puncture injury wont heal

Question
Our quarter horse gelding got a small puncture wound in his shoulder almost a year ago.  We took him to the vet immediately and she put a drain in the shoulder (making a large incision about 8 inches long to do so), gave us antibiotics and sent him home.  The wound refuses to heal..It is puffy, oozes puss and looks nasty.  We have used topical ointments, whiskey wash, antibiotic poultices, nothing seems to help. We are in a very rural area of south dakota and it is over 150 miles to a really good horse vet clinic and takes months to get in.  DO you have any suggestions what I could try? I can send a pic of the wound if that would help. Thanks

Answer
Hi Brenda!

A picture would be great.  I'm wondering if you can email your vet a picture as well and then have them FedEx some more SMZ's or other antibiotic to you.  Sure sounds like he could use another round for sure.  Is he running a fever?  How is he moving?

It sounds like you have worked really hard on this and your horse is lucky to have you!!  One thing that you didn't mention was hydro-therapy.  I would start that right away - twice or three times a day if you can - for at least 15 min each time with cold water.  I would use as much water pressure as he will let you and really flush that thing out.  I'm still amazed at how well water works to clear things up.  If it's on his shoulder, I imagine that it's open and not covered with a bandage or wrap so that's good.

Puncture wounds are the worst because a lot of times, you never know how deep it really is and with it positioned on his shoulder like that, it is really difficult to drain.  That is where flushing it with the hose will really, really help.  Personally, depending on what this wound looks like, I would not put any topical stuff on it simply because ointments and salves tend to attract dirt and nasty micro-organisms that can work their way into the depths of this wound and continue to feed the infection.  Your goal is going to be to flush it really well while increasing the blood flow with the hydro-therapy then let it dry out so you can starve the infection that is currently living like a king in your horse's shoulder muscle.

I would love to know how this evolves!

Judi