Treatment using the ACell Vet Bioscaffold for a Full Thickness Circumferential Laceration at the Upper Pastern of a Quarterhorse.
Submitted by: Robert L. Miller, Jr., VMD Middleburg Veterinary Service, 37 US Highway 522N, Middleburg, PA 17842
Nota Bene: Treatment with the ACell Vet product did not begin in this case until one month after the wound was inflicted. As a new product on the market, the ACell Vet material was unknown to Dr. Miller at the time of the injury. ACell recommends treatment with the ACell Vet bioscaffold as soon as possible so the process of site specific constructive remodeling can be initiated as quickly as possible and the chance of infection reduced. This case represents a direct transcription of Dr. Miller's presentation to ACell, and has been used with his permission.
Synopsis:
"Stroker", a six year old Quarterhorse gelding, presented to Middleburg Veterinary Service on 9/20/2002 after incurring a 360 degree laceration around the upper pastern of his left hind limb the previous day. The laceration exposed the bone around the entire anterior aspect of the limb, completely severing the extensor tendon.
 Photo #1 |
Integrity of neurovascular and tendinous structures on the posterior aspect was questionable, but Stroker was ambulatory without "dropping" at the pastern. |
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The wound was debrided, sutured and placed in a cast. A series of casts were maintained on the limb for 17 days. Antibiotics including ceftiofur and trimethoprim/sulfa were initiated. Treatment with antibiotic and phenylbutazone continued over 30 days. |
 Photo #2 |
After 28 days, a good granulation bed is evident (see photos 3 & 4). Exuberant granulation tissue was excised at 25 days (this "cut back" of proud flesh was repeated at 30 and 42 days). |
 Photo #3 |
Three sheets of the ACell Vet material were used in the period from 10/24/02 through 11/2/02. At 59 days the granulation tissue is level with the skin surface and the wound is contracting nicely. |
 Photo #4 |
After 89 days, with all routine wound care discontinued about one week earlier, the wound shows evidence of further contraction, scurf formation, and minimal scarring. |
