Management practices that influence wound infection and healing

The aim of wound management is to optimize healing in an effort to return the horse to its previous function as rapidly as possible, while respecting the financial constraints of the owner. Infection, with its associated excessive or inappropriate inflammation, is the single most likely cause of delayed healing of wounds healing by second intention. Effective wound preparation, exploration, cleansing via irrigation, and debridement are central to reducing the incidence of infection and promoting uncomplicated healing of accidental wounds. Antimicrobial drugs should be used only when there is clinical evidence of infection or when development of an infection would be life-threatening or career-ending for the patient. Although empiric broad-spectrum antimicrobial therapy may be used initially, definitive selection of antimicrobial drugs should be based on the results of bacterial culture and sensitivity testing of isolates. The use of antimicrobial drugs in surgical wounds should never replace aseptic and atraumatic surgical technique. Where there is evidence of formation of biofilm, repeat debridement and topical administration of antimicrobial drugs should be central to any treatment plan.