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Discussion on Wound not healing?
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New Member:
Lottie
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Posted on Tuesday, Jan 6, 2004 - 7:41 pm:
Hi DrO,
Wasn't sure where to post this, I hope here is OK. I wondered if you could advise me about an old injury on my yearling? About 12 months ago she rolled too close to a gate and lacerated one back leg from hock to fetlock down to the cannon bone, stripping the periosteum. She was at the vet hospital for 3 weeks having the area debrided and cleaned etc and was sent home with a good prognosis.
Two of the three areas of missing tissue have healed well. The third area was the biggest, about 10cm long and 1-1 1/2cm wide. Part of this is still not scarred over. It keeps scabbing in a small area in the centre (about 1cm x 2cm) If you remove the scab there is red granulation tissue underneath with or without small amounts of yellowish pus. She has had a couple of courses of antibiotics which clear the pus but the scab has still not become a scar.
The cannon bone from the fetlock to halfway up its length is thickened from the injury. I was hoping this would remodel but it seems to be as bad as it was several months ago. What is concerning me is why the final area is still not healed after 12 months? I'm especially worried about osteomyelitis but I would have thought this would be more dramatic than a non-healing scab? The yearling is sound and healthy otherwise and there is no heat or swelling in the leg.
Do you have any ideas why this area won't heal?
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Moderator:
DrO
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Posted on Wednesday, Jan 7, 2004 - 6:33 am:
Hello DrM,
The scab which is dried serum is not the origin of a scar, the granulation tissue is. As it matures the matrix of cappilaries becomes connective tissue. Though this is a long time, this will occur with time assuming there are no foreign bodies, underlying dead tissue, ongoing inflammation. These need to be carefully checked for and this may involve careful examination, culture, ultrasound, and/or radiography.
Once complications are ruled out or successfully addresed, rather than looking at this as a bad thing realize that as long as there is healthy underlying granulation tissue you still have the opportunity to get this area covered with skin rather than a scar. For more on this and our recommended therapy see, Equine Diseases » Skin Diseases » Long Term Deep Wound Care.
DrO
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