SKIN LESIONS IN THE HORSE – A CLINICAL SURVEY

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SKIN LESIONS IN THE HORSE – A CLINICAL SURVEY

P. Stadler, Heidrun Gehlen, C.P. Bartmann
Clinic for Horses, School of Veterinary Medicine,
Bischofsholer Damm 15, D-30173 Hannover

The most frequent wounds in horses are lacerations in predisposed localisations. The veterinary surgeon is then faced with the question whether, in order to restore functionality and to achieve a satisfying cosmetic effect, conservative or surgical therapy is indicated. As the result of skin wound therapy largely depends on the primary treatment, a systemic examination should be followed by clarification of localisation, extent of contamination, the involvement of body cavities or musculoskeletal/synovial structures.
A large number of wounds in the horse permit primary wound closure in particular when wounds are immediately surgically cleansed.
After mechanical and physical cleaning and debridment, wound revision should occur with minimal loss of skin. An adaptation of the skin in direction of tension lines with the removal of fat and necrotic muscle tissue and a sufficient prevention of blood-loss should be aimed for. In contrast to human medicine, where secondary wound healing is often classed as therapeutic failure, this is a satisfying method in the horse, despite the high associated costs. Wounds with significant skin loss, in particular in the area of the distal extremity, have been treated through transplantation since the 1950’s. This is possible in fresh as well as in granulated wounds and involves a complete transplantation of skin grafts from one localisation to another. Autotransplants are mainly used in the horse. These consist of skin flaps which include either whole layer of epidermis (full thickness graft) with the entire dermis, or are partial layer of the epidermis with a varying thickness of dermis (split dermis graft). Pedicled grafts are used if the recipient localisation is insufficiently vascularised. Whole layer preparations are advantageous when an optimal cosmetic effect (in particular new hair growth) is the aim. The most frequent cause of adhesion failure is caused by the separation of the transplant from the fibrin bed or a transplantation during the ischeamic phase fresh wounds (approx. 48 hours. The ischaemic phase in granulated wounds is approximately half as long (approx. 22 hours).
The report includes wound-healing management of different clinical cases.

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