Bess' Knee Injury - 2011

The night of the injury/initial vet visit - August 18 (Thursday)

Click on any image for a larger one


Here's her left knee before the vets (Dr. Venner & Dr. De La Cruz from Loomis Basin Equine Center) did any work. All I had done was hose both injured knees with cool water.The bleeding had subsided substantially, but started up a bit just from walking her from the lawn to the driveway. We set up in front of the garage with the door open and John brought out a bright halogen work light. Although the injury happened around 8:15 pm, it was dark before the vets arrived.

This is after shaving the knee areas and through cleaning & debriding (cutting away useless tissue).
This caused the blood to flow again!
You can also see the scrape on her right knee. It wasn't very bad - there was one small hole with a teeny pocket.
All the vets did was scrub & clean this injury.


Another photo of the same stage as the above photo.

Dr. Venner sutures the flap. He sutured the outer edges, leaving the center part free.


He put a drain in through the deepest part of the flap.
Since it wasn't stitched closed, it would have been a basin for fluids to collect.


A better view of Dr. Venner's handiwork.



John & Bess. She's all bandaged & wrapped and already pretty much out of sedation at this point.
She's ready to party with those festive legs! If it heals as we expect, the less injured (purple) knee won't need the extensive wrap job for more than a few days. The other (pink) knee is a different story. There are daily bandage changes in my future for a few weeks!

______________________________________________

Day 2 - August 19 (Friday)
around 4 pm



I removed the wraps & bandages on the left leg. Sure, it looks gross, but it didn't look as bad as I expected.
There had been very little bleeding and the stitches & drain were intact. Minimal swelling.
A fair but not disturbing amount of oozing.


Dr. Venner's wrap job was better, but I think mine will do the trick.

______________________________________________

Day 3 - August 19 (Saturday)
around 5 pm



Bess' right knee - the one that was only scraped - looks good. It's an "every other day" bandage change.
On Monday, I shouldn't have to re-bandage. I'll just put antibitotic ointment on the wound with Swat fly repellent around that.


The bad knee. Sorry the photo is a bit blurry. My wrap job held, and the wound looks good, all things considered. No swelling, stitches/drain intact. A reasonable amount of drainage. I can remove the drain on Monday if the oozing has stopped or decreased significantly.

I won't post updates for a couple of days.
I don't expect her knee to look much different than this, except the drain will be gone.

______________________________________________

Day 5 - August 23 (Tuesday)
around 6 pm


Her right knee looks great.
No need to bandage it any more, I'm just keeping it covered with antibiotic ointment (FuraZone).


All things considered, her left knee looks pretty good too. The stitches have held and I removed the drain last night.
Now it's just a matter of time for the tissue to heal & fill in the gap. The stitches will stay in for about 2 more weeks.
Daily bandage changes are still required. I'll post another update in a few days.

______________________________________________

Day 10 - August 28 (Sunday evening)

Granulation tissue is filling in as it should, although it's starting to grow & push forward, beyond the level of where the skin needs to develop. That's what makes it "proud flesh". The areas that look like pink cauliflower are the proud flesh.

______________________________________________

Day 12 - August 30 (Tuesday evening)



Granulation tissue continues to fill in the gap and there's more proud flesh.
I picked up some Entederm (steroid) ointment at the clinic today; it will reduce the growth of the proud flesh to allow the epidermis (skin tissue) to grow over the granulation tissue as it should. Both photos were taken this evening. The upper one isn't blurry, but the color is off because I had to use the flash. The lower one is a bit blurry.

The good news is that I can switch to every other day bandage changes! Per the vet's instructions, I'll alternate the Entederm with the Thermazene (antibiotic ointment I've been using daily) for every other bandage change.
Bess continues to be a trooper and a good patient.

______________________________________________

September 1st
(I'm not even keeping track of days now . . .)

Healing continues . . .

______________________________________________

September 5th

Healing continues, proud flesh is growing more.

______________________________________________

September 11th

Sutures removed 2 days ago. The vet wants me to use only the Thermazene (antibiotic) and allow the proud flesh to grow so it can fill in the crease. I can change the bandage every third day now.
I've re-worked the bandage process so it's not the entire length of her leg. It's the same layers, but shorter so it covers her knee and a few inches above and below. With enough Elastikon, it's staying in place.

______________________________________________

September 17th

Looking pretty good!

______________________________________________

September 28th
About 6 weeks since the initial injury
and nearly 3 weeks since suture removal

The color is more "strawberry" than the actual wound, the lighting wasn't that great when I tool the photo. Plenty of proud flesh, but the crease is shallower. Waiting to find out from the vet if I continue with just the Thermazene or if I can start using the Entederm again to combat the proud flesh.

Her other knee is healed - it's only obvious because there's a patch of shorter hair over the wounded area.

______________________________________________

September 30th

After a one-day treatment with Entederm (steroid) to reduce the proud flesh.
The crease is really just a dent now, which is great.

Back to the Thermazene (antibiotic) for four days. The proud flesh is being allowed to grow because it's granulation tissue, the base tissue under the skin, and it needs to fill in all the gaps. When that has done its job, it'll be time to allow the skin to grow over. The skin can't grow over where the proud flesh protrudes beyond the skin level, so that's why the proud flesh has to be reduced at some point.

I took this photo at the same time, but used the flash.

______________________________________________

October 8th

The crease is gone and the wound continues to get smaller. I haven't used any more Entederm per the vet's instructions. Continuing to use the Thermazene (antibiotic)
______________________________________________

October 13th

Healing really nicely!

______________________________________________

October 21st

At this point I changed my wrap to something a little less complicated with fewer layers and less padding, since the wound was healing so well and I was mostly concerned with keeping it clean. I was changing the bandage every 4 days or so. I came up with what I called my mini-wrap. This wrap consisted of a large bandaid with strips of adhesive tape to hold it in place, then some cottony gauze wrap, some generic Kerlix (another type of gauze) and Elastikon top & bottom to hold that all in place. Then I put tubular stretchy netting over that and taped it top & bottom with Elastikon. This held up really well and I was able to extend the wrap change to once every 6 days or so. I continued to use the Thermazene on the wound.
Here's the mini-wrap:
______________________________________________

November 2nd

The wound is getting smaller . . .

______________________________________________

November 7th

. . . and smaller . . .

______________________________________________

November 21st

. . . and smaller . . .

______________________________________________

December 4th

. . . and finally a nice scab and I don't have to bandage it any more! Up until 3 days before this, I had still been using the Thermazene with every bandage change. I put Entederm (steroid) on it three days ago. It scabbed over nicely and now I'm just using a Furazone ointment on the wound.

The End!