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Benign question
So… wound cleaning. Should I add a curved tip irrigation syringe to my collection? Every time I think I have a full complement of first aid “stuff”, the horse gives me a reason to get something else. The good old fashioned hose in this case is a bit too much pressure, or so says the horse.
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3 Replies
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Wound irrigation is important. Cleanliness is happiness! But being gently does not get the job done.
Scrubbing with gauze and Betadine is essential followed by flushing with high pressure water. Using peroxide is fine too. Anything to dislodge dirt with minor attention to the non-sterile environment of hose water. Follow everything with copious amounts of sterile saline through an 18ga needle (green top) to further dislodge any remaining dirt.
Do all of the above ONLY on the first cleansing of the wound. After this, only a gentle flow of sterile saline from a syringe tipped with an 18 to 20 ga needle (pink top) to add enough pressure to force out debris but NOT to disrupt the healing cells of the epithelium.
Always use a non-stick dressing and bandage pressure on any leg wound to prevent proud flesh. Please see the videos on wound healing and proud flesh in the topics section for more information.
I am sorry to say to your horse, “Suck it up!” but unfortunately using gentle flow from an irrigation syringe will not be enough for any dirty wound. I once spent 30 to 40 minutes cleaning the shoulder of a horse who had slipped on the gravel road. I was absolutely sure I had thoroughly cleaned this wound before starting the sutures. But with the very first placement of my needle, I heard a crunch as the needle tip scraped across a pebble I had not found buried deep in the wound. I had to start all over but glad I did as it healed beautifully.
Adding an irrigation syringe is fine but a needle on a syringe works well too. Doc T
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Whew, I’ve done the first steps right. I did hit it with the water trying to knock out any debris, and I scrubbed it with Betadine. Earlier today I irrigated with saline and had to cold hose some swelling below, and wrapped it. Funny how high a horse can lift a hind leg sideways without kicking. He’s usually very good but this one hurts. (Would is on the inside, below gaskin area. So fun to wrap.) Thanks for the tips and reminders!
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As a general rule of thumb, wounds below the knee and hock can get proud flesh while above, not so much. Therefore, above these structures where it is difficult to wrap you have 3 options: 1) suture, 2) wrap or 3) keep clean and let heal by “second intention.” #1 and #3 work well where there is a lot of underlying muscle while less well where there is little muscle.
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