The Cutting Edge Veterinary Podcast

STUDENTS: Brooke Whitmarsh and Megan Johnson

FACULTY MENTOR: Dr. Holly Sparks

Equine synovial sepsis is a serious complication often following traumatic wounds. Due to its high mortality rate and aggressive treatment requirements, many field practitioners are uncomfortable managing septic wounds. With the goal of familiarizing the literature surrounding synovial sepsis, our review is organized into diagnosis, prognostic indicators, and treatment. Diagnosis, crucial to dictating treatment, can be achieved by anatomic knowledge, wound exploration, and further diagnostics. Microbial culture, synovial fluid analysis, and serum SAA have empirical evidence as options for definitive diagnosis of synovial sepsis. An understanding of relevant prognostic indicators is important in guiding treatment. We discuss the variety of negative prognostic indicators that may influence decision making regarding treatment. Early and aggressive treatment can be accomplished in the field or a referral setting, with various treatment modalities. Even one early intervention can have a significant impact on eliminating infection. Evidence shows no increased risk of infection of joints in the field, suggesting that treatments can be efficacious without referral. Treatment with endoscopic lavage can be referred, but studies comparing through-and-through lavage with endoscopy are lacking. Overall, septic wound management is feasible in the field, if the practitioner can recognize, diagnose, and pursue aggressive treatment, while minimizing negative prognostic indicators.