A Really Good Way to Clean Wounds (Really)

Somehow, some way, it seems like the common variety garden hose has become something of an indispensable weapon in the war against horse wounds.  

A good, firm jet of water run vigorously over the cut on your horse’s leg, or rinsing out a deep wound on his body, most assuredly makes you feel like you’re doing something good for your horse. And, frankly, I’ve always thought so, too.

But you know me—I’m always trying to get to the bottom of things. And so I started wondering if, by watering a horse’s wound, we’re really doing any good. Or worse: are we doing any harm?

I am going to step right up and say that there are a lot of undeniable advantages to using a garden hose to rinse out a horse’s wound.

• For one, a good firm stream of water can certainly knock off some of that nasty surface debris that preoccupies so many wound caretakers.
• Of course, it’s easy enough. That’s a good thing, because in my experience, something that is easy is also more likely to get done. If you’re like, say, most everyone else on the planet, you’d just as soon not have to do something too difficult if there’s an easier way. Happily, turning on a hose is one of those things that isn’t too complicated.
• Lastly, hosing out a wound is pretty safe. Trust me, you’re a lot better off squirting away at your horse’s back leg wound from five feet with a stream of water than you are trying to get your head down in the kicking zone to scrub away some little speck of dirt that’s particularly irritating (to you, anyway).

But, you know, if there’s a simple and easy solution, it may also be wrong, and there are theoretical concerns about why hosing off your horse’s wound might NOT be such a good idea. And first and foremost is the fact that water doesn’t have any salt in it (at least, not the water that comes out of a hose).

“And,” you ask, “Why is that important?”

Well, body fluids have salts in them. Those salts perform a lot of important functions that make physiology tests sometimes very difficult. Among their most important function is helping to maintain water in the horse’s body. The concentration of salts gives body fluids a property called tonicity. Theoretically, anyway, you’d like to squirt off your horse’s leg with a fluid that has the same concentration of salt in it as do his own body fluids.

The water running out of a horse is hypotonic. That is, it doesn’t have any salt in it. And what that means is that if you soak the leg long enough, salt will come out of the tissues, and the tissues will become sort of water-logged. And that’s not likely to be a good thing.

So me, being all scientifical and all, I have run around for most of my career thinking that while hosing with water might not be a good thing, getting a client kicked in the head by insisting that they use bottled saline to clean wounds SURELY isn’t a good thing, so I’ve kind of been mum about the whole process. I mean, the horse who is getting his leg hosed off is getting care and attention, and I think that’s a great thing, and particularly when the hose water doesn’t cost any more than hose water costs. (I’m sure that there’s a marketing opportunity here, but I can’t immediately see it).

Anyway, since I’m a big believer that while theory is good, reality is even better, I decided to go snooping around in the medical literature (just one of many ways to have a good time, doncha know), and see what ACTUALLY happens to wounds when you wash them in plain old tap water (the medical term is irrigate, but I’ll spare you). And, frankly, I was surprised as I could be.

First, I was surprised that there have actually been quite a number of studies done on irrigating wounds with tap water. I mean, who would have thought, what with all of the things that there are out there to investigate, that someone would have devoted time and attention to the good old H2O that comes right into your house, ranch or stable. But they have devoted time and attention—and a lot of it.  

Here’s some really interesting findings.

1.  Tap water seems to be every bit as good as sterile saline when it comes to rinsing out a wound prior to sewing it up

(Which I have done in the dark, on my knees, essentially standing on my head, dodging hooves, and in any number of other different situations and contorted positions). So I’m happy about the fact that tap water isn’t harmful, because I’ve been advising people to run hose water on wounds for 30-some years, and I would feel really awful if it turned out that I had been actually making things worse over all these years. You can see the study if you CLICK HERE.

2. There’s this big group in England, called the Cochrane Collaboration

This group of fun-loving folks likes to sit around and collect all of the studies that they can find about a particular topic, and see if they can come up with an overall conclusion. And, when it comes to tap water, and fresh wounds, they did (presumably in between soccer games or something). Turns out that not only is tap water not harmful, there’s some evidence that it might even reduce the rate of infection.

How about that?  Easy, and helpful, too!

Oh, and one other important thing. The Cochrane group also stated that there’s pretty limited evidence that all of the cleaning of wound surfaces does much to prevent wound infections anyway. I mean, when you get a scrape on your arm, do you feel compelled to wash it all the time? Keep that in mind next time that you’re tempted to speed to the stable for your third wound cleaning and bandaging session. Sometimes, a little less is a little more.  And CLICK HERE if you want to see the Cochrance study.

And there’s lots more.  

Rinsing out wounds with tap water works just as well as using saline in hospital emergency rooms (lots of studies). And it turns out that most human medical people don’t worry nearly as much about rinsing out old wounds as horse folks do. When you think about it, old wounds have already got bacteria growing on them anyway, and the best thing that you’ll do by hosing it off is wash a few of them off.

So I feel like I can confidently say that if you want to go and hose off your horse’s wound, go right ahead. If you’re dealing with a fresh wound, I’d advise you to make sure that the bleeding stops first, because if you keep hosing a wound that’s bleeding, all you’ll do is wash off the little clots that are trying to form. Let the bleeding stop, then hose away.

I just love it when science supports what most folks would do in the first place. Tell your friends.

This article originally appeared on DoctorRamey.com and is reprinted here with permission.