42

EQUINE WOUND MANAGEMENT

timely fashion. This implies that infl ammation should initially be stimulated and later on be inhibited. In fact,
we should aim to model the course of the infl ammatory response in a horse wound to a more “pony-like course”
(Figure 1.22).

Roughly speaking, this means that infl ammation should be encouraged until the wound is fi lled with

granulation tissue, and that it should be inhibited from that point onward to reduce the formation of EGT and
facilitate contraction and epithelialization. By modulating the infl ammatory response, the successive phases of
the healing process will simultaneously be infl uenced. The initial enhancement of infl ammation will also boost
the formation of granulation tissue and the initial impetus to wound contraction, whereas the preclusion of
chronic infl ammation will benefi t both wound contraction and epithelialization (for more details see Chapter
8). Therefore, treatment of wounds healing by second intention can be simplifi ed by focusing on the infl amma-
tory phase and can be subdivided in either stimulation or inhibition of the infl ammatory response.

Stimulation of the Infl ammatory Response

The initial infl ammatory response in horses should be encouraged and in no manner be limited. Simultane-

ously, the formation of granulation tissue will be enhanced, which is desirable until the wound cavity has fi lled
in. First, the need for infl ammation and the risk of infection can be reduced by surgical debridement, regardless
of whether a wound is to be sutured. Surgical debridement is required when necrosis, exposed cortical bone,
or frayed tendons are present in the wound of a horse because cellular debridement, by the infl ammatory
response, is slow in horses.

Furthermore, it is advisable to bandage the wound with interactive dressings or topical gels that increase

infl ammation and stimulate healing.

42

Solcoseryl

®

(Solco Basle Ltd., Birsfelden, Switzerland) was proven experi-

mentally to stimulate infl ammation in the wounds of horses.

43

A gel containing activated platelets (Lacerum

®

,

BeluMedX, Little Rock, AK) may also be expected to do this,

44,45

as should alginate dressings, acemannan-

Time

Horse wounds

Pony wounds

Inflammatory phase

Formation of granulation tissue

Wound contraction

Epithelialization

+

_

Figure 1.22. Schematic representation of the wound healing phases
in horses. Infl ammation should initially be stimulated (green shaded
area) until the wound is fi lled with granulation tissue, and thereafter
be arrested (pink shaded area) to reduce the formation of exuberant
granulation tissue and facilitate contraction and epithelialization. In
fact, we should aim to treat horse wounds in such a way that the
pattern of healing will resemble that of ponies.