Background: There are currently no evidence summaries on wounds in the horse. Objectives: To develop evidence-based guidelines on wound management in the horse. Study design: Evidence review using the GRADE framework. Methods: Research questions were proposed by a panel of veterinarians, and developed into PICO format. Evidence in the veterinary literature was evaluated using the GRADE evidence-to-decision framework. Searches for human evidence summaries were conducted in the NICE, Cochrane and JBI databases. Final recommendations were based on both veterinary and human evidence. Results and recommendations: The research questions were categorised into three areas: A. Wound lavage and topical treatments; B. Wound debridement and closure; C. Therapeutics for wound healing. Three hundred and six veterinary publications were identified across thirteen different topics. Fourteen papers were assessed using the GRADE criteria. Twenty-five human evidence summaries were reviewed. The results were developed into recommendations: A Wound lavage and topical treatments: (i) Tap water should be considered instead of saline for lavage; (ii) Povidone iodine lavage should be considered for contaminated wounds; (iii) Topical silver sulfadiazine may not be suitable for acute wounds; (iv) Optimal lavage pressures are around 13 psi. B Wound debridement and closure: (i) Debridement pads should be considered for wound preparation; (ii) Larvae debridement should be considered in selected cases; (iii) Hydrosurgery should be considered in acute contaminated wounds. C Therapeutics for wound healing: (i) Honey may reduce duration of some phases of wound healing. There was insufficient evidence to draw conclusions on the use of chemical debridement, therapeutic ultrasound, laser therapy, wound closure with staples compared to sutures, or identify optimal concentrations of antiseptic lavage solutions. Main limitations: Low quality evidence in veterinary literature; majority of recommendations were based on human evidence. Conclusions: These findings should be used to inform decision-making in equine primary care practice. | 19 FREEMAN Et Al.

SummaryThe objective of this prospective clinical study was to investigate the cause and describe the presentation, diagnosis, treatment techniques and outcome of Prunus spinosa (blackthorn) injury and synovitis in the horse. In all cases presented with blackthorn injury and synovitis, surgical treatment was performed within 24 h, using a two‐stage procedure: 1‐Perisynovial technique using ultrasound guided electrosurgical dissection; 2‐Endoscopic technique. The diagnosis was confirmed by retrieval of black plant material from or close to the affected synovial structure. Mean lameness score on presentation was 4/5 (range 1–5). The most commonly affected structures were extensor tendon sheaths (12/35) and fetlock joints (11/35). All cases had thorn material removed, 80% had thorn material removed at surgery and in 49% it was intra‐synovial. On presentation, the mean synovial fluid total protein level (TP) was 47.6 g/L (range 18–66); mean total nucleated cell count (TNCC) was 176 × 109 cells/L (range 12–312). Two days post‐surgery, mean total protein levels were 33 g/L (range 16–52), mean TNCC was 13 × 109 cells/L (range 1–35). At 5 days post‐surgery, the mean total protein was 23 g/L (range 12–28) and TNCC was 5 × 109 cells/L (range 1–12). All synovial fluid cultures were negative. Twenty‐eight (80%) horses were sound 5 days post‐operatively, seven (20%) were not lame in walk; they all returned to full work in an average time of 8 weeks (range 3–48 weeks). Surgery achieved accurate identification and removal of thorn material. In contrast to previous studies of synovial sepsis, these cases had a positive outcome despite high pre‐ and post‐operative synovial fluid TP and TNCC. These findings suggest that Prunus spinosus (blackthorn) synovitis has a different aetiology to synovitis originating from sepsis or other types of contamination.

Clinical Research Abstracts British Equine Veterinary Association Congress 2015 Foreword and AcknowledgementsThis supplement is devoted to the publication of abstracts from the 2015 Congress of The British Equine Veterinary Association. The quality of research at the Congress was, as in previous years, high, and the selection process was difficult. Despite the inclusion of a larger number of research communications than in previous years only two-thirds of those submitted could be accepted. This year's Congress committee utilised the selection process initiated last year by Professor Celia Marr in partnership with EVJ. Abstracts were reviewed and objectively graded by two peer reviewers and a member of the Congress Committee before being subjected to a final selection process overseen by the Congress Chair. Thereafter, abstracts had to satisfy the requirements of EVJ for publication in this supplement. Those authors who have had their work accepted should be proud of their achievement. Those who were unsuccessful are doubtless disappointed; however, they have the reassurance that the standard was high and the process was fair.Implementing such a process necessitates a considerable amount of work by dozens of individuals. I am extremely grateful to Professor Celia Marr, Sue Wright and Jane Woodley at EVJ for inviting the Congress Committee to work in partnership with them and for enabling us to utilise their review process. Without the infrastructure provided by EVJ, such a comprehensive review process would not have been possible, and without the endless patience and assistance of the aforementioned individuals, it could not have worked. The Congress Committee themselves: Debbie Archer, Madeleine Campbell, Huw Griffiths, Philip Ivens, Andy Fiske-Jackson, Malcolm Morley, Michael Schramme, Henry Tremaine and Lesley Young deserve thanks and recognition for a year of hard work. Particular thanks also to all of the anonymous peer reviewers who receive no recognition but gave their time not only to grade the abstracts submitted but also to provide constructive feedback to their authors.The selection process adopted for BEVA Congress sets a standard for other meetings to follow. Given the increasing competition for acceptance of research communications at major international meetings, and the importance of achieving acceptance for those seeking to fulfil the requirements of specialist colleges, such a rigourous selection process seems only right. David Rendle Chairman BEVA 2015 Scientific Programme Guardians Congress Session Sponsors EFFICACY OF OVIDUCTAL FLUSHING WITH PGE2, IN MARES, IN AND OUT OF THE BREEDING SEASONMartynski, P.D., Payne, R.J. and Wylie, C.E. Rossdales Equine Hospital & Diagnostic Centre, Cotton End Road, Exning, Newmarket, Suffolk, CB8 7NN, UK. Email: pmartynski@rvc.ac.uk Reasons for performing study: There are limited data surrounding the efficacy of oviductal flushing in restoring fertility in mares with repeated returns to oestrus. Objectives:To determine the conception and foaling rates in...

BackgroundThere is relatively little literature on elbow disease in the horse. The only published reports on soft tissue conditions describe collateral ligament and biceps brachii injuries.Case presentationA three-year old Thoroughbred gelding presented with a history of acute onset right forelimb lameness of less than one week duration, one month after commencing training in a National Hunt racing yard. Physical examination and peri-neural anaesthesia failed to localise the lesion. Lameness was localised to the distal humerus by nuclear scintigraphy and intra-articular anaesthesia. A partial avulsion of the tendinous origin of the ulnaris lateralis and enthesiopathy of the lateral humeral epicondyle was diagnosed on ultrasonography. Ultrasonographic findings were loss of longitudinal fibre pattern, a discrete hypo-echoic region within the ulnaris lateralis tendon of origin, and remodelling of the lateral epicondyle of the right humerus at the site of the origin of the ulnaris lateralis. No abnormalities were identified on radiography. The lameness did not resolve with rest, but was successfully treated with extra corporal shockwave therapy (ECSWT) and intra-lesional corticosteroid injections.ConclusionThis is the first report of partial avulsion of the ulnaris lateralis and enthesiopathy of the lateral humeral epicondyle in the horse. In contrast to other reported soft tissue conditions of the elbow, this horse had a successful return to work. This case highlights the value of ultrasonography in assessing peri-articular soft tissues, and the importance of pain relief as treatment in some soft tissue injuries.

<strong>PICO question</strong><br /><p>In horses with longitudinal tears of the deep digital flexor tendon within the digital flexor tendon sheath, is surgical repair as effective as tenoscopic debridement alone for returning to previous level of performance?</p><strong>Clinical bottom line</strong><br /><p>Current literature on the efficacy of surgical repair or tenoscopic debridement is limited. Criteria to define and evaluate performance outcomes is not uniform and confounded with multiple variables, merely representing low quality evidence that is difficult to draw meaningful conclusions from. However, the literature suggests tenoscopic debridement alone has been associated with improved outcomes. A more definitive conclusion cannot be made until higher quality evidence is made available on this topic.</p><p> </p><img src="https://www.veterinaryevidence.org/rcvskmod/icons/oa-icon.jpg" alt="Open Access" /> <img src="https://www.veterinaryevidence.org/rcvskmod/icons/pr-icon.jpg" alt="Peer Reviewed" />