CHASING to the cut

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The art of wound management on the farm.

by Jon Geller, DVM

Liters of blood ran down my arms, soaking my coveralls and congealing like cherry pudding in puddles around my boots. "All bleeding eventually stops," I said over and over to myself as the blood from a gelding's shoulder wound began to ease. Soon the horse would weaken and collapse and the bleeding would, in fact, stop.

Critters on the farm manage to get hurt in many ways, and while Mother Nature does a pretty good job with healing wounds, domestic animals do not possess the genetic fortitude of their wild relatives. Untreated wounds can get infected, abscess, putrefy, necrotize and slough, leading to amputation, or, in the case of a large animal, euthanasia. For the cat with the bite-wound abscess, the foal with the wirecutter, the dairy cow with the lacerated teat, or the dog whose foot was crushed by a coyote trap, timely and correct treatment is essential. By following a few consistent steps, any informed person can administer some early treatments to ensure complete wound-healing.

OPEN WOUNDS

If you have to stop the bleeding on a bad cut, there are few treatments better than applying direct pressure. It is by far the most effective way to stop bleeding. Ice packs can also help to constrict blood vessels.

After the bleeding stops, the most important step in open wound treatment is irrigation. Thoroughly flush the wound with dilute disinfectant, saline solution or even water. The fluid flushes out contamination and bacteria, and provides gentle pressure on the macerated tissues to stimulate the healing process. Eventually, circulating proteins in the bloodstream attract a new layer of epithelial cells to form a matrix of healing tissue over the wound. Using this scaffolding of new cells, the body will, over time, rebuild its normal tissues.

In the case of the injured gelding, I hung a liter of fluids with an extension line from the ceiling joist, letting the fluids gravitate down into the wound. I returned a week later to determine what muscles, tendons, ligaments and skin were still viable and then trim away any dead tissue (a process called debridement).

Until then, Carrie, the horse's owner, had to flush the wound twice a day. I showed Carrie how to do hydrotherapy - a fancy name for applying a steady stream of water onto the wound using a garden hose for ten or 15 minutes - instead of the careful saline irrigation I had done initially. Surprisingly, most horses will tolerate hydrotherapy once they get used to it. Since all of the tissues of the wound on Carrie's horse were laid open, the wound's edges could not be sutured back together. Even so, several months of hydrotherapy and two weeks of antibiotics would heal the shoulder.

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