BEVA primary care clinical guidelines: Wound management in the horse.
Authors: Freeman Sarah L, Ashton Neal M, Elce Yvonne A, Hammond Anna, Hollis Anna R, Quinn Greg
Journal: Equine veterinary journal
Summary
# Editorial Summary: BEVA Primary Care Clinical Guidelines on Equine Wound Management The British Equine Veterinary Association established the first evidence-based guidelines for equine wound management after recognising a significant gap in synthesised veterinary literature on this common primary care problem. A multidisciplinary panel of veterinarians formulated clinical questions across three domains—lavage and topical treatments, debridement and closure, and therapeutic healing interventions—which were then systematically evaluated using the GRADE framework, incorporating 306 veterinary publications alongside human evidence from NICE, Cochrane and JBI databases where equine-specific evidence proved insufficient. Key recommendations emerging from this rigorous appraisal include preferring tap water over saline for routine lavage, applying povidone iodine specifically to contaminated wounds, avoiding silver sulfadiazine in acute phases, and targeting lavage pressures around 13 psi; for debridement, the guidelines favour debridement pads and larval therapy in selected cases, with hydrosurgery recommended for acute contaminated wounds; honey showed promise in modulating wound healing phases, though evidence remained limited. Whilst low-quality veterinary literature underpinned these recommendations—necessitating substantial extrapolation from human wound care evidence—these guidelines provide farriers, veterinarians, physiotherapists and other equine professionals with practical, evidence-informed decision-making frameworks for primary care wound management, particularly useful where clinical experience and local resources must be balanced against best available evidence.
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Practical Takeaways
- •Use tap water instead of saline for routine wound cleaning, and maintain lavage pressure around 13 psi for optimal cleaning without tissue damage
- •For contaminated wounds, incorporate povidone iodine lavage and consider larvae debridement or hydrosurgery in acute cases; avoid topical silver sulfadiazine on acute wounds
- •Consider honey as a topical treatment to potentially accelerate healing phases, though evidence quality remains limited
Key Findings
- •Tap water should be considered as an alternative to saline for wound lavage in horses
- •Optimal wound lavage pressure is approximately 13 psi
- •Povidone iodine lavage is recommended for contaminated wounds
- •Honey may reduce the duration of certain phases of wound healing in equine wounds