We have this unquestioning trust for doctors and veterinarians that they know what they are doing with their extensive education and with the emerti ones still in research in the universities. But is this trust warrented when they can't see the "elephant in the room"?
I recently emailed Dr. Rich Redding at NCSU after reading his 2010 presentation to the Assoc. of Equine Practitioners AAEP titled "An In Depth Look at Puncture Wounds to the Foot" Since I have some experience with healing puncture wounds, I wanted to make some contact with him thinking he might be interested in how I did it.
The first email to him he answered by asking "what product" I used. (??!!) As if trimming for circulation and barefoot hoof health was a product!
Here is part of my second email to him:
I want to bring your attention to the horse's foot you show as the first photo illustration in your article, An In Depth Look at Puncture Wounds.
It is very characteristic of a shod, contracted foot.
The black necrotic frog on that white foot is indicative of eschar tissue. Shod contracted hooves have necrotic tissues appearing as dull black in the area of the frog. This is especially obvious in the frog and the skin above the frog but continues deep into the interior structures of the foot. The photo of the hoof you used is a perfect example of this. The accumulation of necrotic tissue is of major clinical significance when trying to heal any wound, including a puncture wound. The eschar tissue is thought to promote bacterial colonization and prevents healing. This is the 'elephant in the room' I was talking about! The necrotic burden is already in existance, even before the puncture injury, and severely hampers any attempt at healing the puncture wound. It's very obvious to me, but you make no mention of it in your article. A contracted shod foot is similar to a chronic wound. The existant necrotic burden can prolong the inflammatory response and mechanically obstruct the process of reepithelization.
It seems a major concern that should be addressed in your article. The whole process of healing a puncture wound is severely complicated by the fact that it occurs in a shod, contracted foot with necrosis.
I recently emailed Dr. Rich Redding at NCSU after reading his 2010 presentation to the Assoc. of Equine Practitioners AAEP titled "An In Depth Look at Puncture Wounds to the Foot" Since I have some experience with healing puncture wounds, I wanted to make some contact with him thinking he might be interested in how I did it.
The first email to him he answered by asking "what product" I used. (??!!) As if trimming for circulation and barefoot hoof health was a product!
Here is part of my second email to him:
I want to bring your attention to the horse's foot you show as the first photo illustration in your article, An In Depth Look at Puncture Wounds.
It is very characteristic of a shod, contracted foot.
The black necrotic frog on that white foot is indicative of eschar tissue. Shod contracted hooves have necrotic tissues appearing as dull black in the area of the frog. This is especially obvious in the frog and the skin above the frog but continues deep into the interior structures of the foot. The photo of the hoof you used is a perfect example of this. The accumulation of necrotic tissue is of major clinical significance when trying to heal any wound, including a puncture wound. The eschar tissue is thought to promote bacterial colonization and prevents healing. This is the 'elephant in the room' I was talking about! The necrotic burden is already in existance, even before the puncture injury, and severely hampers any attempt at healing the puncture wound. It's very obvious to me, but you make no mention of it in your article. A contracted shod foot is similar to a chronic wound. The existant necrotic burden can prolong the inflammatory response and mechanically obstruct the process of reepithelization.
It seems a major concern that should be addressed in your article. The whole process of healing a puncture wound is severely complicated by the fact that it occurs in a shod, contracted foot with necrosis.