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This Concept Map, created with IHMC CmapTools, has information related to: Case 2 Septic Arthritis, Intra -Operative COnsideration What to do Surgical procedure, Post Operative Considerations Prognosis Prognosis 1.Good: low incidence of complications if the appropriate candidate is selected for surgery and all infectious tissue is adequately removed or managed correctly. 2. Lameness should improve within hours of surgery. 3. The animal should be using the limb normally within 3 weeks of the surgery. 4. Animals rarely remain in the herd from more than 1.5 to 2 years., Post Operative Considerations Risk Possible compliations, Septic arthritis Involves Intra -Operative COnsideration, Advantages Include Disadvantages, Digital Amputation Has Advantages, Make an incision in the interdigital space Extend distally to the level of the distal aspect of the proximal phalanx Extend the incision over the dorsal aspect of the affected digit abaxially at an angle of approximately 30 ˚. Continue the incison around the abaxial aspect of the digit, approximately 0.5cm above the coronary band and cutting down to the bone. Step 2 Obstetrical wire is inserted into the interdigital incision. Sawing using the obstetrical wire should be done at an oblique angle (ideally 30˚) Enusre all bone and cartilage is removed. Possible synovia production can interfere with wound healing if left behind. An alternative approach it to incise through the joint (disarticulation of the joint) using the scalpel blade and then removing the distal portion of phalanx 2 using obstetrical wire. (mouse over), Surgical procedure Chosen Digital Amputation, Obstetrical wire is inserted into the interdigital incision. Sawing using the obstetrical wire should be done at an oblique angle (ideally 30˚) Enusre all bone and cartilage is removed. Possible synovia production can interfere with wound healing if left behind. An alternative approach it to incise through the joint (disarticulation of the joint) using the scalpel blade and then removing the distal portion of phalanx 2 using obstetrical wire. (mouse over) Step 3 Using this technique the wound is not surgically closed and heals by secondary intention. If skin flaps were created, however they would be reflected over the surgical wound and closed using simple interrupted sutures. Non-adhesive dressing covered with antibiotic ointment should be applied to the amputated stump . A thick gauze pad or another suitable absorbent material along with a pressure bandage to keep everything together should be placed over the stump., Possible compliations May include 1.Excessive hemorrhage due to poor surgical technique 2.Persistent lameness if sugery was not successful or iff all infected tissue was not removed 3. Ascending infection., Post Operative Considerations Observation ឈh, Post Operative Considerations Observation ᡐh, Anti-septic Techniques and Consideration Involves 1.Clip hair with 2.Wash hair off with saline. 3.Scrub area with 3.75% povidone iodine surgical scrub OR chlorhexidine, followed by 70% methylated spirits. This is repeated three times then finally again with 3.75% povidone iodine surgical scrub. The healthy claw is placed on a block to elevate the surgical wound off the ground., Pre-Operative Considerations (mouse over) consider History, Post Operative Considerations Risk Reason for failure, Pre-Operative Considerations (mouse over) Handling Restraints (mouse over), Septic arthritis Involves Pre-Operative Considerations (mouse over), Digital Amputation Has Disadvantages, Septic arthritis Involves Anatomy (See main map), Possible complications may include 1.Excessive hemorrhage due to poor surgical technique 2. Ascending Infection 3. Continued lameness