harmful). For more on peroxide see the articles on wound care on the skin diseases menu, Equine Diseases » Skin Diseases ».

If you really have a flap of dead skin, it can just be cut off since it has neither a blood supply or live nerves. However it would surprise me if the wound has healed with a flap of dead skin just hanging there, perhaps you should have a veterinarian evaluate it for what you are looking at. If you post some pictures of ir I would be glad to comment further.
DrO

Member:
Paix

Posted on Sunday, Nov 9, 2003 - 2:36 pm:

Thanks for your quick reply on H2O2 use. I am reading all the wound information.

I will take some pix of CHesters forehead and get them posted. It is not necessarily "hanging" that was a poor choice of descriptive terminology. It is LOOSE, most definitely. I will post pix tomorrow.

Thanks!
New Member:
Rodman1

Posted on Thursday, Aug 5, 2004 - 1:41 pm:

My three year old gelding received a nick or puncture on the front of rear fetlock joint. It became infected and painfully swollen. I've had him in to the vet four times in three weeks and although the wound looks healed, there is still substantial swelling. x/rays were taken and no metal showed. Wound was probed for foreign object and thoroughly flushed twice. Vet, also administered naxcel injection twice. I followed up with oral antibiotic for five days initially. All looked well until two days after medicine ran out. Wound was oozing and swelling recurred. Again after vet flushed wound and naxcel was administered, I followed up with my own naxcel injections for six days along with oral antibiotic for eight days. Still looks swollen from infection. Could I still need to run more of, or a different antibiotic. Skin appears pinkish and wrap has been off for three days.
Member:
Rodman1

Posted on Thursday, Aug 5, 2004 - 1:45 pm:

My three year old gelding received a nick or puncture on the front of rear fetlock joint. It became infected and painfully swollen. I've had him in to the vet four times in three weeks and although the wound looks healed, there is still substantial swelling. x/rays were taken and no metal showed. Wound was probed for foreign object and thoroughly flushed twice. Vet, also administered naxcel injection twice. I followed up with oral antibiotic for five days initially. All looked well until two days after medicine ran out. Wound was oozing and swelling recurred. Again after vet flushed wound and naxcel was administered, I followed up with my own naxcel injections for six days along with oral antibiotic for eight days. Still looks swollen from infection. Could I still need to run more of, or a different antibiotic. Skin appears pinkish and wrap has been off for three days.
Moderator:
DrO

Posted on Thursday, Aug 5, 2004 - 6:21 pm:

Rod does the vet know if the joint has become infected or just the tissues around the joint?
If there is still signs of infection then yes, you need to continue antibiotics but persistant problems in face of a antibiotic suggests a wound with a foreign body or that is not draining well.
DrO
Member:
Eoeo

Posted on Friday, Aug 6, 2004 - 11:09 am:

I would mix an epsom salt solution up and set his leg in it to cover the wound and let it soak for 15 min. for a few days along with the antibiotics. Maybe that would bring the foreign object out? EO
Moderator:
DrO

Posted on Saturday, Aug 7, 2004 - 9:50 am:

The problem is this brings all the bateria from the bottom on the feet in contact with the wound predisposing to worsening infection. If I thought there was such a foreign object, I would go searching with radiographs, ultrasound, and surgically.
DrO
Member:
Rodman1

Posted on Tuesday, Aug 10, 2004 - 8:28 pm:

Dr. O.,

After another trip to the vet, exploratory and scraping of the bone, the word now is that the horse sustained a deep bone bruise and now has bone sequestrum. Ironcially a neighbor (also a vet) stopped by and wonders if there is a fracture since the original vet guarenteed that there is no foreign object in the wound. Have an appointment this Friday morning to have more x-rays. Apparently time will heal this IF the joint is not involved. Any advise on what questions should be asked etc? Of note, neighbor vet believes a fracture has to be in place in order to consider sequestrum????
Moderator:
DrO

Posted on Wednesday, Aug 11, 2004 - 9:50 am:

Not necessarily Rod. Severe blunt trauma could result in an area of bone to die without fracture. Or more commonly there is a nondisplaced fracture that is not easily seen radiographically. If we presume there has been some trauma to the joint, what is being done to minimize the inflammation from said trauma and minimize the chance of arthritis?
DrO
Member:
Rodman1

Posted on Wednesday, Aug 11, 2004 - 8:17 pm:

Dr. O.. Thanks much for responding. The bone has been scraped of dead material and the area wrapped. No more antibiotics were directed as this could complicate the sequestrum (so I was told). Was instructed to administer 'Bute', 4mgs per day (Which has been administered daily since four weeks ago now).I am scheduled to take Copper in for x/rays Friday, to determine if sequestrum has gotten into joint. My neighbor is also bringing his x/ray machine home for his own look later that same day. Of course both vets seem to differ on the diagnosis and prognosis. The swelling has never gone completely away during this period. I've already spent a ton of money. Is there a chance the horse will never be sound again? Would you suggest another treatment for swelling and future arthritis? I feel that there is more of an emergency here than is being tended. Any suggestion would be appreciated. Need more help, Rod.
Moderator:
DrO

Posted on Thursday, Aug 12, 2004 - 10:41 am:

Only if the joint develops arthritis, otherwise nothing you have posted so far suggests a permanant injury. The bute is important but oral chonDrOitins might be logical. Intraarticular hyaluronic and steroid would also be logical if this can be done without significant risk of introducing infection.
DrO
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