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  Discussion on Wound won't granulate
Author Message
New Member:
Gsgrim

Posted on Monday, Oct 30, 2006 - 4:59 pm:

My 6 year old thoroughbred gelding had surgery 5 weeks ago to relieve a severe hematoma in his stifle. Before the surgery he had what looked like a water balloon the size of a small watermelon hanging off of his left hind thigh. The cause of the injury is unknown, but radiographs and high powered ultrasounds have shown that his joint is not structurally damaged in any way.

The surgeons drained the pocket of fluid and placed two quarter-sized holes in the interior part of his stifle to allow for drainage. One of the holes has almost completely healed. The other started to heal but quickly plateaued and continues to drain. The skin is failing to granulate.

It has been 5 weeks and the docs are running out of ideas. The primary problem is the location of the injury. It is in an area that endures a lot of movement and is impossible to properly wrap, providing needed pressure so that the skin can re-adhere. They have been palpating the open pocket every couple of days to try and stimulate granulation, but to no real avail. Now they are proposing scarlet oil to spur cell regeneration.

Wednesday will begin his sixth week in the hospital stall and the fourth month of stall rest since the initial injury in early August. Does anyone have any ideas or advice to share?
Member:
Mrose

Posted on Monday, Oct 30, 2006 - 6:01 pm:

No advice really, but was just going to tell you that when one of our stallions was injured his injury drained for a very long time and seemed to take forever to close. The vet gave me antibiotics that I flushed into the wound to keep the hole open and clean. He eventually healed up fine and has only a very small scar.

Boy! reading all the posts with injuries today makes you wonder why we all have horses! Maybe we should be growing earthworms or something instead.
Member:
Dres

Posted on Monday, Oct 30, 2006 - 6:32 pm:

Sara, I have often said ,, earthworms are key, you can slice and dice em and they can multiply still. !

Gretchen, I have had to help heal out a lot of deep injuries.. and sometimes the location is a factor on how fast they heal..

On the first day God created horses, on the second day he painted them with spots..
Moderator:
DrO

Posted on Monday, Oct 30, 2006 - 7:40 pm:

Welcome to posting Gretchen,
Other than the palpations, what have you been doing to clean the wound and what have your been using to treat the wound?
DrO
New Member:
Gsgrim

Posted on Tuesday, Oct 31, 2006 - 1:47 pm:

Thanks, Dr. O. Every day for the last five weeks, the wound has been hosed for about 10 minutes, cleaned with a surgical scrub and wrapped with a loose fitting cotton sleeve that fits his stifle like a stretched out tube sock (to keep shavings out and flies away). Every couple of days it gets irrigated with a betadine wash. He has been on SMZ for 5 weeks. No sign yet of any infection.

There has been no other treatment per say.
Moderator:
DrO

Posted on Wednesday, Nov 1, 2006 - 6:23 am:

Assuming it gets the blessings of your vet I suggest to promote granulation I would hose for just a minute, discontinue the daily surgical scrub, and treat with nitrofurazone ointment or neosporin ointment (see the article on wound care as to why). You may be removing the early granulation tissue with such an aggressive treatment plan.
DrO
New Member:
Gsgrim

Posted on Friday, Dec 1, 2006 - 10:08 am:

An update on Timber Cowboy, my 6 year old thoroughbred with a perpetual hematoma on the inside of his stifle. He likely cast himself in his stall and tore a bunch of vessels on the inside of his leg on August 7th. He had surgery to drain a watermelon sized hematoma on September 29th. He was released from the hospital yesterday after 8 weeks. FINALLY the wound has begun to granulate, the fluid is slowing down, and his leg is beginning to heal. Having tried just about everything to get his stifle to granulate and heal (surgically installing drains, treatment with scarlet oil, atropine, etc,), the treatment that finally worked (and this is a gross simplification) was drawing 250cc's of Cowboy's blood, distilling that into three 10cc injections of platelets, and injecting those back into his stifle every three days . His improvement over the last 10 days has been excellent. He will likely have one more injection (they froze another round of platelets just in case) next Friday as an out patient.
So thank you all for your help and ideas and to the wonderful and wise surgical staff at Tufts Large Animal Hospital.
And keep this platelet treatment in mind if you ever have a similar situation.
Peace.
Member:
Paul303

Posted on Monday, Dec 4, 2006 - 2:47 am:

Wow, wow, wow, Gretchen. Incredible! My niece is an equine vet in Mass. She went to Tufts. I've seen their set - up...it's really something. Continued good luck with Timber Cowboy.

Many thanks for the update.
Member:
Mrose

Posted on Monday, Dec 4, 2006 - 10:15 am:

So glad Cowboy is finally healing! I'm going to file away the treatment to have on hand in case we have a similar problem here. It sounds like something any vet could do that has a centrifuge, and the way horses are...you never know.
New Member:
kippie

Posted on Monday, Jul 28, 2008 - 10:47 pm:

Gretchen, your post from 2006 with the information about the platelet injections for the perpetual hematoma may be the answer to my prayers. My horse had a hematoma the size of a goose egg on his side 8 weeks ago. The first vet came out and opened it and drained out the blood clots and told me to flush it with water and apply panalog. I did this, but when after 8 weeks there was mot much change I called him (he couldn't find time to come and check my horse) and he told me that I might have created a permanent wound, but didn't show any interest in coming to see my horse. The current vet had me pack the wound with scarlet oil and betadine soaked gauze after she abraded the inside of the pocket and the edges. She was back out today and is pleased with the fact that the surfaces look more likely to heal, but we are waiting to see what happens. I am very eager to share your information with her. She was very puzzled concerning the next step if the anticipated healing did not occur, but had some ideas of where to search for more information. Your sharing of this valuable information may make a huge difference to my horse and to others as well. I hope that Cowboy is doing well with no further problems. What a great site this is!
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