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Equine veterinary journal2020; 53(1); 18-29; doi: 10.1111/evj.13289

BEVA primary care clinical guidelines: Wound management in the horse.

Abstract: There are currently no evidence summaries on wounds in the horse. Objective: To develop evidence-based guidelines on wound management in the horse. Methods: Evidence review using the GRADE framework. Methods: Research questions were proposed by a panel of veterinarians, and developed into PICO format. Evidence in the veterinary literature was evaluated using the GRADE evidence-to-decision framework. Searches for human evidence summaries were conducted in the NICE, Cochrane and JBI databases. Final recommendations were based on both veterinary and human evidence. Conclusions: The research questions were categorised into three areas: A. Wound lavage and topical treatments; B. Wound debridement and closure; C. Therapeutics for wound healing. Three hundred and six veterinary publications were identified across thirteen different topics. Fourteen papers were assessed using the GRADE criteria. Twenty-five human evidence summaries were reviewed. The results were developed into recommendations: Wound lavage and topical treatments: (i) Tap water should be considered instead of saline for lavage; (ii) Povidone iodine lavage should be considered for contaminated wounds; (iii) Topical silver sulfadiazine may not be suitable for acute wounds; (iv) Optimal lavage pressures are around 13 psi. Wound debridement and closure: (i) Debridement pads should be considered for wound preparation; (ii) Larvae debridement should be considered in selected cases; (iii) Hydrosurgery should be considered in acute contaminated wounds. Therapeutics for wound healing: (i) Honey may reduce duration of some phases of wound healing. There was insufficient evidence to draw conclusions on the use of chemical debridement, therapeutic ultrasound, laser therapy, wound closure with staples compared to sutures, or identify optimal concentrations of antiseptic lavage solutions. Conclusions: Low quality evidence in veterinary literature; majority of recommendations were based on human evidence. Conclusions: These findings should be used to inform decision-making in equine primary care practice.
© 2020 EVJ Ltd.
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Publication Date: 2020-07-17 PubMed ID: 32463930DOI: 10.1111/evj.13289Google Scholar: Lookup
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Summary

This research summary has been generated with artificial intelligence and may contain errors and omissions. Refer to the original study to confirm details provided. Submit correction.

This research provides evidence-based guidelines for treating wounds in horses. The study evaluates both veterinary and human literature on this topic, and categorizes the findings into three key areas: wound lavage and topical treatments, wound debridement and closure, and therapeutics for wound healing.

Objective of the Study

  • This research aims to establish evidence-based guidelines on how to manage wound injuries in horses. Previously, there were no such guidelines, which made this study necessary.

Methodology

  • The study uses the GRADE framework for its evidence review, where research questions are proposed and formulated into the PICO format. This involves identifying the Problem or Patient group, Intervention, Comparison group and Outcome.
  • The researchers started by reviewing veterinary literature for relevant evidence, and further conducted searches for human evidence summaries in the NICE, Cochrane, and JBI databases.
  • The guidelines were derived from analyses of both veterinary and human evidence.

Results and Recommendations

  • The research questions were split into three categories: wound lavage and topical treatments, debridement and closure, and therapeutics for wound healing.
  • 306 relevant veterinary publications were identified from thirteen different topics. Further, 14 papers were assessed using the GRADE framework and 25 human evidence summaries were reviewed.
  • In case of wound lavage, tap water was recommended over saline for washing the wound. Povidone iodine is also recommended for contaminated wounds, while topical silver sulfadiazine may not be suitable for fresh wounds. The optimal lavage pressure was determined to be around 13 psi.
  • For debridement and closure, debridement pads and larvae debridement are recommended for wound preparation. Hydrosurgery is recommended for acute contaminated wounds.
  • In the case of therapeutics for wound healing, honey was found to reduce the duration of some phases of wound healing.

Limitations and Conclusions

  • The researchers found insufficient evidence to make conclusions on the use of chemical debridement, therapeutic ultrasound, laser therapy, wound closure with staples compared to sutures, or identifying optimal concentrations of antiseptic lavage solutions.
  • They concluded that the veterinary literature available is of low quality. Hence, most of the recommendations are based on human evidence. However, these guidelines should help inform decision-making in equine primary care practice for wound management.

Cite This Article

APA
Freeman SL, Ashton NM, Elce YA, Hammond A, Hollis AR, Quinn G. (2020). BEVA primary care clinical guidelines: Wound management in the horse. Equine Vet J, 53(1), 18-29. https://doi.org/10.1111/evj.13289

Publication

Equine veterinary journal
ISSN: 2042-3306
NlmUniqueID: 0173320
Country: United States
Language: English
Volume: 53
Issue: 1
Pages: 18-29

Researcher Affiliations

Freeman, Sarah L
  • University of Nottingham, School of Veterinary Medicine and Science, Loughborough, Leicestershire, UK.
Ashton, Neal M
  • Oakham Veterinary Hospital, Oakham, Rutland, UK.
Elce, Yvonne A
  • Equine Referral Hospital, Langford Vets, Langford, Bristol, UK.
Hammond, Anna
  • Equine Referral Hospital, Langford Vets, Langford, Bristol, UK.
Hollis, Anna R
  • Centre for Equine Studies, Animal Health Trust, Newmarket, Suffolk, UK.
Quinn, Greg
  • Waikato Equine Veterinary Centre, Cambridge, New Zealand.

MeSH Terms

  • Animals
  • Anti-Bacterial Agents / therapeutic use
  • Anti-Infective Agents, Local
  • Horse Diseases / drug therapy
  • Horses
  • Primary Health Care
  • Surgical Wound Infection / drug therapy
  • Surgical Wound Infection / veterinary
  • Wound Healing

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Citations

This article has been cited 6 times.
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  2. Partusch L, Rutland CS, Martens A, Du Cheyne C, De Spiegelaere W, Michler JK. Collagen composition in equine exuberant granulation tissue reflects tissue immaturity. PLoS One 2025;20(11):e0335179.
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  3. Albanese V, Straticò P, Fischer H, Petrizzi L. Equine Distal Limb Wounds: Economic Impact and Short-Term Prognosis of Non-Synovial Versus Synovial Lesions in Southern Germany. Vet Sci 2025 Mar 1;12(3).
    doi: 10.3390/vetsci12030205pubmed: 40266953google scholar: lookup
  4. Ribeiro G, Carvalho L, Borges J, Prazeres J. The Best Protocol to Treat Equine Skin Wounds by Second Intention Healing: A Scoping Review of the Literature. Animals (Basel) 2024 May 18;14(10).
    doi: 10.3390/ani14101500pubmed: 38791717google scholar: lookup
  5. Helal IE, Al-Abbadi HA, El-Daharawy MH, Ahmed MF. Enhancement of chronic wound healing with maltodextrin/ascorbic acid gel: a clinical evaluation of distal limb wounds in horses. J Anim Sci Technol 2022 Sep;64(5):997-1007.
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