Sunday, January 3, 2016

Healing by Secondary Intention: Bob's Story

by Kip Tulin M.D.

Bob's wound, Day One
In early December (a month before this writing) Bob, an older gelding in the Farm school program, sustained a deep laceration to the right side of his face, cause unknown. (Mary Gallagher discovered his plight in the course of a morning feeding and checked around the pen, with no luck.) As you can see from the photo, the cut went from just below his eye and way down the cheek, gaping open almost an inch. Mary examined the wound carefully, noting some places where the wound went all the way through; she could hear a sucking sound as Bob breathed.

Obviously such a deep cut needed to be stitched, right?

Not so fast. Mother Nature has endowed her creatures with an amazing ability to heal given proper care.  Stitching, or suturing a wound (also called healing by primary intention in the auld medical lingo) if done right, often gives a better cosmetic result, but it should only be done on a clean wound. Keeping a wound clean is difficult with humans and almost impossible with horses, let alone trying to get the latter to hold still while you work.

Applying Manuka honey
So Mary wisely decided to help the wound heal itself, or healing by secondary intention. She cleaned the wound carefully and applied Manuka honey* from her first aid kit.

Applying honey to wounds is a recently re-discovered treatment, used by many cultures and dating back at least 4000 years. Manuka honey is the only honey that has been approved (by the FDA, 2007) for use in wounds. Regular store-bought honey will not do the trick. Manuka honey apparently releases hydrogen peroxide (which is antibacterial) locally, into the wound. It even kills antibiotic resistant bacteria like MRSA in surface wounds, eliminates strong odors from wounds, and appears to cut down scarring.

Mary continued the treatment daily by gently peeling the scab and applying more honey. As time went on, Bob’s nasty cut slowly closed, with a smooth scar that gives him a slightly swashbuckling attitude.

Here are some photos which show the healing sequence.

At left, a few days later, freshly peeled, closing on its own. Center, about two weeks after the original cut, no need for treatment.  Right, a smooth, healthy scar at three weeks.

In conclusion, natural wound healing has a definite place in natural horsemanship. 

And Bob is pleased.
Bob with the author, three weeks after.
  For further reference:

* Manuka honey is produced by European honeybees who feed from tea trees in Australia and New Zealand. In the U.S. it's name is commonly pronounced [muh-noo-kuh].) Read more about manuka honey in this Wikipedia article.

Also, here is a link to a scholarly article on the use of honey for wounds.

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