Comparison of the role of the subcutaneous tissues in cutaneous wound healing in the dog and cat

Objective— To describe and compare the contribution of the subcutaneous tissues to 1st and 2nd intention cutaneous wound healing in the dog and cat.
Study Design— Experimental study.
Animals— Domestic shorthaired cats (n=6) and 6 beagle dogs.
Methods— Paired wounds were created on either side of the dorsal midline; the subcutaneous tissue was removed on 1 side and left intact on the other. Square, open wounds of the dorsal aspect of the thorax were observed for 21 days to monitor granulation tissue formation, wound contraction, epithelialization, and total healing (contraction+epithelialization). Breaking strength of sutured linear wounds was measured 7 days after wounding. Laser-Doppler perfusion imaging (LDPI) was used to measure cutaneous perfusion.
Results— First intention healing: subcutaneous tissue removal had no consistent effect on sutured wound strength at 7 days in dogs or cats. Second intention healing: removal of subcutaneous tissue reduced wound perfusion, granulation, contraction, epithelialization, and total healing. Granulation tissue formation and wound contraction were delayed to a significantly greater degree in cats than in dogs ( P <.05). Two dogs (33%) had minor wound infections.
Conclusions— The subcutaneous tissues make an important contribution to 2nd intention cutaneous healing. Dog and cat wounds had delayed 2nd intention healing when subcutaneous tissues were removed; wounds in dogs, but not cats, had largely recovered from this delay by 21 days.
Clinical Relevance— Extensive debridement of subcutaneous tissue may delay wound healing particularly in feline patients. A higher risk for wound infections may accompany extensive removal of subcutaneous tissues in dogs.     

Second-intention repair in the horse and pony and management of exuberant granulation tissue.

Second-intention repair is faster in ponies than in horses and faster in body wounds than in limb wounds. To a large extent, the differences between horses and ponies can be explained by differences in the local inflammatory response, which are a result of the functional capacity of leukocytes. In ponies, leukocytes produce more inflammatory mediators,resulting in better local defense, faster cellular debridement, and a faster transition to the repair phases, with more wound contraction. In horses,leukocytes produce fewer mediators, initiating a weak inflammatory response, which becomes chronic. This inhibits wound contraction and gives rise to the formation of exuberant granulation tissue. The anatomic environment that influences the inflammatory response and wound contraction most probably determines the differences between body and limb wounds. In body wounds, better perfusion results in faster initiation of the inflammatory phase. The weaker local resistance results in a greater degree of contraction. In limb wounds, particularly of horses, the initial inflammatory response is weak and wound contraction is restricted. Both factors give rise to chronic inflammation, which further inhibits wound contraction and promotes exuberant granulation tissue. The high incidence of exuberant granulation tissue in limb wounds of horses can thus be explained by the chronicity of the inflammatory response as well as by the common use of bandages during treatment. Chronic inflammation is often not recognized as a cause of exuberant granulation tissue. It must be prevented and treated to promote the healing process. Bandages and casts stimulate the formation of exuberant granulation tissue; however, they are advantageous in many respects and play an important role in support of the overall healing process.     

The effectiveness of the haemodialysate Solcoseryl for second-intention wound healing in horses and ponies

Second-intention healing of limb wounds in horses is often problematic. Solcoseryl is a protein-free, standardized dialysate/ultrafiltrate (HD) derived from calf blood, which has been shown to improve healing in both animals and humans. The efficacy of HD in the healing of deep wounds in horses and ponies was investigated. Deep wounds of 20 by 35 mm were created on both metatarsi (skin, subcutis, periosteum) and on both femoral biceps muscles (skin, subcutis, muscle) of five horses and five ponies. The wounds on one side were treated with HD, four times a week during the period that the wounds were bandaged and once daily thereafter. The wounds on the other side were left untreated. In the first 4 weeks of the healing period HD stimulated healing but inhibited healing thereafter. This pattern was significant for all wound groups (P < 0.001). Because of this change in effect, the overall effect on wound healing over the entire period was not significant (P = 0.77). HD stimulated healing initially by provoking a greater initial inflammatory response, faster contraction and faster formation of granulation tissue. Subsequently, HD inhibited healing because it significantly delayed epithelialization and caused protracted inflammation. The effects of HD were most pronounced in the horses. Because this study distinguished between contraction and epithelialization, it could be shown that HD stimulated contraction but inhibited epithelialization. Therefore, HD is useful in horses for the treatment of deep wounds during the initial phase of healing by second intention, i.e. during the first weeks when wound contraction can be expected. Treatment should be ceased when epithelialization becomes predominant.     

Cutaneous wound healing in the cat: a macroscopic description and comparison with cutaneous wound healing in the dog

OBJECTIVE: To describe the macroscopic features of first and second intention cutaneous wound healing in the cat and compare with the dog. STUDY DESIGN: Experimental study. ANIMALS: Domestic shorthaired cats (6) and beagle dogs (6). METHODS: Square, open cutaneous wounds created on the dorsal aspect of the thorax were evaluated for 21 days for temporal and spatial development of granulation tissue, wound contraction, epithelialization, and total healing. To evaluate first intention healing, breaking strength of sutured linear cutaneous wounds was measured at 7 days post-wounding. Laser-Doppler perfusion imaging was used to measure cutaneous perfusion. RESULTS: First intention healing: sutured wounds in cats were only half as strong as those in dogs at day 7 (0.406 versus 0.818 kg breaking strength). Second intention healing: cats produced significantly less granulation tissue than dogs, with a peripheral, rather than central distribution. Wound epithelialization and total wound healing (total reduction in open wound area from contraction and epithelialization) were greater for dogs than for cats over 21 days. Wound contraction on day 7 was greater for dogs, but not on day 14 or 21. Cutaneous perfusion was initially greater for dogs than for cats, but no differences were detected after day 7. CONCLUSIONS: Significant, previously unreported differences in cutaneous wound healing exist between cats and dogs. In general, cutaneous wounds in cats are slower to heal. Cats and dogs also appear to use different mechanisms of second intention healing. In cats wounds close mainly by contraction of the wound edges, whereas in dogs wounds close more from central pull, and epithelialization. CLINICAL RELEVANCE: Surgeons should view the cat as a unique species, which presents its own special challenges in wound healing, and should take this into account when planning treatment of feline wounds, either by primary closure, or by second intention healing.     

Effects of a proprietary topical medication on wound healing and collagen deposition in horses

Full-thickness skin wounds were created on the dorsum of both metacarpi in 8 horses. Three topical treatment regimens were studied. All wounds were bandaged with a nonadherent dressing, which was held in place with a snug elastic wrap. Group-A wounds were treated with a proprietary topical wound medication that consisted of a spray and an ointment. Group-B wounds were treated with the same regimen, except the putative active ingredients in the ointment were omitted. Group-C wounds were treated with a dry nonadherent bandage only. Wound dressings were changed every day and the limbs were photographed every other day until the wounds were healed. Specimens of normal skin and biopsy specimens of healed wounds were examined histologically and were assayed for hydroxyproline content. Wound healing measurements quantitated for each wound were number of days to healing, maximal wound size attained, day wound contraction commenced, day epithelium first noticed, rate of wound contraction, final wound size, and fraction of the wound that healed by contraction. The cosmetic appearance of the healed wounds was also graded. Significant differences were not noticed in hydroxyproline content, histologic appearance, or any of the wound healing measurements between treatment groups. The cosmetic appearance of healed group-A and -B wounds was significantly better than the appearance of group-C wounds. The topical treatment regimens studied neither enhanced nor inhibited wound healing in this study.     

The modified Meek technique as a novel method for skin grafting in horses: evaluation of acceptance, wound contraction and closure in chronic wounds

REASONS FOR PERFORMING STUDY: The acceptance of skin grafts in horses is unpredictable and the final cosmetic result can be disappointing. Besides movement and infection, graft failure is often caused by chronic inflammation, inherently present during second intention healing of limb wounds in horses. In human burns affected by infection and inflammation, the acceptance of the island skin grafts of the modified Meek technique appeared to be better than meshed sheet skin grafts. HYPOTHESIS: The percentage take of Meek micrografts is higher than of other techniques; and rates of both wound contraction and epithelialisation are increased. METHODS: Large traumatic limb wounds of 13 horses healing by second intention were grafted using the modified Meek technique. Photographs of the wounds were taken at set intervals. Wound areas, and areas of acceptance and rejection were determined using a digital image post processor (Scion Image). The percentages of take, wound contraction and epithelialisation were calculated. RESULTS: The initial mean wound area was 7500 mm2. Graft acceptance was mean +/- s.d. 93.7 +/- 5.9%. Wound closure was due to contraction (55.2 +/- 11.1%) and epithelialisation (44.8 +/- 11.1%) and resulted in a 96.7 +/- 3.6% reduction of the initial wound area 29.1 +/- 6 days after grafting. All wounds showed functional and cosmetic healing. CONCLUSIONS: The method for skin grafting in horses achieved higher percentages of take than reported previously and consistent cosmetic and functional results. The grafts increased not only the rate of epithelialisation but also had a strong positive effect on wound contraction, resulting in rapid closure and smaller scars. POTENTIAL RELEVANCE: The modified Meek technique proved to be a novel technique for skin grafting equine wounds in clinical practice, which can be performed easily. The molecular background of the increase of wound contraction by the grafts may provide a clue in the search for medicinal stimulation of wound contraction during second intention healing.     

Effect of wound location and the use of topical collagen gel on exuberant granulation tissue formation and wound healing in the horse and pony

Preformed collagen gel was topically applied to cutaneous wounds of the equine dorsal fetlock (thoracic limb) and metatarsal regions to evaluate the effect on exuberant granulation tissue production and wound healing. In 6 horses and 3 ponies (less than 140 cm high at the withers and less than 365 kg), 36 standardized cutaneous limb wounds were surgically induced (4 wounds/animal); 18 wounds were treated topically with collagen gel, and 18 wounds were not treated (controls). Collagen gel was initially applied to the wound at 0, 2, or 7 days after wound formation (groups 1, 2, and 3, respectively). Four measurements were regularly made: amount of wound contraction and the size of the granulation bed, epithelial covering, and total wound. Sequential skin and wound biopsies were evaluated histologically to assess wound healing. Using a computer, data were analyzed for differences in the 4 measurements between treated and control wounds, between fetlock wounds and metatarsal wounds, and among groups 1, 2, and 3. Analyses were performed on days 15 and 45 of wound healing and on the final day of healing. A significant difference (P greater than 0.05) in the production of exuberant granulation tissue, rate of epithelialization, or degree of wound contraction was not detected between the collagen-treated and control wounds. Total healing time and final scar size were similar. Wound healing patterns were significantly different (P less than 0.05) in the fetlock wounds and metatarsal wounds. All wounds enlarged up to day 15 with fetlock wounds enlarging significantly more than did the metatarsal wounds.(ABSTRACT TRUNCATED AT 250 WORDS)     

Influence of wound shape on wound contraction in horses.

Three sets of paired circular and square full-thickness skin wounds were made on the dorsum of the metacarpus (n = 48) of 8 horses. Each wound was 6.25 cm2 in area. The wounds were treated topically with an ointment, nonadherent dressing, and bandaged with a snug elastic wrap. Wounds were photographed every other day until healing was complete. Wound areas were measured and exponential and linear wound healing models were applied to the wound healing data generated. Wound healing variables measured for each wound were: number of days to healing, maximal size attained, rate of wound contraction (calculated by use of first-order and linear models), final wound size, and percentage of wound that healed by contraction. The exponential model fit the data significantly better than the linear model. The maximal size attained by circular wounds was significantly smaller than the maximal size attained by square wounds. Wound shape did not influence the rate of wound healing. On the basis of our findings, conversion of circular defects to square defects would not speed wound healing.     

Effects of topical application of taurolidine on second intention healing of experimentally induced wounds in rats

OBJECTIVE: To determine the macroscopic effects of topical application of taurolidine on second intention healing of experimentally induced wounds in rats. ANIMALS: 32 adult Sprague-Dawley female rats. PROCEDURES: In each rat, 2 skin wounds were created in the lumbar area. Groups of 7 rats were assigned to have 1 wound treated topically with hydroxycellulose gel (HDCG), 2% taurolidine in HDCG (T-HDCG), 2% taurolidine-sodium citrate solution, or bacitracin-neomycin-polymyxin B ointment; the other wound was not treated. Four control rats (8 untreated wounds) were used. Wounds were monitored for contraction, epithelialization, and complete healing at 4, 8, and 14 days after wound creation. The number of days to complete healing was also recorded for each wound. RESULTS: Compared with other treatments or untreated wounds, wounds treated with T-HDCG had decreased total healing at day 8 and decreased epithelialization and decreased total healing at day 14. Wounds treated with T-HDCG required approximately 3 days longer to completely heal than all other treated and untreated wounds. Application of bacitracinneomycin-polymyxin B ointment did not enhance wound healing. Mean time to complete healing of untreated wounds in all treatment and control groups was 10.00 to 10.14 days. CONCLUSIONS AND CLINICAL RELEVANCE: In rats, topical application of T-HDCG to wounds had a negative effect on second intention healing by delaying the epithelialization process. In mammals, generally, wounds treated topically with taurolidine may need to be treated and monitored for a longer period than other wounds treated with other common woundhealing compounds or untreated wounds.     

Effects of Topical Application of Sunflower-Seed Oil on Experimentally Induced Wounds in Horses

The objectives were to evaluate clinical and histopathological aspects of topical application of sunflower-seed oil (Helianthus annuus) on the healing process of experimentally induced wounds in lumbar and metacarpal areas of healthy horses. Six adult horses were used. Eight wounds were surgically produced on each horse: two 6.25-cm² wounds cranial to the sacrum on each side of the lumbar region and two 2.89-cm² wounds close to the proximal epiphysis of the metacarpus on the lateral aspect of each forelimb. Left side was used for macroscopic observations and right side for histopathological analysis. The experimental lesions were treated daily with sunflower-seed oil, whereas saline solution was used in control lesions. Macroscopic and histopathological analyses were performed on tissue harvested at 3, 7, 14, and 21 days. Complete healing time for all wounds was recorded. For lumbar region’s wounds, a contraction of 90.78% was recorded for those treated with oil and of 79.27% for control wounds after 21 days of treatment. For metacarpal region’s wounds, a contraction of 47.63% was recorded for wounds treated with oil and of 30.21% for control wounds. Wounds in the sunflower-seed oil treatment group had an elevation of polymorphonuclear cells, a newly formed vascular bed during the inflammatory phase, and a better alignment of collagen fibers during the remodeling phase. In conclusion, topical application of sunflower-seed oil was beneficial in the healing process of experimentally induced skin wounds in horses, with best results for treatment of lumbar wounds, making it a therapeutic option in equine wound healing.     

Effects of Chlorhexidine Diacetate and Povidone-lodine on Wound Healing in Dogs

To correlate the results of an in vitro study with clinical response, the effects of 0.005 and 0.05% chlorhexidine diacetate and 0.1 and 1.0% povidone-iodine concentrations on wound healing were evaluated in five beagle dogs. Full-thickness skin wounds (2 X 2 cm) were irrigated once daily for 14 days with the antiseptic solutions or physiologic-buffered saline. Chlorhexidine diacetate 0.05% had significantly more bactericidal activity than povidone-iodine and saline, and both chlorhexidine diacetate concentrations had residual effects 6 hours after irrigation. Neither povidone-iodine nor saline had significant bactericidal activity. The percentages of unhealed wound area and wound contraction were calculated 7, 14, and 21 days after wounding. Healed wound area and contraction were similar in wounds treated with chlorhexidine diacetate and povidone-iodine. However, wounds treated with chlorhexidine diacetate had more healed wound area on days 7 and 14 and more contraction on days 7, 14, and 21 than saline-treated wounds. At the concentrations tested, chlorhexidine diacetate irrigations provided bactericidal activity and were more beneficial to wound healing than irrigations with saline alone. These results suggest that concentrations of chlorhexidine diacetate which are cytotoxic to tissue culture fibroblasts in vitro do not interfere with wound healing in vivo.     

Effects of a hydrolyzed collagen dressing on the healing of open wounds in dogs

OBJECTIVE: To determine the effects of a hydrolyzed bovine collagen dressing (HBCD) on healing of open wounds in healthy dogs. ANIMALS: 9 female Beagles. PROCEDURES: 2 full-thickness skin wounds were made bilaterally on the trunk of each dog. Wounds on 1 side were treated with powdered HBCD covered with a semiocclusive nonadherent bandage. Wounds on the other side (control wounds) were covered with a semiocclusive nonadherent bandage only. Wound healing was subjectively assessed, and percentage increase in tissue perfusion was assessed by use of laser Doppler perfusion imaging (LDPI). Planimetry was performed to determine the percentages of contraction, epithelialization, and total wound healing. Biopsy specimens were examined microscopically to evaluate histologic changes. RESULTS: The HBCD did not induce a strong inflammatory reaction, as reflected by results of LDPI and histologic examination. Moreover, HBCD appeared hydrophilic and provided an environment to keep wounds clean and enhance early epithelialization. After treatment for 7 days, treated wounds had a significantly greater percentage of epithelialization than control wounds (12.13 vs. 7.03%). CONCLUSION AND CLINICAL RELEVANCE: The hydrophilic property of HBCD may cleanse contaminated wounds with the body's homeostatic fluids and enhance early wound epithelialization.     

The effect of a porcine-derived small intestinal submucosa product on wounds with exposed bone in dogs

OBJECTIVE: To determine the effect of a porcine-derived small intestinal submucosa product (PSIS) on healing time, epithelialization, angiogenesis, contraction, and inflammation of wounds with exposed bone on the distal aspect of the limbs of dogs. STUDY DESIGN: Prospective, controlled, experimental study. ANIMAL POPULATION: 10 young adult, purpose-bred, male Beagles. METHODS: Small wounds with exposed bone were created on the lateral aspect of metatarsal V and the medial aspect of metatarsal II on both hindlimbs. Three sheets of PSIS were sutured into the wounds of the treated limb, and the other limb served as a control. On day 10, punch biopsies of the medial metatarsal wounds were collected and were evaluated microscopically after routine hematoxylin and eosin and phosphotungstic acid hematoxylin (PTAH) staining. The lateral metatarsal wounds were evaluated by planimetry and laser Doppler perfusion imaging on days 7, 14, and 21. Time until complete wound healing was also recorded. The level of significance was set at P < or =.05 for all statistical analyses. RESULTS: Laser Doppler perfusion measurements were significantly higher in control wounds on day 7, but no differences were noted on days 14 and 21. No significant differences in planimetric values, histopathologic appearance, or time until complete wound healing were noted among treated and control groups. CONCLUSIONS: No objective differences in healing were noted between control wounds and wounds treated with PSIS. CLINICAL RELEVANCE: There appears to be no contraindication to the use of PSIS on clean wounds with exposed bone on the distal limbs of dogs. However, our objective data provides no evidence that this product affects epithelialization, contraction, or time to complete healing in wounds with exposed bone.     

An overview of the topical management of wounds

Wounds in animals are a common and frequent reason for seeking veterinary attention. The way in which wounds are managed affect the rate of healing, the time to return to normal function, the final cosmetic appearance, and hence the satisfaction of customers. The management of wounds depends on the stage of wound healing and can include irrigation, mechanical and chemical debridement, the use of antiseptics and antimicrobials, adherent and nonadherent dressings, and miscellaneous topical applications such as aloe vera, honey and live yeast cell derivative. The advantages, disadvantages and indications for initial wound management, topical applicants and dressings are discussed.     

Effects of topical application of antimicrobials and bandaging on healing and granulation tissue formation in wounds of the distal aspect of the limbs in horses

OBJECTIVE: To determine whether povidone iodine ointment or 2 forms of silver sulfadiazine applied topically to wounds of the distal aspect of the limbs in horses affect the rate of second intention healing and to evaluate the additional influence of bandaging with these antimicrobials on granulation tissue formation. ANIMALS: 6 healthy adult horses. PROCEDURE: Six standardized 2.5-cm2 skin wounds/horse were distributed between the dorsomedial surfaces of the metacarpi and metatarsi. One of the following 6 treatments was applied to each wound: 1% silver sulfadiazine cream with bandage, 1% silver sulfadiazine slow-release matrix with bandage, 1% silver sulfadiazine slow-release matrix without bandage, povidone-iodine ointment with bandage, untreated control with bandage, and untreated control without bandage. Wound area, granulation tissue area, and perimeter were measured by use of planimetry software applied to digital images. Exuberant granulation tissue was excised when present. Days until healing, rate of healing parameter, rate of contraction, and epithelialization were compared among wound treatment groups. RESULTS: Healing parameters and mean days to healing did not differ significantly among any of the wound treatment groups. Percentage wound contraction and rate of epithelialization were similar among wound treatments. All bandaged wounds produced exuberant granulation tissue, which was surgically excised; none of the unbandaged wounds produced exuberant granulation tissue. CONCLUSIONS AND CLINICAL RELEVANCE: When exuberant granulation tissue is removed, rates of epithelialization and wound contraction were not different among wound treatment groups, whether bandaged or unbandaged. Topical application of 1% silver sulfadiazine slow-release matrix on unbandaged wounds induced the same result as medications applied beneath bandages, but without exuberant granulation tissue formation.     

Wound management in rodents.

Successful wound management requires appropriate evaluation of the wound at the time of initial physical examination, an all throughout the healing process. Factors affecting wound healing need to be identified though a complete patient history and addressed to ensure proper healing. The clinician must have current knowledge of topical medications and bandages available and their clinical applications according to the stage of healing. It is essential to remember that wounds are painful; therefore, analgesics should be administered to render the animal pain-free during wound cleaning, debridement, bandaging, and surgical procedures.     

The Effect of Occlusive and Semi-Occlusive Dressings on the Healing of Acute Full-Thickness Skin Wounds on the Forelimbs of Dogs

This project compared the effects of hydrocolloid (HC) and hydrogel (HG) occlusive dressings and a polyethylene (PE) semi-occlusive dressing on the healing of acute full-thickness skin wounds on the forelimbs of 10 dogs. All treatments resulted in a similar degree of healing at postoperative days 4 and 7. No significant differences existed in the number of wounds that were more than 90% healed at postoperative day 28 between the group treated with the HG dressing and the group treated with the PE dressing. There were significantly fewer wounds more than 90% healed at postoperative day 28 in the group treated with the HC dressing. Wounds under the HG dressing had the largest mean percentage of contraction at postoperative days 21 and 28. Wounds under the HG dressing also had the largest contraction/re-epithelialization ratio (postoperative days 21 and 28) compared with wounds under the PE and HC dressings. Wounds under the PE dressing had a significantly higher mean percentage of re-epithelialization than wounds under both occlusive dressings on postoperative days 14, 21, and 28. Wounds under the two occlusive dressings had exuberant granulation tissue present more often than wounds under the PE dressing. The two occlusive dressings had significantly higher bacterial counts on wounds compared with wounds under the PE dressing; analysis of variance (ANOVA), P = .0008. Wounds under the HC dressing showed the poorest healing in all parameters.     

The effect of low level laser therapy (LLLT) on wound healing in horses.

Laser therapy is used in many countries, including South Africa, for the treatment of skin wounds. Low level galium aluminium arsenide (GaAlAs) laser was administered to full thickness skin wounds (3 x 3 cm) induced surgically on the dorsal aspect of the metacarpophalangeal joints of 6 crossbred horses in a randomised, blind, controlled study. Treated wounds that received a daily laser dosage of 2 J/cm2 were compared with nontreated control wounds on the opposite leg. There were no wound complications. Both groups of wounds were cleaned daily using tap water. Wound contraction and epithelialisation were evaluated using photoplanimetry. There were no significant differences in wound contraction or epithelialisation between the laser treated and the control wounds. It was therefore concluded that laser therapy had no clinically significant effect on second intention wound healing in this study.     

Application of Exogenous Esterified Hyaluronan to Equine Distal Limb Wounds

The objective of this study was to evaluate the efficacy of topical application of a hyaluronan (HA) derivative in wound healing with respect to the rate of epithelialization, fibroplasia, angiogenesis and contraction, magnitude of the local inflammatory response, local expression of transforming growth factor-β 1 and 3 (TGF-β 1 and 3), tumor necrosis factor-α (TNF-α), and collagen type III deposition. In six healthy adult horses, six full-thickness skin wounds were created on the dorsal aspect of both metacarpi using a sterile template. Sites were sampled at 0, 1, 2, 5, 14, 21, and 35 days following wounding. Wounds on one limb were dressed with commercially available esterified HA fleece under a nonadherent dressing. The opposite limb was covered with the nonadherent dressing alone (control). Images of the most proximal wounds were used to determine the area of total healing and the relative contributions of epithelialization and contraction to healing. At each sample time, a control and treatment biopsy were taken for histological evaluation and special stains. All samples were evaluated for degree of inflammation, fibroplasia and angiogenesis; in situ hybridization for type III collagen, TGFβ1 and 3, and immunohistochemistry for TNF-α. Mean percentages of total wound healing, epithelialization, and wound contraction were not significantly different between control and treatment groups. In treated horses, initial wound expansion was significantly decreased during the first 2 weeks. Mononuclear cell numbers, counted in the granulation tissue, increased in both control and treated limbs over the entire course of the study. However at day 35 the macrophage numbers counted in the treated horses were significantly increased compared with the control limbs (P < .05). Although not statistically significant, relative staining for type III collagen in the treated wounds was less than that of control wounds. Results of the present study do not support a benefit of an exogenous HA-derivative in the healing of distal limb wounds in horses. The shortcomings of the study design are discussed.     

The effect of ambient temperature and type of wound on healing of cutaneous wounds in the common garter snake (Thamnophis sirtalis).

The effects of ambient temperature (13.5 degrees C, 21 degrees C, 30 degrees C) and type of wound on healing of skin wounds were evaluated in common garter snakes (Thamnophis sirtalis). Linear unsutured incisions and circular excisional wounds were evaluated grossly and microscopically in three snakes held at each temperature at each of two, five and ten days after surgery. Linear sutured and unsutured incisions and circular and square excisional wounds were similarly evaluated three and six weeks after wound production in groups of six snakes held at each temperature. The rates of stabilization of wound margins, scab formation, migration and maturation of the regenerating epithelium, resolution of dermal inflammation, and fibroplasia varied directly with temperature. The inflammatory reaction to wounding was similar in character and intensity in snakes held at all three temperatures two days after surgery. Unsutured linear incisions, compared to sutured incisions, tended to have more rapid epithelial maturation and a less intense inflammatory response. Healing of square and circular excisional wounds was similar; contraction of round wounds was slightly more irregular and, at a few observations, dermal maturation was slower and inflammation more widespread. It was concluded that healing of skin wounds can be accelerated by holding reptiles at the upper end of their voluntary temperature range. Wounds, if possible, should be created along the axis of lines of skin tension. Suturing small incisional wounds may not be advantageous.