Wound: primary closure in Horses (Equis) | Vetlexicon
equis - Articles

Wound: primary closure

ISSN 2398-2977


Introduction

  • To allow first intention healing with minimal epithelialization or formation of granulation tissue Wound: healing – stages.

Primary closure

  • Wound closed immediately.

Delayed primary closure

  • Primary closure delayed until wound free of signs of infection and debris but before granulation tissue forms.

Uses

  • Achieves good functional and cosmetic result.

Advantages

  • Rapid healing.
  • Minimal scar tissue.

Disadvantages

Technical problems

  • Wound dehiscence possible due to inadequate dead space management, increased skin tension and/or inadequate control of contamination/infection before wound closure.

Alternative techniques

Secondary closure

  • See Wound: secondary closure.
  • Closure is delayed until granulation tissue has formed in the wound.
  • Advantage: granulation tissue → decreased risk of subsequent infection.
  • Disadvantage: skin less mobile → undermining skin edges required for complete closure.

Second intention healing

  • See Wound: healing – second intention.
  • Wound left to heal by natural process of wound healing – granulation, contractionWound: granulation 03 - contractionWound: breakdown 01, epithelialization.
  • Indications: significant skin defect, severe contamination/infection, when cosmetic outcome not important.
  • Disadvantage: scar tissue results.
  • Works well for body wounds – can achieve excellent cosmetic outcome.

Time required

Preparation

Procedure

  • Depends on the size of the wound 5-60 min.

Decision taking

Criteria for choosing procedure

Primary closure
  • Clean, clean-contaminated or contaminated wounds Wound: types – overview.
  • No or minimal skin defects.
  • No severe compromize to blood supply at wound edges.
  • Minimal motion between wound edges.
  • Minimal surrounding soft tissue damage.
Delayed primary closure

Requirements

Subscribe To View

This article is available to subscribers.

Try a free trial today or contact us for more information.

Preparation

Subscribe To View

This article is available to subscribers.

Try a free trial today or contact us for more information.

Procedure

Subscribe To View

This article is available to subscribers.

Try a free trial today or contact us for more information.

Aftercare

Subscribe To View

This article is available to subscribers.

Try a free trial today or contact us for more information.

Outcomes

Subscribe To View

This article is available to subscribers.

Try a free trial today or contact us for more information.

Further Reading

Publications

Refereed papers

  • Recent references from PubMed and VetMedResource.
  • Eggleston R B (2018) Wound management: wounds with special challenges. Vet Clin North Am Equine Pract 34 (3), 511-538 PubMed. 
  • Ludwig E K & van Harreveld P D (2018) Equine wounds over synovial structures. Vet Clin North Am Equine Pract 34 (3), 575-590 PubMed. 
  • Maher M & Kuebelbeck L (2018) Nonhealing wounds of the equine limb. Vet Clin North Am Equine Pract 34 (3), 539-555 PubMed. 
  • Caston S S (2012) Wound care in horses. Vet Clin North Am Equine Pract 28 (1), 83-100 PubMed. 
  • Quinn G (2010) Equine practice: management of large wounds in horses. In Pract 32 (8), 370-381 VetMedResource.
  • Theoret C (2005) Wound management. Vet Clin North Am Equine Pract 21 (1), 1-240 ScienceDirect.
  • Trotter G W (1989) Techniques of wound closure. Vet Clin North Am Equine Pract (3), 499-511 PubMed.

Other sources of information

  • Hendrickson D A (2019) Superficial Wounds, Deep and Chronic Wounds, Sinus Tracts, and Fistulas.In: Equine Surgery. 5th edn. Eds: Auer J A & Stick J. Saunders, USA. pp 403-425.