Urgent Care: Loose Skin Flap
- What you see: Good-sized open wound, with a skin flap but no puncture
- Panic level: Orange (moderate)
- Causes: Many and varied
- Immediate action: Clean the area, put on a wrap to hold the skin flap back to the body
- Call your vet: Call your vet, but this is not an immediate, drop-everything emergency
- Prevention: Determine what your horse got cut on
Horses, bless them, are prone to getting injuries. Bruises and small cuts are common. A large wound with a skin flap will require more than home care.
Your first job is to clean the wound. A running hose will often do the job though in cold weather you may need to simply pour water over the area. A chlorhexidine wash would also be good to use after you have removed any big debris like bedding or dirt.
Look for any punctures though they are not always obvious. It does not hurt to give your horse a tetanus booster and some antitoxin, especially if the wound is not fresh when you discover it. If your horse is recently boostered, your veterinarian may feel a booster is not required but always consider it.
Once the wound is cleaned, you can apply a very light coating of antibiotic ointment and then try to wrap the skin flap back up over the wound. Be sure that the underside of the skin flap has been thoroughly cleaned too. Depending on the location of the flap, the skin itself may or may not be salvageable. The question will be if blood vessels to the area are intact. Even if the flap won?t survive, it makes a nice temporary moist covering for the wound. Roll gauze can be used to hold the flap in place then lightly tape it.
At this point, call your veterinarian. This is not usually a ?drop everything and rush over here,? type emergency?though if a very large area is involved it might be. If there is blood spurting, such as from a cut artery, that is more of an emergency. In those cases, apply pressure to the area and have someone call the veterinarian.
Your goal is to keep the wound clean and moist until your veterinarian arrives. Put your horse on cross ties or hold him on a lead rope so he can't roll or rub on the area.
Your veterinarian will decide if the wound needs to be sutured and if the flap is likely to survive. If the flap clearly won?t make it, your veterinarian may simply trim it off. Sometimes a flap is sutured with the hope that at least part of the skin will reattach, saving your horse having to fill in the big wound area. A drain may need to be placed depending on the size and location of the wound.
A decision will be made about whether or not your horse needs antibiotic follow-up and if any tetanus therapy is required. A long-acting antibiotic injection may be given.
Now comes the hard work on your part. You have two jobs to do. First, you need to keep your horse from chewing or rubbing on the wound area. Some horses simply ignore a wound while others fidget with it. If stall rest is required, think about using a slow-feed hay net to keep your horse occupied, as well as investing in a couple of stall toys. Bitter sprays used to deter dog chewing can help, but do not spray directly on the wound!
Second, you need to try to determine how and where your horse was injured to begin with. Check his stall carefully for any protruding nails or wood splinters. Walk the fence line if he was injured while outdoors. Look for sharp objects on the ground in the pasture or turnout areas that he might have rolled on.
Article by Contributing Veterinary Editor Deb Eldredge, DVM.