Friday, 6 October 2017

Things that affect healing ...

For the past few weeks I have been blogging about injury and how types of therapy can help healing and repair after injury.  However, there are factors which can negatively affect healing too.

Position of the wound is important because healing depends on the blood supply to the area.  Parts of the horse with lots of arteries and veins eg: the face, will heal more quickly.  The lower leg has a much poorer blood supply and so healing is slower.  In addition to this, if the wound is in an area of the horse which is moved often, healing will be slower.  As with any other animals, horses will also lick or bite painful wounds which can again slow healing.

The shape of the wound can also affect healing.  Larger wounds will heal more quickly if the skin is loose because the wound is able to contract, where there is less skin the wound is filled much more slowly as it relies on the multiplication of epithelial cells.  In these situations excess granulation tissue can also form.  

Granulation tissue is a normal part of the healing process.  However, in the lower leg it can become a problem.  In the normal healing process  the surface of the wound will heal over at the same time as the deeper part of the wound is healing.  Unfortunately, if this is slow (as in the lower leg), the wound will not heal over quickly enough to confine the granulation tissue.  In this situation the granulation tissue can grow over the edge of the wound and form proud flesh.  Epithelial cells will NOT grow over proud flesh but through and this is VERY SLOW.  The granulation tissue will cause the epithelial cells at the edge of the wound to die so it is important to prevent proud flesh forming.

Foreign bodies in the wound will also affect the healing process because they harbour bacteria.  The foreign body eg: a thorn, will irritate the area and stimulate the inflammatory process .  The foreign body will then be caught in the fibrous tissue and form an abscess.  The area will not heal until the foreign body has been removed (or made its own way to the surface).

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Until next time!

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