A Medical Case Report on Class 1: Abraded Wound in Horse

In Partial Fulfillment of Equine Medicine

School of Veterinary Medicine
Aklan State University
Banga, Aklan

Dominique Joy G. Raso

Kevin Hendrix T. Reyes, DVM

ABSTRACT

Hob, a 5-year-old Thoroughbred female horse was usually allowed to roam around their vicinity,
however on December 20, 2022, she accidentally slipped and fell beside their vicinity’s pool. Upon
physical examination after the said incident happened, it showed that Hob was otherwise healthy
and there were no visible signs of limping. However, she has a wound on the front of her shoulder
and forearm. Treatment was performed immediately after the incident happened. A wound is
typically thought of as an externally induced skin injury that may also affect deeper tissues.
External forces, however, can hurt or harm deeper tissues without necessarily penetrating the skin.
In this report, abrasion was the main cause of injury, it was defined as the skin's most superficial
wounds where the outer layers of the skin are rubbed off after it comes into tangential contact with
a rough surface, revealing the more delicate layers beneath, and at the edge of the wound, pieces
of the abraded layers may be found stacked up (Veterian Key, 2016). In Veterinary Medicine, the
therapeutic importance of accurate wound classification rests in its capacity to predict the
likelihood of postoperative complications, surgical site infections, and reoperation. Furthermore,
accurately diagnosed wounds may be useful in determining morbidity, mortality, and quality of
life.

Keywords: Abrasion. Class 1, Class 2, Class 3, Lavage, Wound

INTRODUCTION

A wound is typically thought of as an externally induced skin injury that may also affect
deeper tissues. External forces, however, can hurt or harm deeper tissues without necessarily
penetrating the skin. (Veterian Key, 2016). Wounds are categorized into open or closed wounds
and through this, veterinary practitioners can choose the best course of treatment and can allow to
evaluate the extent and duration of contamination. Open wounds include abrasions, avulsion,
incision, laceration, and puncture wounds. Closed wounds are contusion and crushing injury.
Duration and degree of contamination is also defined as an important part of wound therapy and
healing. Duration is the length of time that passes between inflicting a wound and treating it, while
degree of contamination is classified as follows: Class 1: An uncontaminated, clean wound with a
0 to 6 H duration, Class 2: Significantly contaminated wounds as well as those lasting 6 to 12 hours,
and Class 3: Wound with severe contamination or lasting more than 12 hours (Today's Veterinary
Nurse, 2013).
In this report, abrasion was the main cause of injury, and according to an article of Veterian
Key on 2016, it was defined as the skin's most superficial wounds where the outer layers (the
keratinized portions) of the skin are rubbed off after it comes into tangential contact with a rough
surface, revealing the more delicate layers beneath, and at the edge of the wound, pieces of the
abraded layers may be found stacked up. Abrasions frequently leak tissue fluid instead of bleeding,
and according to this, the damage initially seems moist before gradually becoming darker and drier.
A black scab may develop, and blood may seep from injured dermal papillae when the somewhat
deeper layers of the skin are implicated.
In Veterinary Medicine, the therapeutic importance of accurate wound classification rests
in its capacity to predict the likelihood of postoperative complications, surgical site infections, and
reoperation. Furthermore, accurately diagnosed wounds may be useful in determining morbidity,
mortality, and quality of life.
SIGNALMENT AND HISTORY
Hob, a 5-year-old Thoroughbred female horse was usually allowed to roam around their vicinity,
however on December 20, 2022 she accidentally slipped beside their vicinity’s pool. The owner
explained that Hob formerly had an eye surgery last July the same year due to Thelaziasis, an
infestation of Thelazia roundworms, which are parasitic nematodes that typically infest the eyes.
The effect of the surgery slightly affected Hob’s vision which was a possible factor on why the
incident happened that led to a wound on her shoulder and forearm.

EXAMINATION FINDINGS
After the incident, upon physical examination, it proved that Hob was otherwise healthy and there
were no visible signs of limping. However, she has a wound on the front of her shoulder and
forearm. Treatment was performed immediately after the incident happened. Visual status, menace,
and dazzle responses were also assessed and showed no problems with her eyes. It was presumed
that the incident happened was not connected to her previous eye surgery and was purely an
accident.

DIAGNOSTIC WORK-UP AND FINDINGS

The presumed diagnosis was confirmed through direct ophthalmoscope, which showed normal
visual status, menace, and dazzle response, and by the attending veterinarian, that her previous
surgery and eye problem was already healed before the accident happened. The present wound was
then categorized as an open wound abrasion because the skin damage that was only involved is the
loss of an epidermis and a portion of the dermis. The duration and degree of contamination was
classified as Class 1 as it is a wound with minimal contamination and was treated immediately
(Today's Veterinary Nurse, 2013).

TREATMENT PLAN
Lavage or irrigation of the wound was immediately done by spraying a normal sterile saline
solution to thoroughly clean the wound. As a result, there is a lower chance of infection. The
attending veterinarian decided not to close the wound since it was small (Winkler, 2022). Then it
was managed by using a wound powder called Wonder Dust. The directions on how to use are as
follows: shake well before using then open nozzle by turning tip up. Hold the nozzle 2 to 4 inches
from wound and squeeze the container firmly, puffing powder freely over the entire surface of the
wound. Application is repeated once a day until the wound completely healed (Farnam, 2023).

OUTCOME
The treatment plan followed showed remarkable results where it helped stopped the bleeding fast
and helped in drying up the wound. The wound however was still healing after a month of using
Wonder Dust leaving a scab on the horse’s front shoulder and forearm.

IMAGES

Figure 1: Normal Sterile Figure 2: Wonder dust – Figure 3: Dried wound or scab
Saline Solution used wound powder used in wound after using Wonder
during lavage of fresh treating the wound Dust
wound

DISCUSSION
Wound care is a crucial component of patient treatment with a lot of potential to affect how long
and how far an animal recovers after surgery or trauma. In this report, Class 1 abraded wound was
treated by following proper aseptic procedures during the lavage of the wound with normal saline
solution removing any debris or contamination in the wound (Winkler, 2022), and managed by
treating the wound with Wonder Dust, a wound powder that has the following actions: (1) it is a
blood coagulant and stops capillary bleeding fast and (2) aids in the prevention of proud flesh
(Farnam, 2023). The wound is still however undergoing the process of healing or the phase of
remodeling where it is the last stage of wound recovery. According to the article of Winkler in the
year 2022, the freshly laid collagen fibers restructure along tension lines during this time and this
procedure enables the wound's strength to gradually develop over time which is usually up to 2
years, and this confirms why the wound was not completely healed after a month of using the
wound powder. Healing can also be affected by a variety of circumstances, including the
environment, the animal's general health, and medication therapies. One environmental component
that has an impact on wound healing is temperature. Around 86°F (30°C) is the best temperature
for wound healing. Colder temperatures may weaken wounds, delaying their recovery.

CONCLUSION
Horses are prone to accidents since they have these long legs that can run into things and take up
more space when they roll. Their huge, elegant gaits enable them to move faster, cover more
ground, and swing more, making them more prone to traumatic injury which makes it crucial to
understand some fundamental first aid techniques and how to administer ongoing treatment with a
wound. Due of this large variation, it is essential that the horse undergoes a complete physical
examination to assess their overall health and status as well as the severity of their injury. The main
goals of treating a horse wound are to prevent infection, encourage a healthy healing environment,
and restore function to the region as soon as possible. There are various choices for cleansing
wounds, and it's crucial to avoid adding to the trauma when doing so. Every tool a veterinarian uses
has the potential to enhance the trauma to the wound site, so it is important to assess each therapy
to see if the benefit justifies the damage.
REFERENCES
Farnam. (2023). Wonder Dust. Retrieved from https://www.farnam.com/all-products/wound-
care/wonder-dust
Today's Veterinary Nurse. (2013). Principles of Wound Care & Bandaging Techniques. Today’s
Veterinary Practice.
Veterian Key. (2016). Wounds and Injuries. Veterian Key. Retrieved from
https://veteriankey.com/wounds-and-injuries/
Winkler, K. (2022). Wound Management. MSD Veterinary Manual. Retrieved from
https://www.msdvetmanual.com/special-pet-topics/emergencies/wound-management
KEYWORDS
Abrasion - Skin damage with a loss of epidermis and a portion of the dermis
Class 1 - Clean wound with minimal contamination and a 0 to 6 H duration
Class 2 - Wound with significant contamination or 6 to 12 H duration
Class 3 - Wound with gross contamination or > 12 H duration
Lavage - washes away both visible and microscopic debris reducing the risk of infection
Wound - break in the continuity of a tissue of the body.