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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.

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

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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.

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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.

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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.

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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.

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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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