Borate-based bioactive glass is revolutionizing the way we treat equine wounds.
If you spend any amount of time with horses, you know they have a propensity for getting themselves hurt. Consequently, we need techniques to deal with injuries. One of the newer tools available to horse folks is called borate-based bioactive glass (BBBG). Tenda Heal has a pure, fibrous, re-absorbable form for veterinary use only; along with over-the-counter spray and cream that each contain concentrated amounts of BBBG. Dr. Blake Everett, DVM, MS, ACVS-LA at ThorSport Farm in Murfreesboro, Tennessee, shares why he swears by this innovative wound treatment.
What is Borate-Based Bioactive Glass?
Tenda Horse Products launched Tenda Heal in 2018 at the World Equestrian Games at Tryon International Equestrian Center. The product is a state-of-the-art wound treatment with hemostatic, antimicrobial, antifungal borate-based bioactive glass, which Dave Cowan, a representative at Tenda Horse Products, says stimulates the body’s natural healing process.
“BBBG is a network of glass fibers enriched with boron, calcium, zinc and copper ions,” Cowan said. “It functions as a bioabsorbable structure that bonds to existing tissue and encourages growth of fibrin, which is required for clotting and healing. As the body absorbs the BBBG fiber, calcium, zinc and boron ions are released, which are critical to stimulating many biological reactions in tissue repair.”
Everett says the glass fiber is formulated by exposing the specialized glass composition to extreme heat. As cooling occurs, a fiber is formed with a structure similar to cotton.
How Can It Be Used?
Cowan explains that boron is a natural antimicrobial element effective against bacteria, fungi and yeast. Calcium ions stimulate blood clotting to stop bleeding. Zinc is known to be an essential micronutrient for tissue regeneration and repair.
“Copper, essential to wound healing, is antimicrobial and stimulates endothelial cells, which control blood clotting, immune function and platelet adhesion,” Cowan said.
Tenda Heal BBBG comes in various forms, ranging from veterinary-grade wound fiber to an OTC spray and cream. The wound fiber can be pulled apart, fluffed out, and molded to the wound bed. The OTC spray and cream formulas are ideal for treating scrapes, scratches, abrasions, rain rot, and more.
“BBBG rapidly heals wounds of all sizes and types, including surgical wounds,” Cowan said.
Everett says bioactive glass products are used in dental care for humans, for veterinary injuries, and with patients who have ulcers, bed sores, or other slow-to-heal wounds.
“Initially, people are curious about putting glass in a wound — is it going to destroy it?” Everett said. “Actually, it doesn’t. It’s biocompatible. That’s the biggest difference from normal glass. It’s highly porous, and it acts as a scaffold for the surrounding tissue, while engaging what I call the cellular machinery at the molecular level.”
This product also improves blood flow, supplying oxygen directly to the site of the wound, says Everett. It mimics fibrin to stimulate the healing cascade.
“Anytime you have a wound, the first thing that forms is a platelet, or a fibrin plug,” Everett said. “This bioactive glass helps mimic that plug. It helps trap some of those cells and then helps them grow.”
Everett says recent studies have found that equine woulds involving the distal limb can be difficult to heal due to biofilm formation. Biofilm is produced by bacteria that enable them to evade the immune system and proliferate, reducing the penetration and effectiveness of antimicrobials and thereby delaying would healing. But BBBG helps remove the biofilm and encourages the formation of healthy tissue underneath. Tenda Heal is absorbed into the wound bed as the wound heals. “Initially, I started using Tenda Heal on the worst of the worst wounds, but I’ve started using it on less complex ones — anything from abscess pockets, sores and even some abrasions,” Everett said.
Treatment Process
So how do you incorporate a product like Tenda Heal fiber into wound care? Everett says he starts the treatment process as normal — clean the wound, debride any dead tissue and rinse with saline, although he’s since started using Tenda Heal spray in place of saline for its antimicrobial properties.
“I’ll lavage the wounds, and then take the fiber and place it on the tissue and leave it,” Everett said. “If it’s a really large wound, I won’t bandage it, but if it’s something I can [wrap], I’ll bandage it as well. You simply cut or tear the portion of [Tenda Heal] and fill in the tunnel or sinus tract around the tissue first, and you can actually conform it to the shape of the wound’s surface.”
Tenda Heal is hemostatic, which will help control the bleeding and drainage in a wound, Everett said. It debrides itself, helping create better granulation tissue, which is new connective tissue and microscopic blood vessels that form on the surfaces of a wound during the healing process.
“The cool thing is, you can just leave the fiber in — you don’t have to take it out,” Everett said. “So many times, we have to do dressing changes and apply more material, and sometimes you do with this product, but I do truly think this helps get us to a healthier stage in wound healing.”
Case Studies
Everett treated a 10-year-old barrel horse that was kicked in the shoulder last June. The gelding had a draining track at the point of his right shoulder, and he was fairly lame. He’d previously gone to another equine hospital, where the veterinarian took X-rays and removed some bone fragments out of the wound they’d been treating for two months. The owner brought the horse to Everett, because the wound was not healing.
“Following a thorough examination, I determined that a kick to the shoulder had fractured the deltoid tuberosity of the humerus and resulted in dead, infected bone fragments (sequestra) that the body was unable to heal,” Everett said. “To further complicate the case was the precarious location of the wound that made opening up this site more prone to complications. I elected to be more conservative in my approach, and it actually worked well.”
The horse was sedated, wound irrigated with Tenda Heal spray, and Tenda Heal fiber was gently packed into the wound and a stent tie-over bandage was applied. Every three days, Everett performed wound therapy and Tenda Heal fiber was reapplied as needed following gentle wound lavage with Tenda Heal spray.
“Within about a week, you could notice a substantial difference in the amount of tissue that was starting to grow around the draining tract,” Everett said. “As I would go in and clean it every few days, the bone fragments would actually just come out with a sterile swab. My idea was, as I got the tissue around these fragments really healthy, they helped push out the ones that were infected. We went from a wound they had been treating for two months, and essentially it healed in two weeks.”
Another client, a yearling barrel prospect and his pasture mate, ran into a fence during a storm. The pasture mate had a large scrape and a laceration across his hock. The other, “Leroy,” had a large, full-thickness laceration on his forearm, just around the knee. It didn’t seem to involve the carpal canal or the tendon, according to Everett.
“I elected to keep it open instead of doing primary closure,” Everett said. “I did regional perfusion, and I basically just went in, irrigated the wound, loosely packed the fiber in there, and the results were pretty remarkable. We went from it maybe being infected, to the wound actually healing up and maintaining soundness.”
Even though the wound was large, the horse only has a small scar now. He is currently in training.
One horse was sent to Everett as a last-ditch effort. The mare was thought to have a pelvic fracture as previously diagnosed. But, she had a wound on her hock.
“I looked back through the records, and the mare had a small nick at the point of her hock on the back side,” Everett said. “Over time, she had become progressively more lame. She shed a lot of that tissue off and was minimally weight bearing.”
Everett assessed the hock, feeling that a pelvic fracture didn’t make sense in this case.
“I figured out it was a septic calcaneal bursa, and the whole hock was exposed,” Everett said. “This was about a year later, but it’s finally nearly closed in. But that was so far gone, I had to do broad spectrum antibiotics, and I packed it with fiber. We had a 50-50 shot, and chances weren’t looking good. But that poor girl, she sounded up after initiating the therapies.”
Over time, Everett has used bioactive glass as well as irrigating solution and ointments with the mare. As of now, the wound is nearly healed.
“It was amazing — the whole hock, you could palpate the tendons above and below the hock, you could feel the bone [prior to treatment],” Everett said. “She’s just really lucky. I felt, ‘Well let’s just try it. If it’s going to work on anything, hopefully it will be on this one.’”
A few weeks prior to this writing, a mare came in with a lateral splint bone fracture that was open. The mare was very unstable, three-legged lame, and Everett could place his finger in the wound and touch bone. It was not a recent injury, and she was in bad shape. “I debrided it, irrigated it with Tenda Heal spray, which is my go-to as opposed to saline spray these days,” Everett said. “I worked on getting the wound bed healthy, and maybe it would help push the nasty bone fragments out.”
Her soundness has improved following a short course of anti-inflammatories and antimicrobials. He changed bandages every two to three days and soon, it healed up.
“We kept her in the hospital for about two weeks, sent her home on no medications, and they came back for a follow-up two weeks later. There was still a small tract in the wound bed,” Everett said. “I re-shot an X-ray, couldn’t really see a discrete bone fragment, so I used a small bone curette and sterile swab to clean the wound and then packed it again with Tenda Heal fiber.”
Two weeks later, the owner sent a photo to Everett, and the wound had completely scabbed over, and the mare was sound at a walk.
“That’s going from being an infected, open fracture causing severe lameness to nearly sound in a month — those things can often be a booger to get healed,” Everett said. “The cool thing is, we only kept her on antibiotics for a week and a half.”
A product with borate-based bioactive glass is an excellent addition to any barn’s first-aid kit. As more benefits are realized, it may become your go-to wound care product, too.
