Management of Wounds of the Distal Extremities

Schumacher, Jim; Stashak, Ted S.

doi:10.1002/9781118999219.ch13

Cited by 4 publications

(9 citation statements)

References 42 publications

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“…However, these methods of sterilization seemed to be relatively Metacarpal wounds of donkeys were chosen as a model in the present study as they are the most challengeable ones. Its high tendency to develop hypergranulation tissue, poor vascularization, and high risk of contamination due to its proximity to the floor contribute to lower healing rates than in wounds elsewhere [1]. It was taken into consideration to create the wounds under the effect the intravenous anesthesia rather than local infiltration anesthesia because of the probable adverse effect of the local anesthetic on the wound healing [22].…”

Section: Discussionmentioning

confidence: 99%

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Evaluation of fish skin as a biological dressing for metacarpal wounds in donkeys

et al. 2020

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Background The use of biological dressings has recently emerged in the management of burns and wounds. The aim of the present study was to evaluate the Nile tilapia skin as a biological dressing for full-thickness cutaneous metacarpal wounds in donkeys. The study was conducted on nine clinically healthy donkeys (n = 9). Here, fish skin dressings were obtained from fresh Nile tilapia (Oreochromis niloticus and sterilized by immersion in silver nanoparticles (AgNPs) solution for 5 min, with no change in collagen content. Bilateral, circular full-thickness excisional skin wounds (2 cm in diameter) were created on the dorsal aspect of the mid-metacarpals of each donkey. Wounds on the right metacarpals (treated wounds, n = 9) were dressed with sterile fish skins, while wounds on the left metacarpals (control wounds, n = 9) were dressed with sterile non-adherent dressing pads without any topical applications. Wound dressings were changed weekly. Wounds were evaluated microbiologically, grossly, and histologically on days 7, 14, and 21 post-wound inductions. Results Fish skin-dressed wounds showed a significant (P < 0.0001) reduction in microbial counts (Total viable bacterial count, Staphylococcal count, and Coliform count), a significant (P < 0.0001) decrease in the wound size, and a significant reduction (P < 0.0001) in the epithelial gap compared to the untreated wounds. No frequent dressing changes were needed. Conclusions Fish skin dressing accelerated the wound healing process and efficiently inhibited the local microbial activity and exuberant granulation tissue formation suggesting its reliable and promising application for metacarpal wounds of donkeys.

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Section: Discussionmentioning

confidence: 99%

“…Wounds of the distal limbs of equines are common and represent more than 60% of all wounds. These wounds are more problematic than others located elsewhere in the body due to its high susceptibility to contamination, the poor healing nature, and high tendency to form exuberant granulation tissue [1].…”

Section: Introductionmentioning

confidence: 99%

Evaluation of fish skin as a biological dressing for metacarpal wounds in donkeys

et al. 2020

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“…Exungulation brakes up this connection and rotation of the coffin bone may occur [7]. Even when no complications happen, the horse can remain lame because of the amount of tissue loss [7,19,20].…”

Section: Discussionmentioning

confidence: 99%

“…This injury can involve different and deep structures in the hoof capsule. Implication of deep structures should be evaluated by clinical and imaging exams [19]. Osteomyelitis, distal phalanx fractures, septic arthritis and degenerative disease are common complications [20].…”

Section: Introductionmentioning

confidence: 99%

Complete Avulsion of the Hoof Capsule and Subsequent Testicular Degeneration in a Criollo Stallion

Mousquer

Curcio

Müller

et al. 2021

Acta Scientiae. Vet.

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Background: Complete avulsion of the hoof in horses, also known as exungulation, is not a commonly reported injury and usually leads to euthanasia due to the great amount of tissue loss, intense pain, secondary complications, expensive and lengthy treatment. It can involve deep structures and cause different complications leading to chronic lameness. In stallions affected by such injury, the reproductive tract and performance may also be affected. The aim of this study was to report a case of complete avulsion of the right front hoof in a Criollo stallion and subsequent bilateral testicular degeneration.Case: A 10-year-old Criollo stallion was referred to the Veterinary Clinical Hospital of the Federal University of Pelotas (HCV- UFPel) with a complete avulsion of the left front hoof. At admission, the stallion had clinical parameters compatible with intense pain and blood loss. Evaluation of the wound demonstrated that the distal end of the third phalanx (P3) was exposed but no fracture was detected on radiological evaluation. No other structure was apparently affected. Initially, anti-inflammatory (phenylbutazone) and opioid (morphine) was given for pain control and supportive fluid therapy was started to restore hydration. Antibiotic (Sulfamethoxazole with trimethoprim) were administered for 10 days. Continued therapy with phenylbutazone, pentoxifylline, omeprazole and supplementation with methionine, biotin and zinc was also given. Local treatment was carried out by cleaning the wound, applying an antimicrobial ointment and dressing it with a bandage. Wound management was adapted according to the evolution and healing process. The stallion was kept in stall rest during its hospitalization time. In the second month after the injury, accumulation of liquid in the scrotum was observed. Clinical and ultrasound evaluation lead to a presumptive diagnosis of testicular degeneration. The stallion was discharged after three months when the wound was almost healed and the hoof had started to grow. Six month later, a follow up by the referring vet showed that the hoof was almost completely grown and the x-ray assessment demonstrated a cranial rotation and resorption of the distal end of the third phalanx.Discussion: The stallion of this report had a complete avulsion of the hoof capsule caused by trauma. Conservative treatment was established including wound cleaning and dressing to avoid contamination, control of pain and inflammation, antimicrobial care and supplementation to support hoof growth. Time period for wound healing and hoof growth was in agreement with other cases described previously. Bone sequestrum of the distal end of the third phalanx, and detachment of a fragment were observed in this case, followed by bone resorption. The stallion was closely monitored to prevent laminitis in the contralateral limb and no alterations were detected during the treatment period. Testicular degeneration was observed, probably caused as a consequence of hoof avulsion and due to a long period of stall rest. Degenerative alterations in testicles interfere with thermoregulation and spermatogenesis, affecting semen quality and reproductive performance. Rotation of the third phalanx was also observed six months later caused by the hoof loss. In conclusion, the patient of this report had a complete regrowth of the hoof capsule although a long intensive treatment was necessary to achieve this result. As a consequence, testicles degeneration may happen impairing its function as a stallion.Keywords: exungulation,hoof trauma, degenerative changes.

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“…Dentro de estas lesiones, las heridas son la emergencia más común que enfrentan los veterinarios en la práctica equina (Clodagh, 2009). Un 60 % de ellas afectan la parte distal del miembro, presentan más problemas que otras ya que por su proximidad con el suelo la probabilidad de contaminarse e infectarse es mayor (Schumacher y Stashak, 2017). Otro factor importante es la alta probabilidad de verse involucradas estructuras vitales como articulaciones, vainas sinoviales, ligamentos y tendones, esto se debe a que numerosas estructuras musculo-esqueléticas para la carga del peso o locomoción son relativamente superficiales en esta zona y, por lo tanto, susceptibles de sufrir daños (Schumacher y Stashak, 2017).…”

Section: Introductionunclassified

Osteítis séptica secundaria a una herida accidental en plantar de nudo del miembro posterior en un equino Reporte de caso

Perez¹

2023

Veterinaria (Montev.)

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El objetivo de este trabajo fue relatar el caso clínico y su posterior evolución de un equino con osteítis séptica en los huesos sesamoideos proximales en el miembro pélvico derecho debido a una herida traumática. El paciente, una yegua tordilla, raza pura sangre de carrera, de 8 años de edad, de actividad deportiva, fue admitido en el Centro Hospital Veterinario de la Facultad de Veterinaria en el año 2020, presentaba una herida en plantar de la articulación metatarso-falangiana, producto de un traumatismo al realizar ejercicios de natación en un arroyo. En la evaluación clínica se determinó una herida con sección del tendón flexor digital superficial y profundo, evolucionando a tendosinovitis y artritis séptica con posterior osteítis séptica de los huesos sesamoideos proximales como complicación. El tratamiento consistió en un abordaje multimodal, con el propósito de controlar la infección y contaminación de la herida, su reparación y analgesia. Debido al tratamiento agresivo instaurado posterior al diagnóstico definitivo, el paciente evolucionó favorablemente y disminuyó el grado de dolor y claudicación, en posteriores controles radiográficos se observó infección ósea controlada y en proceso de remodelación ósea con anquilosis de la articulación metatarso-falangiana; lo cual fue beneficioso en este caso debido a la disrupción del aparato de sostén del nudo.

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Management of Wounds of the Distal Extremities

Cited by 4 publications

References 42 publications

Evaluation of fish skin as a biological dressing for metacarpal wounds in donkeys

Evaluation of fish skin as a biological dressing for metacarpal wounds in donkeys

Complete Avulsion of the Hoof Capsule and Subsequent Testicular Degeneration in a Criollo Stallion

Osteítis séptica secundaria a una herida accidental en plantar de nudo del miembro posterior en un equino Reporte de caso

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