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When a horse sustains a serious leg injury, it is sometimes necessary to stabilize the limb and control bleeding and swelling until your veterinarian arrives. A pressure bandage is an effective first aid tool that can be used to accomplish this task. Keep in mind, however, that any leg injury, serious enough to require a pressure bandage, is serious enough to require immediate professional attention. 

You should also recognize that pressure bandages can be potentially harmful if not applied correctly. If you know how to correctly apply a pressure bandage, you can come to the horse’s aid without causing further damage.

PURPOSE

The purpose of the pressure bandage is to protect the injured area and control bleeding without constricting normal circulation. 

Pressure bandages are used to:

- Control Bleeding

- Minimize swelling

- Provide support for an injured limb

- Absorb fluids (exudates) from a wound

- Protect a wound from contamination or additional trauma 

WOUND CARE 

The severity or type of injury will determine the best course of action. If there is an open wound with profuse bleeding, or it appears that a major blood vessel has been cut (blood appears to spurt not trickle), your primary concern will be to stop the bleeding. You will probably need to forego cleaning and apply pressure to the wound immediately. If the bleeding is light to moderate, it may be best to cleanse the wound using cool running water from a hose prior to bandaging. Avoid prolonged hosing (not more than 10 to 12 minutes) as it may increase swelling. 

A commercially available sterile saline solution or a solution of two tablespoons plain table salt to one gallon of water, can also be used. Ideally, the saline solution should be applied with pressure to loosen and flush dirt and debris from the wound. Avoid scrubbing as this may further damage tissue, increase bleeding or drive dirt and debris deeper into the wound. An antibacterial soap can be used to wash the surrounding area, but care should be taken to avoid getting soap into the wound itself.

Stress or traumatic injuries, such as bowed tendons, will benefit from being hosed or iced for five to 10 minutes prior to applying a pressure bandage.

PRESSURE BANDAGING MATERIALS 

If an open wound is involved, gauze pads, a clean cotton washcloth, sanitary pads or other sterile, non-stick dressing should be placed over the wound. Do not use sheet or roll cotton directly against a wound. While cotton is absorbent and provides excellent padding, the fibers will stick to the tissue and contaminate the wound. 

Once the wound is covered, you should use roll cotton, sheet cotton or leg quilts to pad the bandage. Adequate padding is essential to distribute pressure evenly around the limb. Padding should be at least two inches thick. This will allow you to apply sufficient tension to the support bandage to control bleeding and swelling. The extra padding will also absorb drainage from the wound. Generally, the longer a bandage is to remain in place, the greater the amount of padding needed. 

Track or polo wraps, cotton flannels, roll gauze, bandaging tape, elastikon, ace bandages or even duct tape can be used for the external (pressure) layer. Bandaging material should be at least two to three inches wide. This will help prevent a tourniquet effect and allow for sufficient overlap of the layers. Using stretch fabric makes bandaging easier, allows for movement and is less apt to restrict circulation as long as it is not pulled too tightly.

GENERAL GUIDELINES

If you have never bandaged a horse’s legs, ask your veterinarian or an experienced equine professional to demonstrate the proper techniques. Practice under his or her supervision before doing it on your own. 

Follow these basic guidelines: 

1. If blood loss does not appear excessive, clean the wound, removing as much dirt, hair and debris as possible prior to bandaging.

2. Cover open wounds with sterile, non-stick gauze or dressing. Do not apply sprays or chemicals to wounds that may need to be repaired. Water-soluble ointments can always be used; petroleum based ointments should not be used in surgically repairable injuries.

3. Apply soft, absorbent padding, such as roll cotton, at least two inches thick around the injured limb. Make sure it lies flat and wrinkle-free against the skin.

4. To prevent slippage, begin the support bandage at the foot, covering the heel bulb and coronary band (where hoof meets hair) and work up the leg.

5. Extend the pressure bandage 4-6 inches above the injury site. If the injury is in the lower leg, always bandage to the knee or hock.

6. Wrap the leg front to back, outside to inside (counterclockwise on left legs, clockwise on right legs).

7. Spiral support fabric upward, overlapping each proceeding layer by 50 percent. 

8. Use smooth, uniform tension on the bandage to compress the padding without forming lumps or ridges beneath the bandage.

9. Apply sufficient pressure to control the bleeding, but do not wrap so tightly that you cannot slip a pinky finger inside the bandage.

10. Do not wrap too loosely as the pressure bandage will not do its job.

SPECIAL CONSIDERATIONS 

- A pressure bandage should be left in place until the veterinarian arrives.

- Point out the exact location of the injury so the veterinarian can avoid disturbing it when removing the bandage.

- If blood soaks through the bandage, place a second bandage over it as before. Do not remove it, as this could disturb any blood clots that may be forming and encourage more bleeding.

- Monitor and evaluate the horse frequently. Remember, pressure bandages can be dangerous. If swelling develops above the bandage or lameness increases, check to see that the bandage is not cutting off the circulation and seek your veterinarian’s advice.

- Watch for other problems. If the horse loses its appetite or there is an elevation in body temperature, contact your veterinarian. If the bandage appears to be too tight, cut through the support layers, leave them in place and wrap the new bandage around the first one more loosely. 

- Extreme emergencies include injuries that do not stop bleeding within 15 to 20 minutes, lacerations that extend into joints and tendons and severe breakdowns or injuries in which the horse is unable or unwilling to walk. In any of these situations, get veterinary assistance immediately.

If you have any further questions or concerns about pressure bandaging techniques, contact your equine veterinarian.

This information was produced through a joint venture between 3M Animal Care
Products and the American Association of Equine Practitioners.