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  Discussion on Wound reopening/should I do something?
Author Message
Member:
Pkb540

Posted on Wednesday, Aug 3, 2005 - 1:41 pm:

Hello Doctor,
I wrote you a while back asking about a possible sequestrum and you told me that it could take time. Almost two months ago, my horse had a kick above his knee on the inside of his leg. There was a puncture there. Radiographs indicated that there was some bone reaction, but no fragments appeared at that time. After antibiotics and the standard treatment, the wound seemed healed: the bump went down, the hair was growing back. About a week ago, I noticed that the wound was opening up again. The vet was here for other purposes, but she said that I should leave it alone and let whatever work itself out.

The bump is bigger now, and sort of mushy. I talked to the vet and she said to wait. She said that antibiotics wouldn't reach the area because it is "walled off." She did say that if I wanted, she could ultrasound it. She clearly felt that the best thing to do was just wait and that even if there is a sequestrum requiring surgery, the longer I let it work itself, the less extensive the surgery.

I am wondering if I should just get the ultrasound now. I am also not sure what I should be doing, if anything. I asked her if I should keep hosing it, and she said if I thought it was helping, go ahead.

Please let me know what you think I should do. Thank you.
Moderator:
DrO

Posted on Thursday, Aug 4, 2005 - 9:37 am:

If it has not opened yet hosing might not help but preparing for the day it does and to speed it up keep it clean and perhaps a light coat of CLEAN vaseline will speed up the maturation. Once open treat it like recommended in our article on long term wound care. In the meantime I would have the wound radiographed, it will show up a sequestrum much better than ultrasound and not all sequestrums will abscess out as some are adhered to the bone. If the radiograph is negative you can either ultrasound for other foreign body or wait to see what comes out when it opens.
DrO
Member:
Pkb540

Posted on Thursday, Aug 4, 2005 - 1:33 pm:

Thanks for your response. I hosed it because it was opening up. The wound had pretty much healed over three or four weeks ago, and there was just a thin line. Then in the past two weeks, it started opening and the wound, hairless area expanded and the bump got bigger. I was sure it was progressing to drain, but this morning it looks like it is drying up, not as large a bump, and closing up again. I had been putting sulfa on it
Thanks again. It is very comforting to have some advice from a competent source. Maybe I will get radiographs, because this is driving me crazy, even though the horse doesn't seem fazed at all.
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