SerahRose

Skin Grafts And Horses

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Anyone ever had a skin graft done on their horse? I have a friend who is a research vet (in a lab, with mostly fish) but is also owns and competes horses. She commented on a recent pic of my mare's leg injury that I should look into skin grafting for the leg. She's not got any personal experience to share with me - so I thought I'd come here and get some input.

From some of the reading I've done, I may already be too late in the game to get a graft done? Wound is 9 days old now.

Here's day 1 of the injury

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We're not exactly sure what happened, but my theory is she caught the small nubbin from a previous injury, and it just tore down the scar line and created a much larger version of the previous injury.

Here's a pic of what the previous injury looked like at the "mostly healed ish" stage

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and here are pics of day 8 in the healing process - these are taken immediately after unwrapping, no cleansing of the wound performed yet

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Now, in the last pic you see the "flap". The vet decided he didn't want to immediately excise the "flap" of skin, because the bone was visible , and he hoped the flap would help protect that part of the leg in initial healing, and he was hopeful that part of that flap may survive. I was going to excise the flap today, but upon seeing how much more granulation needs to take place under there, I wasn't so sure. I know leaving that flap there can encourage infection, especially if more of the flap is dead than I think. Will be having the vet out again - and hopefully he can be convinced to excise. While I've excised skin on other horses, this horse is kinda my world and I'm having a hard time talking myself into it.

Where I currently live I'll have to haul my horse a few hours to get to a real equine vet - the guy I use for the basics is primarily cattle focused. I miss living 3 miles from a fabulous equine vet hospital.

This is the 3rd fairly traumatic (to me...lol) injury in the past 4 months - I'm ready to move back to SD! I'm blaming it all on Missouri. lol

ANYwhoodles...skin grafts. tell me your experiences if you have any! And any other input is always appreciated and taken into consideration.

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That looks to be a reasonably healthy granulation bed. Pinch grafting is probably the easiest to do especially in a field situation, unless you want to refer for an actual partial thickness graft. With pinch grafting, punch biopsy samples are taken usually off the belly, stab incisions made into the granulation bed and the punch samples literally plugged into the granulation bed. Everything is bandaged up and from there its the hope and prayer that the grafts take. If even 50% fail, you still are that much further ahead in the healing process.

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Thank you both!

Another vet visit and he thinks the "flap" is actually alive and reattached at this point. The bump has gotten to be less drastic, and the steed is doing well so far.

pics from yesterday - immediately after bandage removal before any cleaning/flushing/treatment. The "nonstick" pad stuck a little when I removed it (as I was taking it off I realized it was sticking so I soaked the bandage in some sterile saline - but not before I caused a bit of bleeding. whoops)

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A friend of mine had grafts done on her gelding who fell thru a storm grate. I believe they did the grafts about 6 months into healing because the vets were not happy with the lack of tissue that the horse was developing or not developing as the case was. It wasn't a total success but he at least doesn't break the area open anymore just by moving around which was happening before the grafts.

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these pics were taken a month to the day from the re-injury. It's healing up really well, I have ridden her briefly and soon will be putting her back into training.

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Still off the supplement, behavior had been all over the place, but so has the weather. I'm definitely not seeing any of the rearing and playing, though!

The flap that was dangling that I thought we were going to have to excise somehow reattached so I stopped considering skin grafts. My treatment routine has simply been a wet abdominal pad soaked in purishield wrapped around the wound and changed daily. I read a few studies about wet healing vs dry healing and decided to give the wet route a go.

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I've resigned myself to the fact that she'll need protection over that scar for quite a while to ensure it's as healed and as strong as possible before left uncovered. I'm applying vitamin e topically to keep edges soft and supple. Probably nothing scientifically proven about doing that...but at this point what have I to lose, ya know?

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I've used enough vitamin E on wounds by now to KNOW it helps. Keep it up.

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I have not had much luck with flaps, far as the wound healing with great integrity. . I did leave a flap on a young stallion, who had torn a similar wound on a back leg., but I believe worse than the one on your horse. There was always a bump left under that flap, plus too much scar tissue. I had it cut back down, a year later, and it healed much better, far as end result.

Never tried skin grafts on that stallion, but did on Einstein, who torn out a back quarter on one rear hoof, taking hoofwall, coronary band and some pastern tissue. Lying down at night, in his stall, he tore off the bandage and pulled out most of the grafts! Thus, he always had a scar area where that coronary band is missing, and over the years, in crusty snow , he has developed an injury , that led to a hoof abscess.

I'm not a vet, but will tell you want has worked really, really well for me, over the years, when I had two similar injuries. I cut off the flap myself, even one that involved a fair depth of tissue, and then used cut heal. Yes, it stings, but it also causes the wound to heal from the inside out, keeps the area moist, and thus both of those injuried healed so that only a hairline scar was left, not evident , unless you looked for it, in the hair

Every second or third day, i would wash the area, and it would be 'fresh', but without any proud flesh, and evidence of the epithelium moving across that surface. No wrapping with Cut Heal.

Your horse's leg looks pretty good though, so whatever works!

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New pics from today. I really couldn't be happier with how it's healed so far.

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Yes, my horse was out in 5 inches of snow...and came in with MUD everywhere. Don't know how she does it.

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Nice! I don't think I've ever seen an injury over a cannon bone heal w/out copious amounts of proud flesh. Do you think the wet-to-dry bandaging played a large part in that outcome? Good job!

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Heidi, from what I've read the wet wrapping is definitely a contributing factor. Hair is indeed growing back beautifully on almost every part that has healed shut so far!

I think the purishield has a lot to do with our progress, as well. I'm basically ready to be their spokesperson. Lol

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I'm a stupid stupid idiot. I'd been leaving the leg unwrapped for a few hours at a time, riding her, etc. I decided to leave it unwrapped overnight. It swelled up and tore. Why oh why did I do that? ! I'm so upset with myself.

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(((hugs))) You couldn't 'know. If she had been doing well for the couple hours/day there's no reason for you to have thought she wouldn't have done well overnight. I'm sorry the healing process has been set back.

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I woke up at 1am and had the thought I should go check on her...wish I would have. I'm pretty sure I'm psychic. Lol

The swelling is down a little, and the tearing doesn't look as bad as I initially thought...I'll just keep her wrapped forever and ever, amen. :P

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I'd absolutely love some pics and progress reports! At this point there is nothing left to graft on my mare, thank goodness. Even with the setback not too much reopened.

I've heard of using honey...but the science behind purishield had me convinced it was worth a shot, and it's definitely a permanent part of my arsenal!

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I'll second honey as I've used it on myself. It kept the wound moist and I felt the (small) cut healed quicker than if I'd used my normal stuff. Using it was an experiment on my part and I was pleasantly surprised at how well it worked.

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hmm....poster who came in and commented on her horse and skin grafts/honey has disappeared, along with her comments. :( bummer!

Here are a few pics

Morning of swelling/tearing incident (Feb 13th):

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and Feb 23rd:

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I've found some equine compression type socks I am going to order and try once the wound is closed back up again. I don't mind using polo wraps for coverage in the cold weather, but once it warms back up outside I DO mind using polos - or any other wrap for that matter...

Going to start riding her again tomorrow. So yay.

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Considering where it is, and what you started with, it's looking really good.

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Thanks Oz - I'm happy again with how it's looking. I had a pit in my stomach for a few days after the swelling incident. It's back to looking really good again. I've been wrapping it as loose as I possibly can without it being so loose that the wrap falls or slouches - and it's not swelling up - so I feel like weaning very very slowly using a looser wrap method is the way to go for now, and if anyone has any input whatsoever I'll definitely listen and consider!

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My vets have always told me that wrapping something like that til it's pretty much healed helps keep the proud flesh problem away.

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still dealing with swelling problems if I leave it unwrapped for more than an hour or so and she remains inactive. It's totally fine as long as she's in constant motion though. So still keeping it wrapped with as light of a compression as I can while keeping the polo on. I take it off 2 times a day to give the leg a wrap rest - which means she is either getting ridden or lunged to remain active during the wrap rest. I tried to just leave her in the pasture hoping she'd get enough motion from grazing out there, but that wasn't enough and it got a little puffy within an hour.

This horse o mine! Constant vigilance...

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Would it be possible to make your wrap smaller and smaller until it basically becomes a wound covering?

I ask this because I can't really see the need to support the entire leg when there is only a healing wound that needs to be protected and kept clean. I'd try to wean the bandaging down to a sanitary pad on the healing wound, sticky side of pad stuck to vetwrap holding pad in place and elastikon bandage tape (top and bottom of vetwrap) holding the vetwrap and pad over the healing wound so it can't slip down the leg.

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