Tourniquet injury of the foot

On Thursday, August 15, 2019, a mix breed, one-year-old female puppy was found by hikers in the woods near Lexington, Kentucky. She was discovered with a retractable leash that created tourniquet type injury that cut off circulation to her hind foot. The hikers transported the puppy that evening to the Jessamine County Animal Care and Control Shelter (JCACCS) in Nicholasville, Kentucky.

On the morning of Friday, August 16, the puppy was taken to the Animal Hospital of Nicholasville (AHON) to receive initial emergency care, and was renamed “Honey”, by the AHON Team. Dr. Stacey Burdick, DVM, and Dr. Dan Bowling, DVM, are the owners of AHON and were Honey’s attending veterinarians.  Because of Honey’s injuries, stewardship was transferred from JCACCS to Friends of the Animals of Jessamine County, Inc. (FOAOJC), a nonprofit organization that is solely run by volunteers with AHON providing Honey’s housing and medical care until an adoptive home could be found.

Dr. Burdick reached out to Kentucky Equine Sports Medicine and Rehabilitation Center (KESMARC), to use their hyperbaric chamber for Hyperbaric Oxygen Therapy (HBOT) on August 20^th.  Honey had 5 HBOT sessions every other day.  While visiting with Kirsten Johnson and KESMARC veterinarians about the injury, it was suggested that PEAK Biologics, a distributor for AniCell regenerative amnion products be contacted to use the CanisCell StemWrap product line on Honey’s wound.

Initial Presentation of the Wound on Saturday, August 24th, 2019.

Honey is sedated for initial wound evaluation and wound preparation for the application of CanisCell StemWrap product to right forelimb 13 days after injury.

Product Preparation

CanisCell StemWrap D is rehydrated with Sterile Saline and then drawn up into a syringe for application.

Implantation of Product

StemWrap D is implanted into the healthy skin margins of the wound and in the toes to promote neo vascularity of the tissue and preserve the toes.

Placement of Biobandage

The Amnion StemWrap 5x5cm is cut to fit the wound and placed to cover the entire defect.  This amnion covers and protects the wound.

Bandage

Once product is place, non-adherent dressing is placed and then wrapped to secure.

August 30th, 2019 – Day 6 Recheck

Day 6 Recheck of Wound

September 4th, 2019 – Day 11 Recheck

On Day 11, Dr. Burdick, DVM evaluated the wound.  Due to the exposed bone, the wound is classified as ” complicated” requiring an additional application of amnion to provide enough material to complete the regrowth at the same progress.

September 4th, 2019 – Day 11 Retreatment

After the wound is evaluated, it is mildly debrided to reincite an inflammatory response and a second application of StemWrap is applied.

September 16th, 2019 – Day 23 Recheck

A standard cursory veterinary examination to determine overall health of the subject, and assess condition.  Treatment site cold, no inflammation, subject standing and walking sound and comfortable.  Granulation tissue covering the bone on the medial side, and near 100% of the bone on the lateral side.

September 24th, 2019 – Day 30 Recheck

A standard examination of the patient and subject is standing, walking, and trotting sound and comfortable. Granulation tissue completely covering the bone on both the medial and lateral side. Slight heat & noticible sewlling of the foot. Sole of the foot fused.

Case Series of Honey’s Leg Wound

41 days after the initial injury and 30 days after treatment, the wound has come a long ways with no signs of infection or complications.