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Equine field surgery: Distal limb (Proceedings)

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Aug 01, 2010

Advantages of Field Surgery

     • low overhead
     • relative mobility
     • potentially lower costs for the owner
     • usually excellent footing for recovering the horse from anesthesia
     • warm, fuzzy feeling when all goes well

     Disadvantages
     • often less than desirable conditions and assistants
     • inevitable complications can be difficult to manage
     • a clean field is difficult to maintain
     • administration of safe and reliable anesthesia may not always be achieved
     • a seemingly unlimited opportunity for failure

What are we talking about?

     • Procedures that can be done in < 1 hour
     • Procedures that do not enter the abdomen or joint
     • Procedures that do not require "Special" equipment.
     • Ideally, you need at least one trained assistant to adequately perform most of these selected distal limb, head, and neck surgeries.
     • veterinary school training likely did not provide enough experience to perform all of these procedures
     • review the anatomy
     • study the procedure including potential complications and pitfalls
     • practice the procedures on cadaver specimens prior to performing the procedure on a client animal
     • learn how to effectively use the anesthetic protocols required for the specific procedures.

Field Anesthesia

     • Equine field surgery requires portable anesthesia
     • Elective procedures
     • Generally healthy
     • Requires knowledge of drugs used
     • Supportive care
     • Epidural procedures

Typical instrument pack

     • needle driver
     • several mosquito and Kelly forceps
     • thumb forceps
     • tissue forceps
     • suture scissors
     • tissue scissors
     • several towel clamps
     • scalpel handles & blades
     • gauze sponges
     • disposable drapes

Specific Field Surgeries

Distal limb surgeries
     • Periosteal stripping
     • Transphyseal bridging
     • Annular ligament desmotomy
     • Lateral Digital Extensor Tenectomy
     • Medial Patellar Ligament Desmotomy
     • Distal check ligament desmotomy
     • Proximal check ligament desmotomy
     • Distal splint bone resection
     • Deep digital flexor tenotomy
     • Semitendinosus Tenotomy and Myotomy
     • Palmar digital neurectomy