Page 62 - Manual of Equine Field Surgery
P. 62
58 LIMB SURGERIES
J
J O
J
'/ I
Ii, (
.J .......,,......
Drill bit
Can nu lated
screw
Tap r§I. e.: t4u...-
Figure 8-6 A stab incision is made in the proximal portion of the pastern midway between the lateral and dorsal
aspect. An appropriately sized drill bit is used to create a pilot hole for the cannulated screw.
COMPLICATIONS
Severe tissue irritation from the antibiotic perfu-
sion may occur but is rare. Partial thrombosis of
the vein used for perfusion may occur, especially
if used repeatedly. Complete thrombosis is un-
common.
ALTERNATIVE PROCEDURES
Regional perfusion can be performed in many
areas of the limb and has been described in the
tarsus, radius, and carpus.v" Intraosseous perfu-
sion can also be performed with a 14-gauge needle
placed through a 2-mm drill hole or the male end
of a Luer tip extension set placed through a 4-mm
Figure 8-7 Intraosseous screw placement for perfu- hole, but slight inaccuracies in fit can result in
sion of the pastern and coffin joint region. leakage of the perfusion solution.11
sepsis and does not replace systemic antibiotic
therapy, appropriate debridement, lavage, and COMMENTS
drainage. Because regional antibiotic perfusion
can achieve high tissue levels of antibiotics in In some studies, intravenous perfusion techniques
affected sites, it can improve the outcome. In one have resulted in higher tissue levels of antibiotics
study, the overall survival rate was 860/o when than intraosseous techniques.v" Both methods
distal limb perfusion was used in conjunction produce much higher tissue levels than the
recommended peak serum concentrations. Intra-
with aggressive systemic and local therapy.8
