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Recent papers published on dealing with wounds

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01 June 2014, at 1:00am

Assessment of a device for managing of distal extremity wounds in dog

Robert Hardie and James Lewallen, University of Wisconsin 

Wounds to the distal extremities are relatively common in dogs and their management can be particularly challenging because of the mechanical stress experienced during weight bearing and the limited soft tissue in that region for closure or reconstruction. 

The authors investigate the use of a custom orthotic boot in managing injuries to the distal extremity and pad. The device was made of lightweight co- polymer plastic to protect the wound and immobilise the paw. It was made in a bivalve design with close cell foam padding and adjustable straps. A window was cut immediately over the wound to minimise direct contact with the boot. It was tested in three dogs with full thickness wounds and these healed by contraction and epithelialisation in 21, 21 and 45 days 

The only complication noticed was mild skin irritation at the top of the boot in two dogs and this was managed with additional padding. So the device was effective in the treatment of chronic, slow healing injuries to the distal extremity and metatarsal pads. The authors report that a similar device has since been used to treat an injury in a cat, with equivalent success.

  Veterinary Surgery 42 (6): 678-682.

A bio film preventing the healing of wounds to the canine elbow 

Elizabeth Swanson and others, Purdue University, Indiana 

Bacterial bio films may cause post- operative complications in veterinary patients by forming around the implants used in orthopaedic procedures but they have not previously been reported as a cause of chronic wounds in dogs. 

However, the authors describe a case in a four- year-old spayed female mastiff with chronic non-healing pressure wounds over both elbow regions following hypertrophic callus excision. Bacterial bio films consisting of Staphylococcus intermedius, S. epidermis and Streptococcus canis were identified histologically in tissue specimens from both wounds. 

Both lesions were successfully treated with a combination of debridement, vacuum assisted closure and systemic antimicrobials.

Journal of the American Veterinary Medical Association 244 (6): 699-707.

Second intention healing after wide local excision of soft tissue sarcomas 

Cassandra Prpich and others, Southpaws Specialty Surgery for Animal, Moorabbin, Victoria 

There is controversy over the most appropriate surgical treatment for soft tissue sarcomas affecting the distal aspect of the limbs of dog. The authors investigate the surgical outcome and recurrence rates in 31 dogs treated with wide excision margins and second intention healing. 

Complications during open wound management occurred in 22.6% of patients and long-term complications such as intermittent epidermal disruption and wound contracture were noted in 25.8% of the group. However, their findings show that wide local excision with margins measuring 2cm laterally and one fascial plane deep provided excellent long-term tumour control.

Journal of the American Veterinary Medical Association 244 (2): 187-194.

Comparison of exuberant granulation tissue in horses and human keloid scars 

Christine Theoret and others, University of Montreal, Quebec 

Humans and horses are the only mammalian species known to develop excessive granulation tissue during wound healing. The authors compare the histopathological features of the two broproliferative disorders, equine exuberant granulation tissue and keloid in humans. 

They detected differences and similarities between the fibroblast populations in samples from the two species which have not been reported previously. Differences in the inflammatory response may account for the contrasting cellular populations with equine biopsies showing increased myofibroblasts, small vessels and acute inflammatory cells compared with keloids. 

Veterinary Surgery 42 (7): 783-789.

Skin fragility syndrome in a cat with multicentric follicular lymphoma

Odile Crosaz and others, National Veterinary School, Maisons-Alfort, France 

Acquired feline skin fragility syndrome is a rare condition in which the skin defects are often associated with some other underlying condition. The authors describe the first reported case of skin fragility in a cat with lymphoma. 

The 11-year-old spayed female domestic shorthair presented with a right flank wound and several star-shaped cigarette paper-like lesions appeared on the skin during the examination, which also revealed an abdominal mass. The cat’s condition deteriorated and it died spontaneously. A post mortem examination confirmed the diagnosis of lymphoma.

Journal of Feline Medicine and Surgery 15 (10): 953-958.

Cat scratch-induced Pasteurella multocida necrotising cellulitis in a dog

Frane Banovic and others, North Carolina State University 

In humans, Pasteurella multocida-related cellulitis following a cat scratch or bite is well-recognised condition and may sometimes progress to fatal necrotising fasciitis. However, a similar condition in dogs has not been reported previously. The authors describe a case in a three- year-old spayed female whippet which developed ecchymosis, swelling and pain within 24 hours of being scratched on the ventral thorax. 

 The patient was given analgesia and over the next few days the lesions progressed with haemorrhagic bullae and skin necrosis. A heavy growth of P. multocida was seen on bacterial culture. The lesion resolved following surgical debridement, skin grafting and intravenous antibiotic treatment. 

Veterinary Dermatology 24 (4): 463-465.

Effects of topical mesenchymal stem cell transplantation on skin wounds in dogs

Ju-Won Kim and others, Konkuk University, Seoul, South Korea 

Studies of mesenchymal stem cell transplantation in humans and laboratory animals have demonstrated that it can promote more rapid wound healing and improved dermal regeneration. The authors investigated the effects of cultured bone marrow- derived allogenic cells in treating experimentally-induced wounds

in healthy beagles. Compared with control lesions the treated animals showed more rapid wound closure, increased collagen synthesis, cellular proliferation and angiogenesis. Moreover, the treated wounds revealed decreased expression of pro-inflammatory cytokines such as interleukin-2 and gamma interferon. 

Veterinary Dermatology 24 (2): 242-249.

Post-operative septic arthritis after arthroscopy without antimicrobial prophylaxis 

Hanna Borg and James Carmalt, University of Saskatchewan, Canada 

Arthroscopic surgery is the preferred treatment for a range of joint diseases in horses and the reported incidence of post-operative infections is low. The authors investigated whether the use of prophylactic antimicrobial treatment was a factor in preventing complications such as septic arthritis. They examined the records from 444 consecutive equine arthroscopy procedures carried out without routine prophylaxis. 

They found that the incidence of sepsis was 0.5% of these joints and compared favourably with the results in other published studies, carried out both with and without such treatment.

Veterinary Surgery 42 (3): 262-266.

Bacterial contamination of surgical drapes when using a forced air warming system

Lindsay Occhipinti and others, Veterinary Specialists of Rochester, New York State

Hypothermia is a common problem during general anaesthesia in small animal surgical patients. The Bair Hugger forced air warming device was introduced in 1987 and is widely used to maintain normal intra-operative temperatures in both human and veterinary patients. 

The authors compared the rates of bacterial contamination on the surgical drapes used with 100 small animal patients undergoing clean surgical procedures. Contamination of the drapes occurred in 6.1% of cases and there was no significant difference in the rate between the Bair Hugger and control group patients.

Canadian Veterinary Journal 54 (12): 1,157-1,159.

Actinomyces denticolens as a cause of a soft tissue abscess in a horse

Darien Feary and others, University of Adelaide

Actinomyces species are Gram-positive, facultative anaerobic rods that form part of the normal bacterial flora of the oral and respiratory tract in several domestic species. They are not recognised as a common cause of soft tissue abscesses in horses.

However, one such lesion occurred in the case described by the authors in a six-year- old Arabian mare with a four-week history of a large subcutaneous mass at the base of the neck. Purulent aspirate material was taken from the abscess and on bacterial culture shown to have a moderate growth of an Actinomyces species identified as A. denticolens on gene sequencing. The lesion resolved with prolonged antimicrobial therapy.

Australian Veterinary Journal 91 (10): 416-417.

Efficacy of decontamination procedures on a single-use laparoscopic surgery port

James Coisman and others, University of Florida

Decontamination and sterilisation of laparoscopic single-use devices for humans undergoing minimally invasive surgery is controversial as there is a potential risk of wound contamination and the devices being damaged during the sterilisation process. 

The authors investigated the risk of contamination of single-use laparoscopic surgery ports in canine patients. They conclude that standard decontamination and sterilisation procedures are effective in eliminating bacterial contamination and therefore it may be appropriate to re-use such equipment in small animal practice.

American Journal of Veterinary Research 74 (6): 934-938.

Streptomyces cyaneus dermatitis in an Australian terrier 

Phil Nicholls and others, Murdoch University, Western Australia

Streptomyces species are Gram-positive lamentous bacteria normally found in soil and are an uncommon cause of infections in domestic animals. The authors describe one such case in a four-year-old neutered male terrier with a nodular pyogranulomatous mass affecting the right axilla which had responded poorly to antimicrobial therapy. 

Biopsy material revealed an infection with bacteria of the Actinomyces group which includes Streptomyces and gene sequencing revealed it to be S. cyaneus. The dog showed clinical improvement with potentiated sulphonamide treatment but the infection recurred five months later and the patient was euthanased. 

Australian Veterinary Journal 92 (1-2): 38-40.