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Distal limb cast sores in horses: risk factors and early detection using thermography

Tamara Levet UGent, Ann Martens UGent, L Devisscher, Luc Duchateau UGent, Lies Bogaert UGent and Lieven Vlaminck UGent (2009) EQUINE VETERINARY JOURNAL. 41(1). p.18-23
abstract
Reasons for performing stud-v: There is a lack of evidence-based data on the prevalence, outcome and risk factors of distal limb cast sores, and no objective tool has been described for the early detection of cast sores. Objectives: To investigate the prevalence, location, outcome and risk factors of cast sores after application of a distal limb cast and to determine whether static thermography of the cast is a valuable tool for the assessment of sores. Methods: A prospective study was conducted on horses treated with a distal limb cast. At each cast removal, cast sores were graded as superficial sores (SS), deep dermal sores (DS) or full thickness skin ulcerations (FS). In several cases, a thermographic evaluation of the cast was performed immediately prior to removal and differences in temperature (Delta T) between the coolest point of the cast and 2 cast regions predisposed for sore development (dorsoproximal mc/mtIII and palmar/plantar fetlock) were calculated. Results: Mean +/- s.d. total casting time of 70 horses was 31 +/- 18 days. Overall, 57 legs (81%) developed at least SS. Twenty-four legs (34%) ultimately developed DS and one horse had an FS. Multivariable analysis showed that the severity of sores was positively associated with increasing age (OR: 1.111, P = 0.028), a normal (vs. swollen) limb (OR: 3.387, P = 0.023) and an increase in total casting time (OR per week: 1.363, P = 0.002). The thermographic evaluation (35 casts) revealed that the severity of sores was positively associated with increasing Delta T (OR: 2.100, P = 0.000-5). The optimal cut-off values for the presence of SS and DS were set at, respectively, Delta T = 2.3 and 4.3 degrees C. Conclusion and potential relevance: Distal limb cast is a safe coaptation technique with increasing risk of developing sores with time. Thermography is a valuable and rapid clinical tool to monitor the development of cast sores.
Please use this url to cite or link to this publication:
author
organization
year
type
journalArticle (original)
publication status
published
subject
keyword
IN-VITRO, BONE, IMMOBILIZATION, INTERPHALANGEAL JOINT ARTHRODESIS, thermographic detection, risk factors, cast sores, distal limb, horse
journal title
EQUINE VETERINARY JOURNAL
Equine Vet. J.
volume
41
issue
1
pages
18 - 23
Web of Science type
Article
Web of Science id
000262463500004
JCR category
VETERINARY SCIENCES
JCR impact factor
1.837 (2009)
JCR rank
18/141 (2009)
JCR quartile
1 (2009)
ISSN
0425-1644
DOI
10.2746/042516408X343046
language
English
UGent publication?
yes
classification
A1
copyright statement
I have transferred the copyright for this publication to the publisher
id
671415
handle
http://hdl.handle.net/1854/LU-671415
date created
2009-05-29 10:01:57
date last changed
2009-06-23 14:32:31
@article{671415,
  abstract     = {Reasons for performing stud-v: There is a lack of evidence-based data on the prevalence, outcome and risk factors of distal limb cast sores, and no objective tool has been described for the early detection of cast sores.
Objectives: To investigate the prevalence, location, outcome and risk factors of cast sores after application of a distal limb cast and to determine whether static thermography of the cast is a valuable tool for the assessment of sores.
Methods: A prospective study was conducted on horses treated with a distal limb cast. At each cast removal, cast sores were graded as superficial sores (SS), deep dermal sores (DS) or full thickness skin ulcerations (FS). In several cases, a thermographic evaluation of the cast was performed immediately prior to removal and differences in temperature (Delta T) between the coolest point of the cast and 2 cast regions predisposed for sore development (dorsoproximal mc/mtIII and palmar/plantar fetlock) were calculated.
Results: Mean +/- s.d. total casting time of 70 horses was 31 +/- 18 days. Overall, 57 legs (81\%) developed at least SS. Twenty-four legs (34\%) ultimately developed DS and one horse had an FS. Multivariable analysis showed that the severity of sores was positively associated with increasing age (OR: 1.111, P = 0.028), a normal (vs. swollen) limb (OR: 3.387, P = 0.023) and an increase in total casting time (OR per week: 1.363, P = 0.002). The thermographic evaluation (35 casts) revealed that the severity of sores was positively associated with increasing Delta T (OR: 2.100, P = 0.000-5). The optimal cut-off values for the presence of SS and DS were set at, respectively, Delta T = 2.3 and 4.3 degrees C.
Conclusion and potential relevance: Distal limb cast is a safe coaptation technique with increasing risk of developing sores with time. Thermography is a valuable and rapid clinical tool to monitor the development of cast sores.},
  author       = {Levet, Tamara and Martens, Ann and Devisscher, L and Duchateau, Luc and Bogaert, Lies and Vlaminck, Lieven},
  issn         = {0425-1644},
  journal      = {EQUINE VETERINARY JOURNAL},
  keyword      = {IN-VITRO,BONE,IMMOBILIZATION,INTERPHALANGEAL JOINT ARTHRODESIS,thermographic detection,risk factors,cast sores,distal limb,horse},
  language     = {eng},
  number       = {1},
  pages        = {18--23},
  title        = {Distal limb cast sores in horses: risk factors and early detection using thermography},
  url          = {http://dx.doi.org/10.2746/042516408X343046},
  volume       = {41},
  year         = {2009},
}

Chicago
Levet, Tamara, Ann Martens, L Devisscher, Luc Duchateau, Lies Bogaert, and Lieven Vlaminck. 2009. “Distal Limb Cast Sores in Horses: Risk Factors and Early Detection Using Thermography.” Equine Veterinary Journal 41 (1): 18–23.
APA
Levet, T., Martens, A., Devisscher, L., Duchateau, L., Bogaert, L., & Vlaminck, L. (2009). Distal limb cast sores in horses: risk factors and early detection using thermography. EQUINE VETERINARY JOURNAL, 41(1), 18–23.
Vancouver
1.
Levet T, Martens A, Devisscher L, Duchateau L, Bogaert L, Vlaminck L. Distal limb cast sores in horses: risk factors and early detection using thermography. EQUINE VETERINARY JOURNAL. 2009;41(1):18–23.
MLA
Levet, Tamara, Ann Martens, L Devisscher, et al. “Distal Limb Cast Sores in Horses: Risk Factors and Early Detection Using Thermography.” EQUINE VETERINARY JOURNAL 41.1 (2009): 18–23. Print.