Day 0 - This 20-year-old, Paint, gelding was presented to Dr. Jose R. Castro at Davie County Large Animal Hospital on September 14, 2018 with a history of a very large, chronically infected, traumatic wound on the left ventral aspect of his chest. The horse was referred to DCLAH for advanced wound care.

Day 5 - Upon presentation at DCLAH, the wound was thoroughly cleaned, explored, and a combination of surgical and chemical debridement was performed over four consecutive days. On the fifth day, Dr. Castro placed a drain system and partially closed the wound. The zip ties were placed to relieve tension off of the wound edges. While the horse was hospitalized, he was treated with NSAIDs to control pain and inflammation and put on a course of IV antibiotics. He was later switched to oral antibiotics. The wound was flushed with sterile isotonic solution and cleaned twice daily. All of the horse’s vitals remained within normal limits. The horse was discharged on September 21, 2018.

Day 11 - On September 25, 2018, the part of the wound that had remained opened was partially closed. On September 28, 2018, the sutures that had been placed upon presentation to DCLAH were removed and a spray bandage was used to help seal the wound. The patient was discharged and was allowed to start hand walking for 5 to 10 minutes per day. After discharge the horse was maintained on oral antibiotics and NSAIDs. We recommended cleaning the wound only once daily.

Day 45 - Exuberant granulation tissue (proud flesh) was seen, but the wound is almost completely healed. There were no signs of any residual infection. The proud flesh was treated with topical steroids.

Day 60 - The patient’s chest laceration was successfully treated with a combination of surgical and medical management over a period of 60 days. Notice the area where the proud flesh was still present but had drastically decreased in size and amount. The patient went on to heal completely and resumed normal exercise activities.

Horse made a full recovery!