Wound Management & Bandaging

by Erin Denney-Jones, DVM

When to call the vet is the most frequently asked question by a new horse owner. Knowing what is or is not an emergency, especially when it comes to wounds, is also a common concern. Not all wounds can be or should be sutured. Good disinfecting and bandaging may be all that is needed.

But for those cuts, lacerations and wounds you are unsure about whether you should make the call, here are a few questions you need to ask yourself:
• Does the bleeding stop with direct pressure?
• Is the horse lame?
• Does the wound involve a bone, tendon or joint?
• Is it a puncture wound?
• Are there signs of infection?
• Is an eye involved?
• Is there a nail in the sole?

After you have called the vet, what should you do while you are waiting for that return call or their arrival? Here are some suggestions that will help the situation:
• Keep the patient quiet and confined
• Apply pressure to stop bleeding- bandages help!
• Wash dirt from affected area with sterile water
• Do not attempt to flush a puncture wound
• Bandage wound and provide limb support
• Do not remove the nail from the foot

The vet has come, and now you are doing daily treatments and bandaging. Some problems may still arise. The following are signs to watch for:
• Signs of infection: heat, swelling, pain/lame, pus, foul smell
• Wound is not closing
• Proud flesh

Bandaging a horse limb may be necessary in some circumstances. First, let us start with some suggested items to have for your first aid kit to use for bandaging.
• Topical antibiotic ointments (Neosporin, Nolvasan ointment)
• Sterile gauze pad and gauze bandage (primary/contact layer)
• Quilt or cotton roll for padding (secondary/intermediate layer)
• Standing wrap, Vetrap, Elastikon, standing support bandage (tertiary/outer layer)

The key to bandaging is tomake it smooth and tight. It is difficult to wrap over joints due to the curves of the limb, but practice and the right materials will make this task easier. In order to avoid constriction on the limb the cotton roll or quilt is necessary to use under your snug Vetrap, Elastikon or standing wrap. This allows you to apply pressure with the outer layer on a badly bleeding wound or swollen leg. Even with a stalled horse a bandage will loosen in 24 to 36 hours. Changing a bandage every day is necessary to treat wounds, check suture lines for infection and re-apply pressure to decrease swelling.

To place a bandage, first cover your wound with a sterile gauze pad with or without antibiotic ointment and keep in place with roll gauze.

Now place your quilt or cotton over over this making the wound the center of the bandage.

For your tertiary layer, begin wrapping either at the top of the bandage or bottom and overlap by _ as you go around the limb to avoid pinching or constricting parts of the leg. A good suggestion is to not end the bandage over a moving joint area, because the movement of the horse will continue to weaken the bandage and come apart.

A portion of the quilt or cotton must be seen above and below a bandage placed on a horse limb.

Bandaging wounds by the knee or hock in a horse requires a stacking bandage. This keeps the bandage from sliding down the leg as well as keeping swelling out of the lower limb. Bony prominences will require holes to be made in the cotton quilt and avoidance by the tertiary level.

Bandaging of the hoof is difficult and requires practice. I recommend a thin layer of roll cotton placed on the bottom of the hoof and up the wall to the fetlock. Then begin wrapping your Vetrap over the bottom and around the top, but leave some cotton sticking out of the top of the bandage. This protects the coronet band.

Summary

There may be any number of occasions when you will need to bandage your horse’s legs. Bandaging can provide both protection and support for the horse while working, traveling, resting or recovering from an injury. Here are some key points to keep in mind:
1. Start with clean, dry legs and bandages. If there is a wound, make sure it has been cleaned, rinsed and dressed according to your veterinarian’s recommendations.
2. Use a thickness of an inch or more of soft, clean padding to protect the leg beneath the bandage. Apply padding so it lies flat and wrinkle-free against the skin.
3. Start the wrap at the inside of the cannon bone above the fetlock joint. Do not begin or end over a joint, as movement will tend to loosen the bandage and cause it to unwrap.
4. Wrap the leg from front to back, outside to inside (counterclockwise on left legs, clockwise on right legs).
5. Wrap in a spiral pattern, working down the leg and up again, overlapping the preceding layer by 50 percent.
6. Use smooth, uniform pressure on the support bandage to compress the padding. Make sure no lumps or ridges form beneath the bandage.
7. Be careful not to wrap the legs too tightly, creating pressure points.
8. Avoid applying bandages too loosely. If loose bandages slip, they will not provide proper support and may endanger the horse.
9. Leg padding and bandages should extend below the coronet band of the hoof to protect the area (this is especially important when trailering).
10. Extend the bandages to within one-half inch of the padding at the top and bottom. If there is a potential problem with bedding or debris getting into the bandage, seal the openings with a loose wrap of flexible adhesive bandage.

Regardless of the purpose, it is essential that you use proper leg bandaging techniques. Applied incorrectly, bandages may not only fail to do their job, but also may cause discomfort, restrict blood flow and potentially damage tendons and other tissue.
It is often said that it is better to leave a horse’s legs unbandaged than to bandage them incorrectly. Fortunately, there is nothing complicated about learning to apply bandages. It simply takes the right materials and a bit of practice. If you have never bandaged a horse’s legs, ask your veterinarian to demonstrate the proper techniques. Practice under his or her supervision before doing it on your own.

For more information about bandaging techniques, consult your equine veterinarian.