Regional Limb Perfusion with Antibiotics in Three Horses

Whitehair, Karen J.; Adams, Stephen B.; Parker, Jill E.; Blevins, William E.; Fessler, J F

doi:10.1111/j.1532-950x.1992.tb00066.x

Cited by 64 publications

(73 citation statements)

References 9 publications

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“…There were 5 yearlings or young horses that had not started training and 30 foals (age ≤ 6 months). There were 96 horses with septic synovitis (group 1; 74 septic joints, 16 septic sheaths, and 6 septic bursae), 50 with lacerations (group 2; 27 fresh, minimally contaminated intrasynovial lacerations and 23 extrasynovial lacerations), and 28 with other conditions (group 3; osteomyelitis [4], fractures [2], prophylactic use of A-RLP [11], surgical site infections [5], and other conditions [6]). Median (range) duration prior to admission to the hospital was 4 days (0 to 60 days; group 1), 0 days (0 to 25 days; group 2), and 5 days (0 to 180 days; group 3).…”

Section: Resultsmentioning

confidence: 99%

“…Twenty-two (78.57%) horses were available for long-term outcome: 18 (81.82%) were alive, 3 (13.64%) were euthanized for reasons related to the primary complaint, and 1 (4.54%) was euthanized for unrelated reasons. At that time, 17 horses had returned to their previous athletic use: 11 Power calculations-Power was calculated for the multivariate stepwise analysis for each of the groups. Results for power values were as follows for group 1: alive versus dead, 93.67%; return to previous use at the same or higher level versus at a lower level, 83.89%.…”

Section: Other Conditions (Group 3)-thementioning

confidence: 99%

“…achieved in synovial fluid and bone tissue after A-RLP are much higher than those after systemic administration, 7,[9][10][11] and experimental infections have responded favorably to A-RLP. 12 Reported complications of A-RLP include thrombophlebitis of the injected vein, soft tissue inflammation over the intraosseous infusion site, difficult injection into the medullary cavity of the bone, and osteonecrosis of the injected bone.…”

mentioning

confidence: 99%

“…12 Reported complications of A-RLP include thrombophlebitis of the injected vein, soft tissue inflammation over the intraosseous infusion site, difficult injection into the medullary cavity of the bone, and osteonecrosis of the injected bone. 3,6,13 On the basis of clinical experiences and anecdotal clinical reports, 1,5,11,12,14 it is believed that the use of A-RLP has helped increase the successful outcome of horses with orthopedic infections. However, information about ease of use, complications, and short-and long-term results after clinical application of A-RLP in a large number of cases is lacking.…”

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confidence: 99%

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Clinical use of antimicrobial regional limb perfusion in horses: 174 cases (1999–2009)

Rubio‐Martínez

Elmas²,

Black³

et al. 2012

javma

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Objective—To describe the clinical use of regional limb perfusion with antimicrobials (A-RLP), complications, and outcome in a large series of patients. Design—Retrospective case series. Animals—174 horses. Procedures—Medical records of horses treated with A-RLP between 1999 and 2009 were reviewed. Signalment, primary complaint, horse use, etiology, duration of clinical signs, previous treatment, structures involved, concurrent conditions, A-RLP characteristics, additional treatments, complications, and outcome were recorded. At long-term follow-up, 2 outcomes were investigated: survival rate and return to previous use at the same or higher level. Univariate and multivariate logistic regression analyses were conducted. Results—Group 1 (96 horses) included septic synovitis. Group 2 (50 horses) included extrasynovial lacerations (23 horses) and fresh, minimally contaminated intrasynovial lacerations without evidence of established synovial infection (27 horses). Group 3 (28 horses) included miscellaneous other conditions. Only minor complications were reported in 12.26% of horses that received IV (n = 155) and 33% of horses that received intraosseous (27) A-RLP. Horses with septic synovitis had a lower survival rate (53.43%) than did horses with lacerations (91.89%). Within group 2, no significant differences in short- or long-term outcomes were found between horses with extrasynovial and fresh, minimally contaminated intrasynovial lacerations. For the horses returning to previous use, 80% of horses with septic synovitis and 72.72% of horses with lacerations were performing at the same or higher level at the time of follow-up. Conclusions and Clinical Relevance—The results of the present study indicated that A-RLP is a safe technique with minimal adverse effects. The IV route presented fewer complications than intraosseous injection. Horses with infection of synovial structures had a lower survival rate than did those with acute, minimally contaminated intrasynovial lacerations. The latter had a similar prognosis for horses with extrasynovial lacerations treated with A-RLP.

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Section: Resultsmentioning

confidence: 99%

Section: Other Conditions (Group 3)-thementioning

confidence: 99%

mentioning

confidence: 99%

mentioning

confidence: 99%

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Clinical use of antimicrobial regional limb perfusion in horses: 174 cases (1999–2009)

Rubio‐Martínez

Elmas²,

Black³

et al. 2012

javma

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“…It is important to remember that regional limb perfusion is most practically used in conjunction with surgical debridement. In another study, regional limb perfusion was used successfully to treat three horses with osteomyelitis associated with infected orthopedic implants (Whitehair, 1992).…”

Section: Regional Limb Perfusionmentioning

confidence: 99%

Elution of Metronidazole and Gentamicin from Polymethylmethacrylate Beads

et al. 2003

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(ABSTRACT)Ten polymethylmethacrylate (PMMA) beads containing metronidazole (3 concentrations); gentamicin sulfate; or metronidazole and gentamicin sulfate were immersed in 5 ml of phosphate buffered saline in triplicate. Eluent was replaced at specified time intervals for 1 day (1, 3, 6, 12 and 24 hours), daily, or weekly for 21 days.Antibiotic concentrations were measured by High Performance Liquid Chromatography.Changes in antibiotic bioactivity attributable to polymerization or co-polymerization of the antibiotics with PMMA, ethylene oxide sterilization, and storage of antibioticimpregnated PMMA (AIPMMA) beads containing metronidazole were evaluated.Antibiotic elution patterns were similar for all groups. Day-1 elution for groups containing either metronidazole (3 concentrations) or gentamicin represented a mean 63% to 66% and 79% respectively of the 21-day total elution. Approximately 50% of the day-1 elution occurred during the first hour. The elution of metronidazole was dosedependent. There was no significant difference in the total amount of antibiotic eluted from groups that had the saline changed daily versus weekly. The elution of metronidazole (day 3-21) and gentamicin (all days) was significantly greater when metronidazole and gentamicin were combined (p<0.05). Polymerization of PMMA was delayed in groups containing metronidazole.Neither polymerization nor copolymerization of metronidazole and gentamicin with PMMA, gas-sterilization, or 2-month storage of beads containing metronidazole significantly affected antimicrobial bioactivity.Metronidazole elutes from PMMA. The frequency at which the saline was changed did not affect the rate of antibiotic elution.

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Osteomyelitis

Goodrich¹

2019

Equine Fracture Repair

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Regional Limb Perfusion with Antibiotics in Three Horses

Cited by 64 publications

References 9 publications

Clinical use of antimicrobial regional limb perfusion in horses: 174 cases (1999–2009)

Clinical use of antimicrobial regional limb perfusion in horses: 174 cases (1999–2009)

Elution of Metronidazole and Gentamicin from Polymethylmethacrylate Beads

Osteomyelitis

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