Treatment of chronic septic osteoarthritis of the antebrachiocarpal joint with a synovial‐cutaneous fistula utilising arthroscopic lavage combined with ultrasonic assisted wound therapy and vacuum assisted closure with a novel wound lavage system

Abstract

SummaryThis case report describes the successful management of a chronic multidrug resistant infection of the antebrachiocarpal joint with a synovial‐cutaneous fistula 7 weeks after initial trauma in a 14‐year‐old Icelandic stallion. Resolution of the multiresistant Enterobacter cloacae (extended‐spectrum β‐lactamase) infection from the joint and complete closure of the fistula was achieved by arthroscopic lavage under general anaesthesia repeated on 3 occasions, surgical debridement, ultrasound assisted wound therapy and vacuum assisted closure. Lavage of the wound with the vacuum assisted closure in place was facilitated via the novel VeraFlo instillation system consisting of specially designed therapeutic regulated accurate care pad tubing. The combination of these therapies resulted in resolution of the septic arthritis and fistula. Six weeks after admission the horse was discharged from the hospital with a completely healed wound and was not lame at a walk.