CHAPTER 157 Management of Wounds in High-Motion Areas
Wounds over areas of high motion, such as the hoof, pastern, fetlock, carpus, tarsus, and structures of the head, necessitate special care to avoid the propensity of these areas to develop excessive granulation tissue, chronic bandage complications, and poor, prolonged healing. Movement from either the motion of a joint or the underlying tissues, such as an underlying tendon, can delay healing. Whereas some motion is required to ensure proper collagen alignment along lines of tension in wounds, excessive motion in a wound bed can disrupt angiogenesis and increase collagen deposition, which promotes chronic inflammation that will often lead to exuberant granulation tissue and poor-quality repair tissue.