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Case Study - Regional Limb Perfusion

One of the most traumatic and serious injury a horse can suffer from is a wound that involves a joint structure or tendon sheath.

Commonly, these wounds are on the lower limbs and occur from fencing or foreign material in paddocks like barbed wire.

These types of wounds are treated as an emergency and should be assessed by a veterinarian as soon as possible. The wound is contaminated from the time they occur, and infection is a very serious complication that needs to be treated with aggressive antimicrobial therapy.

The horse is usually in a lot of pain and reluctant to bear weight on the affected limb. Sedation and pain relief are often needed to explore the extent of the wounds.

In this case Dr Mitchell Brown treated a horse for a penetrating wound into the near hind hock. The horse was sedated to assess the wound which communicated with a synovial structure known as the “calcaneal bursa”. This was determined by using a sterile probe which was placed into the wound, entering the bursa. This confirmed that the bursa was involved and likely infected. The horse required a drain  to assist in flushing the wound.

A series of “Regional Limb Perfusions” were performed which are required to aggressively treat the associated bacterial infection. A regional limb perfusion is where a high concentration of antibiotics are injected into the limb and a tourniquet is applied to keep the antibiotics in a specific area (lower limb) to allow therapeutic concentrations to be reached.

A large bandage was then placed over the wound to protect the horse from further injury and keep the wound as clean as possible. 7 days after injury the horse was walking well and minimal discharge was seen coming from the bursa. The drain was then removed and the wound was cleaned and re-bandaged.

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