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Discussion on Infection in Foot - is it healing properly

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amy Leonardi
Member
Username: besis111

Post Number: 9
Registered: 7-2009
Posted on Thursday, Jan 21, 2010 - 4:37 pm:   Edit PostPrint Post

Hi, Dr. O. I'm interested in getting your thoughts on the attached images. After several months of dealing with what we believed was an abcess, I had my horse x-rayed and discovered that there was an unresolved infection that had actually infected a small area of the cofin bone. He had surgery to remove the infection and the infected area around the bone. The surgery was performed on December 16th. I've attached a picture from December 27th and two images taken on January 17th. In your opinion, does it look like the foot is healing normally. Does the ridge along the left side look like it is undermined, or does it look like healthy cornification? Do you think this looks like it is healing as you'd expect? My horse is no longer lame. We've been keeping it wrapped with a betadine soaked gauze packing. My vet is coming out tomorrow, but would love to get your thoughts based on the pictures. Thanks!

Picture 12.17
Picture 1.17
picture 1.17 v2
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Robert N. Oglesby DVM
Moderator
Username: dro

Post Number: 24392
Registered: 1-1997
Posted on Thursday, Jan 21, 2010 - 5:56 pm:   Edit PostPrint Post

Hello amy,
It looks very good, clean, non purulent and the cornification you note looks healthy. I am a bit surprised it has not cornified all the way across however. Has the area that has not cornified been debrided since the original surgery? Or the debridement particularly deep in this area? It almost strikes me that sensitive corium, the tissue that forms the horn, was removed and having to reestablish itself by reepitheliation: growing in from the more medial aspects of the wound. In either case it is very likely to continue until the wound is completely cornified and then grows out to establish a normal sole.
DrO
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amy Leonardi
Member
Username: besis111

Post Number: 10
Registered: 7-2009
Posted on Thursday, Jan 21, 2010 - 6:28 pm:   Edit PostPrint Post

Thanks so much for your quick reply. No, there has been no debridement since surgery, except I have washed the whole area gently with a washcloth and soap and water. I believe the area that hasn't cornified was deeper to begin with (you can see what it looked like closer to the surgery in the top photo). How would I recognize if there are areas that are undermined? Other than continuing to pack with gauze, is there anything else I should be doing or should be watching for? Thanks again. I appreciate the reassurance that all is progressing normally, albeit slowly!

Amy
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Robert N. Oglesby DVM
Moderator
Username: dro

Post Number: 24395
Registered: 1-1997
Posted on Friday, Jan 22, 2010 - 12:52 pm:   Edit PostPrint Post

When areas are undermined they tend to collect bacteria and become inflammed and painful. It sounds like you are doing fine.
DrO
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amy Leonardi
Member
Username: besis111

Post Number: 11
Registered: 7-2009
Posted on Friday, Jan 22, 2010 - 3:37 pm:   Edit PostPrint Post

Thanks for your help!

Amy
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