Types of wounds and wound healing

Where the skin has been torn, often from being caught on an object. These will have an irregular edge and may possibly include flaps of skin.

These wounds usually affect the surface layers of the skin. They’re often small and superficial but can have dirt or grit embedded within the wound.

Cleanly cut wounds which have straight edges. They can vary in depth, but they may go through all the layers of the skin. Surgical sites would be the most common incision wound.

A sharp object penetrates through the skin or sole of the hoof. They can often appear small at the opening but can be of varying depth and often affect structures below the skin or hoof surface. If you discover a puncture wound with the object still in place, it’s important not to remove it. You may cause further damage, and your vet will want to assess the wound with the object still in place.

This is the first phase which happens within minutes of the injury. Blood vessels constrict to reduce bleeding and form a blood clot.

Inflammatory cells move from the blood and surrounding tissues to start cleaning the wound. Any dead or damaged tissue and microorganisms (such as bacteria) will be removed by these cells. This phase can last for hours or even weeks, depending on the severity of the wound.

This is where the body starts to heal the wound. Fibrous tissue (known as granulation tissue) quickly covers the wound to protect it. New skin cells (epithelial cells) will begin to grow from the outer edges of healthy wounds. This phase can take days or weeks, depending on the size and condition of the wound.

This is the final phase where the newly laid down tissue strengthens over the weeks and months following an injury.

Proud flesh occurs when during the proliferation phase too much granulation tissue is produced. This creates a raised and bumpy surface which the delicate epithelial cells can’t grow over. If your horse has signs of proud flesh, contact your vet as the excess tissue will need to be removed to allow the wound to heal.

If there’s anything in the wound such as a thorn, splinter, gravel or dead tissue, the body will need to work hard to remove it. This can delay the inflammation stage.

Powders can also clump together when applied to a wound and trigger a foreign body response. Make sure to check with your vet before using topical treatments.

Pain, swelling and discharge can all be signs of infection and should be investigated by your vet. Pus can be discharged from the wound and is often white or yellow in colour. It contains a mixture of dead cells and dissolved tissue so often has a foul smell.

Signs of an infection over a high-risk area, a puncture wound or on a surgical wound, can quickly deteriorate. The infection can travel deep within the tissues to the structures beneath and become very difficult to treat.

Scarring is a natural part of the wound healing process, but it can become excessive and cause complications further down the line, particularly around delicate structures, such as the eyes, muzzle and over joints. Many of these are areas of skin that are continuously moving, and this movement can disrupt the healing process which can increase the risk of scar tissue developing.

Excessive scarring can occur if a wound struggles to heal or is delayed.  Taking appropriate steps early and working closely with your vet throughout the healing process is the best way to limit the amount of scar tissue.