Page 60 - Manual of Equine Field Surgery

56 LIMB SURGERIES

reports, 125 to 1000 mg of amikacin or gentam-

icin per perfusion has been used. 3-6 For other

antibiotics, the systemic dose or less is used.

Exsanguination

Exsanguination of blood from the distal limb

is recommended before perfusion of the tissues.

Placement of the intravenous catheter is easier

before exsanguination. Placement of the bone

screw can be done easily before or after ex-

sanguination. For exsanguination, an Esmarch

bandage is applied to the limb from the hoof to
Figure 8-1 A horse with a chronic distal limb infec- the distal cannon bone and secured tightly at the

tion.
proximal end to prevent loss of the perfusate into

the systemic circulation. A pneumatic tourniquet

can also be applied at the proximal end of the

Esmarch bandage to prevent loss of the perfusate.

After applying the tourniquet or securing the

Esmarch bandage at the proximal end, the distal

portion of the bandage is unwrapped (Figure

8-4). In cases with extensive cellulitis, application

of an Esmarch bandage is not recommended

because of the risk of forcing bacteria from the

\

Figure 8-2 Cannulated 4-inm screw with a nut and

adapter welded to the head,

I

B

•

'
•

A

Figure 8-4 A, A pneumatic tourniquet is applied at

Figure 8-3 Contrast distribution 5 minutes after the proximal end of the Esmarch bandage to prevent

injection into the palmar digital vein in the distal loss of the perfusate. B, The distal portion of the

pastern region. bandage is then unwrapped,