The use of vacuum-assisted wound closure to enhance skin graft acceptance in a horse

A 16-year-old horse was admitted to the clinic of the Department of Surgery and Anesthesiology of Domestic Animals of the Faculty of Veterinary Medicine (Ghent University) for the treatment of a very large, non-healing wound extending over the dorsomedial and dorsolateral aspects of the left metatarsus. Surgical debridement of exuberant granulation tissue and new bone was performed under general anesthesia, followed by standard wound care under a bandage. Once a new bed of healthy granulation had formed, skin grafting was performed using the punch graft method. Due to the presence of a significant amount of wound exudate, cast immobilization was considered to be contraindicated. Instead, vacuum-assisted closure (VAC) therapy was used as a method of securing the skin grafts to the wound bed during the first days post-operatively. After five days of VAC therapy, the wound dressing was removed and an acceptance of nearly 100% of the punch grafts was observed. Complete epithelialization of the wound was evident 42 days after skin grafting. As far as the authors know, this is the first report describing the use of VAC therapy as a method of wound management in combination with punch grafting on the distal limb of a horse

Treatment of acquired flexural deformity of the distal interphalangeal joint in the horse: a retrospective study of 51 cases

Flexural deformity of the distal interphalangeal joint is an important disorder in horses, which can be acquired during the first year of life, often as a result of lateralization during grazing. In this retrospective study, the medical files of 51 cases presented at the Faculty of Veterinary Medicine of Ghent University (1999-2013) were analyzed, followed by a telephone questionnaire. In 65% of the conservatively treated patients, the hoof conformation corrected completely, which was not significantly different from what was seen in the surgically treated group (complete correction in 56% of cases). Foals treated conservatively before the age of six months and foals treated surgically before twelve months of age, had a significantly better chance of a successful correction than older foals. Moreover, cases in which treatment did not restore the hoof conformation completely, presented a significantly higher chance of (persisting) lameness and were significantly less likely to have an athletic career. Finally, this study proved a significant association between the hoof conformation of the dam and her foals

Osteochondral fragments in the metacarpo- and metatarsophalangeal joint and their clinical importance

The radiographic evaluation of the fetlock joint as part of a lameness or prepurchase examination often reveals osteochondral fragmentation. These fragments can either be causing lameness or have no clinical importance at the time of examination. However, they can cause lameness at a later stage. An appropriate analysis of the situation requires a correct assessment of the fragment type and an up-to-date knowledge of their possible clinical importance. In this overview, the most common types of fetlock fragments, such as dorsoproximal first phalanx (PI) and proximal synovial pad fragments, as well as fragmentation on the proximal palmar/plantar border of PI and of the sesamoid bones are discussed. A few cases of uncommon large fragmentation on the abaxial borders of P1 are included. Fetlock fractures, obviously causing lameness, such as dorsofrontal fractures of the proximal phalanx, distal metacarpal/metatarsal and sesamoid bone fractures, are not dealt with in this review

A retrospective study on 195 horses with contaminated and infected synovial cavities

This study analyzes the clinical aspects of contaminated and infected synovial cavities in horses and evaluates their prognosis after treatment. The medical records of 195 affected horses referred between June 1999 and July 2004 were reviewed. Twenty-six horses were euthanized or returned home without further treatment. Therapeutic strategies for the remaining 169 horses were not different from those reported in other recent studies, except that lavage was performed predominantly without endoscopic visualization. Follow-up was obtained by questionnaire for 150 of 169 treated horses. The outcome was considered successful (survival without residual lameness) in 109 of 150 horses (72.7%). Iatrogenic synovial infection, the presence of radiographic signs on admission and the use of regional antibiotic perfusion were significantly related with non-successful outcome. Overall, the outcome in the present study appeared to be slightly less favorable compared to other recent reports, although it certainly improved for horses with deep nail puncture wounds