Wound Management help

[Mouse_amp_Bay]

@RInurse Rider

There is a difference between cheapo supermarket honey and manuka honey. I work in a skilled nursing facility, and we use Medihoney or Therahoney (non-prescription items) for treatment of wounds that need some gentle debridement. Supermarket honey may not even be 100% “real” honey, or so I’ve heard.

Yes’m. Rotten on Netflix has a great episode on counterfeit honey. Yes, that is a thing.

Manuka honey is the best for wound care. Our local Costco has it. Option 2 would be local, organic unprocessed honey. Check your local farmers market. Option 3 would be organic honey from a store. Slightly more processed but would still work.

Honey is is one of the only bacterial and fungal killing properties available. Pretty much magic. I was battling a months long scratches battle with 3 rounds of IV antibiotics. Plus topical and oral meds. Honey cleared it up in less than a week. I am now a believer.

[Postandrails]

I agree that you need Manuka honey or “activated” honey.

Some of the treatment protocols here are nothing like anything I have ever done. I have never cold hosed large wounds which are prone to proud flesh - I was taught that cold hosing PROMOTES proud flesh. With wounds that are to be bandaged, I only cold hose the new wound on the first day to clean it and help reduce inflammation and swelling, but that’s it.

I was also taught that when a bandaged wound is healing it needs to be left alone. After the first couple of days to check there is no infection, bandages stay on for about 3-4 days at a time to allow it to heal. At that time, reapply the treatment and rebandage - but no hosing or messing with it.

If you are constantly removing the bandage and cold hosing then you aren’t giving the fragile new skin a chance to grow.

Honestly, stop the cold hosing. It’s doing more harm than good.

[cutter99]

@Postandrails

I agree that you need Manuka honey or “activated” honey.

Some of the treatment protocols here are nothing like anything I have ever done. I have never cold hosed large wounds which are prone to proud flesh - I was taught that cold hosing PROMOTES proud flesh. With wounds that are to be bandaged, I only cold hose the new wound on the first day to clean it and help reduce inflammation and swelling, but that’s it.

I was also taught that when a bandaged wound is healing it needs to be left alone. After the first couple of days to check there is no infection, bandages stay on for about 3-4 days at a time to allow it to heal. At that time, reapply the treatment and rebandage - but no hosing or messing with it.

If you are constantly removing the bandage and cold hosing then you aren’t giving the fragile new skin a chance to grow.

Honestly, stop the cold hosing. It’s doing more harm than good.

Are you a veterinarian? Where is your degree from? Everything you say is causing harm has actually caused new skin to grow without proud flesh on my horse’s wound, which is 8 + weeks into rehab.

I am following the protocol given to me by my veterinarian, with a real degree, and having success with the protocol. He has examined the horse three times throughout the process, and received daily photos of the wound. According to him, and in my opinion, the wound looks better than either of us ever expected.

The wound is almost totally healed with no proud flesh whatsoever. There are very good reasons to continue cold hosing, which the vet explained to me.

[Postandrails]

Hi Cutter99. No, I’m not a vet. My post was based on two of my vets’ advice, and it has worked for me. I’ve dealt with some pretty serious leg wounds without any proud flesh too. I probably should have worded the last sentence a bit differently, and not so strongly - sorry. I’m also not in the US, so perhaps vets do things differently in different countries.

How did your vet explain the benefits of cold hosing?

[kkgeorgio]

@colorfan

[ATTACH=JSON]{“data-align”:“none”,“data-size”:“medium”,“data-attachmentid”:10504577}[/ATTACH][ATTACH=JSON]{“alt”:“Click image for larger version Name: 1st day.JPG Views: 1 Size: 15.6 KB ID: 10504571”,“data-align”:“none”,“data-attachmentid”:“10504571”,“data-size”:“medium”}[/ATTACH]
Somehow the pictures are out of order, the first picture is the proud flesh regrown and the second picture is the first day after washing.

Yikes, that wasn’t that bad of a wound to begin with. A month later it certainly should be healed by now. I personally think you need to dry that thing out. Stop wrapping with diapers- those don’t breath and create the perfect environment for bacteria to grow. A weeks worth of antibiotics (culture the wound) would be incredibly beneficial, and if you want to keep using honey it needs to be MANUKA. They have it available at Costco. There are also other good salves you can use.

I personally think based on that picture I would do one day of wonder dust to try and dry that thing out and get a good scab on it, and then keep it covered in a triple antibiotic ointment. If you want to keep shavings out of it, use a breathable wrap, but I would honestly probably leave it open to let it dry out. Talk to your vet about a course of antibiotics as it does look infected.

I’ve seen a similar wound, when poorly treated, drag on for months and months and months. I’ve also seen much worse wounds heal up in two-three weeks. What you are doing isn’t working, and I really would recommend another vet.

[cutter99]

@Postandrails

Hi Cutter99. No, I’m not a vet. My post was based on two of my vets’ advice, and it has worked for me. I’ve dealt with some pretty serious leg wounds without any proud flesh too. I probably should have worded the last sentence a bit differently, and not so strongly - sorry. I’m also not in the US, so perhaps vets do things differently in different countries.

How did your vet explain the benefits of cold hosing?

The cold hosing helped to reduce the continued swelling, as well as keep the wound open to help the skin to start to regrow from the sides of the wound without proud flesh. The goal was also to keep it wound from scabbing and prevent the proud flesh from developing. Cold hosing also promotes bleeding, which helped to keep the wound from getting infected and the bleeding also means healthy tissue is growing.

To each his own. I just know I am almost 9 weeks into this process with a horse who cut an extensor tendon in addition to the ugly wound that measured about 4” X 5”. The horse is currently about 90% sound with the wound now measuring about 1” X 3” with no proud flesh and healthy new skin around all the edges.

[FraggleRock]

Yikes, that should be looking a bit better by now. I’d be doing raw unpasteurized honey and keep horse unwrapped in a clean stall. I had a horse come to me with a similar looking wound in the back of his front leg, and it had been there a while, his was likely a bit deeper. Just a bit of scar tissue and the hairs all grown back in nicely.
”‹”‹”‹”‹”‹”‹

[awa]

Highly recommend DermaGel, either gel or spray. No wrapping, no proud flesh, great results.
http://www.derma-gel.com/packaging/index.html

[wannabedvm]

As others have stated, the honey that you want for wounds isn’t supermarket honey or even raw honey–it’s specifically manuka honey. Whether or not that has an effect on proud flesh–no clue.

[bigolebay]

This came in my email today and has a good explanation about debridement. https://thehorse.com/180996/managing-horse-wounds-without-antibiotics/?utm_medium=Health+enews&utm_source=Newsletter

Had a horse in my barn that had a similar injury–really a deep abrasion and puncture wound from a trailer ride. I cold hosed it first, then cleaned with bactine spray and wrapped with a diaper and vet wrap to hold in place til the vet could come for further treatment. The horse was pretty scraped up elsewhere and the vet gave him a shot of exede and tetnus. He didn’t do all the obligatory scrubbing etc, but just instructed to spritz daily with the bactine or saline and gave us an expensive spray on bandage. He did say we could use wonder dust to prevent proud flesh, but to be careful to brush it off the non wound areal as it could affect healthy tissue and cause hair loss. It was summer and flies were an issue, so covered the wound, for turnout at least ,as the spay on bandage just kept weeping off. It did take a long time to heal and looked ugly off and on, but eventually went away with no proud flesh.

[Jo]

I’ve had excellent luck using PF Wonder Salve on proud flesh-proned injuries. It’s a staple at our farm now.