Page 1337 - Equine Clinical Medicine, Surgery and Reproduction, 2nd Edition

1312 CHAPTER 13

VetBooks.ir 13.22 13.23 Fig. 13.22 The use of a foot

cast for the treatment of a severe
heel bulb injury.

Fig. 13.23 This horse has
a wound on the dorsal aspect
of the carpus, which has been
surgically repaired. The limb is
bandaged post surgery in a full
limb Robert Jones bandage, with
splints fitted to the lateral and
dorsal aspects of the limb from
just distal to the elbow to just
above the fetlock.

13.24

Fig. 13.24 A bi-valved cast
or cast–bandage combination is
ideal to treat injuries that require
immobilisation and daily care. Note
that the limb is not allowed to bear
weight during wound therapy.

wound as required, but they must be placed carefully. inflammation at the top of the cast, hot spots or for
Application of a cast may be preferable for wounds lack of use by the horse, all of which may indicate a
where daily access is not required. A bi-valved cast pressure sore. If doubts exist pertaining to any com-
or bandage–cast combination permits the best of plications, the cast should be removed and the limb
both worlds, allowing regular access to a wound and evaluated. Pressure sores over areas such as the prox-
yet providing adequate immobilisation (Fig. 13.24). imal sesamoids or accessory carpal bones may poten-
This modality is extremely useful in cases of wounds tially lead to serious and expensive complications.
affecting synovial cavities, particularly tendon lac-
erations involving the digital flexor tendon sheath, Management of exuberant
where the foot can be maintained in a fixed position granulation tissue
between treatments and the wound can be accessed Exuberant granulation tissue or ‘proud flesh’ stops
daily for care. the process of wound contraction and epithelialisa-
The use of casts for the treatment of open tion and is the most common non-fatal complication
wounds, especially of the distal limb, will facilitate of second-intention wound healing of equine distal
wound healing and prevent the formation of exuber- extremity wounds. Exuberant granulation tissue
ant granulation tissue (Fig. 13.25). A cast requires occurs where conditions of motion and infection are
daily evaluation for cracks, excessive exudates, present, and results in an undesirable cosmetic and