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Discussion on Inferior check ligament surgery

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SKutyba
Member
Username: Skutyba

Post Number: 15
Registered: 10-2004
Posted on Sunday, Jun 4, 2006 - 10:51 pm:   Edit PostPrint Post

I have a 4 month old colt that had bilateral inferior check ligament surgery 10 days ago. The surgery was done to correct acquired club foot, started about 3 months of age. The surgery was done at the local veterinary university.
At 7 days post-op he was re-examined by my regular veterinarian because of local swelling at the surgical site on his right leg. The colt was sedated, and a seroma was drained. He was re-fitted with pressure and standing bandages.
I removed the bandages today, only to find that the seroma has returned. Not quite as large, but most definately there. It is only on one leg, the other leg appears fine (no swelling, heat, etc).
I will be calling my vet in the AM to have her return and re-examine him.
Since this is my first experience with this procedure, I am a bit unfamiliar with complications.
Is seroma formation seen frequently after check ligament surgery? Either way, is this something to have great concern with?
I have been following his discharge instructions specifically (stall confinement, handwalking only, pressure bandages, etc). Is there anything else that I am missing or that should be done to reduce the seroma reoccuring?
So far, he remains sound and appears to be feeling well. He had bute for several days along with gastroguard prophylactically.
Do seromas' increase the likelyhood of scar tissue forming or other complications?
Any information you could provide to educate me would be of assistance.
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Robert N. Oglesby DVM
Moderator
Username: Dro

Post Number: 15799
Registered: 1-1997
Posted on Monday, Jun 5, 2006 - 1:04 pm:   Edit PostPrint Post

It sounds like the pressure bandages are not being placed on with sufficient pressure over the check ligament area. Placing some thick cotton in the grooves just in front of the flexor tendons may prevent this. Probably not a big deal.
DrO
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SKutyba
Member
Username: Skutyba

Post Number: 16
Registered: 10-2004
Posted on Monday, Jun 5, 2006 - 6:15 pm:   Edit PostPrint Post

I don't think it's possible to get any more pressure on the area........the vets are using doubled 4x4's with Flexicon wrapped from knee to ankle, then cotton wraps follows by vetwrap. Even after being drained and wrapped very tight with a wad of the 4x4's on it, the seroma returned.

Our concern now is, do we just leave it alone and hope it resolves itself, or have the vet back out to drain again? We aren't getting much in the way of direction here...........we don't know whether to be concerned or not.

We will, of course, continue to bandage, but don't know if there is something more we could or should do.

The last thing we want is for this colt to be permanently damaged because we failed to act.
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SKutyba
Member
Username: Skutyba

Post Number: 17
Registered: 10-2004
Posted on Monday, Jun 5, 2006 - 7:39 pm:   Edit PostPrint Post

sorry, 4 x 4's, cotton gauze and elasticon from knee to fetlock. Support combine with vetwrap is 2nd layer.
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Robert N. Oglesby DVM
Moderator
Username: Dro

Post Number: 15808
Registered: 1-1997
Posted on Tuesday, Jun 6, 2006 - 9:02 am:   Edit PostPrint Post

I think if the seroma is remarkable it does have a small chance to "scar down" tissues as the serum clots or possibly become infected. I am not much of a fan of withdrawing serum with a needle as it is the result of local conditions so often will reoccur. If you cannot control it with pressure bandaging you could contemplate a drain.

If the seroma is small it will probably resolve as the tissues heal.
DrO
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Christine Holmes Bukowski
Member
Username: Canyon28

Post Number: 138
Registered: 8-2003
Posted on Tuesday, Jun 6, 2006 - 11:58 am:   Edit PostPrint Post

The horse is always going to have a small knot there were the ligament has retracted and bunched up after it was cut, even after the seroma is resolved. It will be at the site of the stitches. I have had two of these surgerys done on young horses and the horse still has the knot to this day. One is 6 years old and the other one is a two year old.
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SKutyba
Member
Username: Skutyba

Post Number: 18
Registered: 10-2004
Posted on Wednesday, Jun 7, 2006 - 1:25 am:   Edit PostPrint Post

'm not sure what qualifies as significant, but if this continues, I may take a picture and post it. Without a ruler (he's a little jumpy right now) I would guesstimate the size of the seroma to be a healthy two+ inch in length, 1 to 1 and 1/2 inchs wide and a good half inch or better high when you first remove the bandages. The other leg looks fine. Sutures are great, no problem at all. Just the one leg is a problem. It may be marginally smaller than a week ago, but I had hoped it would be gone by now. He isn't lame, which is good, but we are concerned about scar tissue. A small knot, we expected, but a huge bulge, no.
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Robert N. Oglesby DVM
Moderator
Username: Dro

Post Number: 15825
Registered: 1-1997
Posted on Wednesday, Jun 7, 2006 - 8:50 am:   Edit PostPrint Post

It is not so much the length and width as it is the height. At 1/2 inch I don't think I would put in a drain at this time but would have to look and palpate to be sure.
DrO
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