Comparison of two topical treatments on wound healing 7 days after disbudding of calves using thermocautery

ABSTRACT

Aims To compare wound healing 7 days after cautery disbudding of dairy calves treated immediately after disbudding with a traditional antimicrobial spray (OXY) or with a topical anaesthetic gel containing cetrimide, adrenaline and two local anaesthetics, lignocaine and bupivacaine (TA).

Method Eighty-one female dairy calves between 6–8 weeks of age were disbudded using a standard cautery disbudding protocol (sedation, cornual block, and analgesia), with complete removal of the horn bud. After disbudding, the wound on the right and left horn buds within each animal were randomly allocated to receive either OXY or TA. One week after disbudding, wounds were visually assessed for the presence of exudate, necrotic tissue, crust, or granulation tissue which were each assigned a grade from 1–3, where 1?=?no evidence, 2?=?moderate presence; and 3?=?marked presence.

Results At 7 days after disbudding, the prevalence of wounds with exudate or necrotic tissue was very low, and independent of treatment. The odds of a disbudding wound treated with TA being scored as having granulation tissue and was 5.2 (95% CI?=?1.72–15.7) times that of a wound treated with OXY. Conversely, the odds of wounds treated with TA being scored as having crusts was 0.18 (95% CI?=?0.06–0.57) that of a wound treated with OXY. No sign of infection was seen in any calves.

Conclusion and clinical relevance The greater prevalence of granulation tissue and reduction in crusting in disbudding wounds treated with topical anaesthetic gel compared to those treated with the antimicrobial spray suggests that use of the topical anaesthetic gel may speed wound healing compared to using antimicrobial spray. This should be further tested in a larger study undertaken over a longer period.     

Surgical management of haemangiopericytoma involving the biceps femoris muscle in four dogs

Four dogs with haemangiopericytoma of the subcutaneous tissue overlying and infiltrating the biceps femoris muscle were successfully managed using complete resection of the involved muscle with 2 to 3 cm skin margins. Postoperatively, no local recurrence was noted in any of the dogs in a follow-up period of four to 33 months (mean 22 months). Wound dehiscence, attributed to increased tension and inadequate exercise restriction, occurred in two of the four cases. Closure of the large cutaneous deficit in the craniolateral thigh and stifle was achieved by rotation of a flank-fold skin flap in one case. Strict exercise restriction and the use of a Robert Jones dressing may prevent muscle suture disruption. These measures should enable primary wound healing in the region to progress without complication.     

Surgical correction of ear curling caused by scar tissue formation in a horse

An 18-month-old Belgian Warmblood mare was evaluated because it had injured the outer convex aspect of the left auricle. Second intention healing of the wound area caused tissue contracture, which resulted in the tip of the ear curling backward. By use of a technique involving undermining of the skin and a flap of granulation tissue on the medial aspect of the wound area and multiple incisions of the auricular cartilage, the curling was relieved and the ear regained a more normal shape. A skin graft was applied to cover the existing wound defect in an attempt to accelerate wound healing; thermoplastic material was contoured to fit the inner concave surface of the ear for immobilization and fixation of the ear in its final shape after surgery. Thirty days after surgery, the graft had healed completely and the ear had a normal conformation. The successful outcome of this treatment suggests that correction of an ear deformity secondary to scar tissue formation by use of an adapted surgical technique and appropriate materials can be achieved with good cosmetic results in horses.     

Digital extensor tendon lacerations in horses: A retrospective evaluation of 22 cases

Hospital records of 22 horses referred to the Royal Veterinary and Agricultural University (RVAU) of Copenhagen between January 1, 1990 and December 31, 1993 for treatment of digital extensor tendon laations were reviewed, and follow-up information on final outcome was collected to determine whether any injury or treatment factors could be associated with the outcome.

Mean age of the horses was 5.2 years (range, 1 to 20 years), and follow-up time ranged from 1 to 5 years after injury. In 21 (95%) of the horses, injury involved the hind limbs. Eleven (50%) horses returned to their original or intended level of use. Eighteen (82%) horses had no signs of lameness. There was no statistically significant correlation between outcome and elapsed time from injury to treatment, type of injury, treatment variables, or wound healing in the present study, and these findings support previous reports.

It was concluded that horses with digital extensor tendon lacerations had a favorable prognosis for return to riding soundness and a fair prognosis for return to their original or intended level of use. Tendon suturing and primary wound healing did not improve the prognosis.     

Impact of topical anaesthesia on pain alleviation and wound healing in lambs after mulesing

Objective     To investigate the impact of using the topical anaesthetic preparation Tri-Solfen® on pain alleviation and wound healing in lambs undergoing mulesing.
Design   Three separate trials, placebo controlled and/or randomised, were carried out over a 5 month period on three mobs of between 60 and 263 merino lambs undergoing routine mulesing.
Procedure     Wound pain was assessed using 10 and 75 g calibrated Von-Frey monofilaments to determine sensitivity to light touch and pain stimulation over a 4 to 8 h period. Pain-related behaviour was documented by trained, blinded observers using a numerical rating scale. Wound healing rates were determined using scaled digital photography and image analysis software to calculate contraction in wound surface area 2 and 4 weeks after mulesing.
Results     There was rapid (3 min) and prolonged (up to 8 h) wound analgesia as shown by pain response scores (P ≤ 0.01), with absent or significantly diminished primary and secondary hyperalgesia (P ≤ 0.01) and significant reduction in pain-related behaviour (P < 0.001) in treated versus untreated lambs. In addition there was improved wound healing in the treated lambs (P ≤ 0.05).
Conclusion     Tri-Solfen® effects rapid and prolonged wound analgesia, reduction in pain-related behaviour and improved wound healing in lambs undergoing routine mulesing, providing effective alleviation of pain associated with routine mulesing in sheep.     

Effects of split-thickness and full-thickness skin grafts on secondary graft contraction in horses.

Full-thickness, circular (4-cm diameter) cutaneous wounds were created on the metacarpi and metatarsi of 6 horses. Immediately after wounding, 1 wound on each horse received a meshed, split-thickness skin graft (0.64 mm) obtained from the ventrolateral aspect of the horse's thorax by use of a pneumatic dermatome, whereas a second wound received a meshed, full-thickness skin graft obtained from the pectoral area. In addition, sections of split-thickness and full-thickness grafts were refrigerated in a solution of McCoy's 5A medium, to which equine serum (10%) and gentamicin sulfate solution (16 mg/dl) were added. Ten days after wounding, 1 granulating wound on each horse was grafted with a stored, meshed, split-thickness graft, and 1 granulating wound on each horse was grafted with a stored, meshed, full-thickness graft. Areas of wounds were calculated from photographs taken of wounds on days 1, 5, 10, 15, 20, 25, and 30 after wounding. Time course of contraction was determined by use of a first-order mathematic model of changes in area through time. Rate constants of contraction for fresh or granulating wounds receiving full-thickness grafts did not differ significantly from those for fresh or granulating wounds receiving split-thickness grafts. Rate constants of contraction for grafted fresh wounds, however, were significantly less than those of grafted granulating wounds, regardless of whether a split-thickness or full-thickness graft was applied.     

A retrospective study of 192 horses affected with septic arthritis/tenosynovitis.

The medical records of 192 horses with septic arthritis/tenosynovitis 1979-1989 were reviewed. Forty-three horses developed infection after an intra-articular injection, 46 following a penetrating wound, 25 following surgery, 66 were foals less than 6 months old, and 12 were adult horses without a known aetiology. Haematogenous infection of a joint occurs in adult horses and should be considered as a differential diagnosis in horses with an acute onset of severe lameness. The aetiology of the infection had a significant effect on the type of bacteria identified by culture. Staphylococcus was cultured from most of the horses that developed infection following a joint injection or surgery, 69% of the horses from which an organism was identified. Horses that developed infection secondary to a penetrating wound frequently provided cultures of more than one organism; Enterobacteriaceae and anaerobes were more frequently isolated in this group. The most common organisms isolated from foals were Enterobacteriaceae; E. coli was identified in more than 27% of the foals. The hock was the most frequently involved joint. Multiple treatments were used over the 10-year period of study. Survival rates were lowest in foals; only 45% survived to be released from the hospital. Survival was greater in adult horses; 85% of the horses that were treated were released from the hospital. Survival was significantly greater in horses with septic tenosynovitis; all 14 of the horses that were treated survived. Survival was not significantly affected by the joint involved or by the type of bacteria cultured from the synovial fluid.(ABSTRACT TRUNCATED AT 250 WORDS)     

The Association of Propofol Usage With Postoperative Wound Infection Rate in Clean Wounds: A Retrospective Study

OBJECTIVE: To determine if the use of propofol influences the postoperative infection rate of clean surgical wounds in dogs and cats. STUDY DESIGN: Retrospective study. SAMPLE POPULATION: 863 dogs and cats undergoing clean surgical procedures. METHODS: Medical and anesthetic records of surgical cases used as part of a previously described epidemiologic study on postoperative wound infection rates were reviewed. The records of all animals with clean surgical wounds were reviewed to determine if propofol had been used for anesthetic induction or maintenance during the procedure. To determine the effect of propofol use on wound infection rate, data were analyzed using Fisher's exact test, followed by multiple logistic regression to adjust for various factors, including surgery time, time from clipping to surgery, antibiotic usage, coexisting distant infection, endocrine disease, and the use of immunosuppressive drugs in the perioperative period. RESULTS AND CONCLUSIONS: Of 863 dogs and cats with clean surgical wounds, 46 received propofol as part of the anesthetic protocol. A total of 6 of 46 animals (13%) receiving propofol developed postoperative wound infections, compared with 33 of 817 animals (4%) not receiving propofol (P = .014; % difference = 9%; 95% CI = 0.5% to 24%). Adjusting for all other factors evaluated, animals receiving propofol were 3.8 times more likely to develop postoperative wound infections compared to animals not given propofol (95% CI = 1.5-9.9). CLINICAL IMPLICATIONS: Propofol is a lipid-based emulsion capable of supporting microbial growth. Administration of a potentially contaminated solution may contribute to surgical wound infection or other patient morbidity or mortality. Strict aseptic technique in the preparation of the solution and prompt disposal of unused drug are imperative to curtail the potential for extrinsic contamination.     

The effects of cancer and cancer therapies on wound healing

Based on experimental evidence in rodents, most of the antineoplastic agents will affect wound healing. With most of the agents, this impairment is not sufficient to produce increased morbidity based on the clinical reports in humans. Radiation therapy appears to inhibit healing in both experimental animals and during clinical trials. In spite of this, it is reported that wounds in animals will heal when they are receiving radiation therapy after surgery. Based on the information presented here and experience at the University of Missouri, the decision to use adjuvant therapy should depend on the surgery performed. With a single incision that had no increased tension, there should be no hesitation to use adjuvant therapy. If removal of the tumor required reconstructive surgery, no radiation or chemotherapy should be used until the wound has healed.     

Stages of wound healing and their clinical relevance.

Wound healing describes the host mechanisms involved in the process of restoring the continuity of tissues after injury. Wound healing progresses through a continuum of overlapping stages characterized by macroscopic, microscopic, and biochemical events. An understanding of the relation between these events can enhance clinicians' skills in wound management.     

Topical and systemic medications for wounds.

There are a plethora of topical and systemic medications available to the veterinary practitioner today that aid the wound healing process. Some of these help to maintain a moist environment. Others increase growth factors, provide local energy sources, control infection, provide for debridement, increase wound blood flow and temperature, or reduce wound edema. Modern wound care requires that the proper products(s)be used, depending on the condition of the wound and the phase of wound healing. This article discusses various wound care products and provides guidelines on their use.     

Percutaneous Cementoplasty in the Palliative, Multimodal Treatment of Primary Bone Tumors of the Distal Aspect of the Radius in Four Dogs

Objective— To (1) evaluate the analgesic effect of percutaneous cementoplasty (PC) in dogs with primary bone tumor (PBT) of the distal aspect of the radius and (2) evaluate the impact on the course of disease by adding PC to a palliative, multimodal treatment protocol in these dogs.
Study Design— Prospective pilot study.
Animals— Dogs (n=4) with PBT of the distal aspect of the radius.
Methods— Tumor lesions were filled percutaneously with polymethylmethacrylate under fluoroscopic guidance. Pamidronate was administered once in a week before PC. Radiotherapy and chemotherapy were initiated 2 and 6 weeks after PC, respectively. Force plate analysis was performed immediately before 2, and 6 weeks after PC. Survival time was defined from PC to euthanasia.
Results— Two dogs had a significant increase in peak vertical force 2 weeks after PC ( P =.043) and remained free of lameness for 18 and 20 weeks, respectively. One dog had an acute relapse after an initially lame-free period of 10 days. The remaining dog failed to improve ( P =.686). Three dogs developed at least 2 complications including transient worsening of the lameness after PC, cement leakage, wound infection and suspected thromboembolism in combination with cough and anemia. Median survival was 4.8 months (range, 1–5.7 months).
Conclusions— PC in combination with pamidronate significantly improved lameness in 2 dogs; however, PC is not risk-free. Deep wound infection, intraarticular cement leakage, and venous thrombosis were the main complications.
Clinical Relevance— PC might be a useful addition to established palliative, multimodal treatment protocols in dogs with PBT; however, because of the complications encountered PC warrants further study before routine use can be considered.     

Management of fractures near the carpal joint of two calves by transarticular fixation with a circular external fixator

A four-ring circular external skeletal fixation device was evaluated for transcarpal fixation of compound fractures in two calves. Case 1 was an eight-month-old female Holstein-Friesian x indigenous breed calf weighing 72 kg, which had a Salter-Harris type II fracture at the distal metaphysis of the right radius/ulna with an open contaminated wound on the medial aspect of the carpus. Case 2 was an 18-month-old crossbred Haryana heifer weighing 105 kg, which had a comminuted fracture at the proximal end of its left metacarpus with severe soft tissue trauma and an open wound on the medial aspect. In both cases, the fractures were repaired with four-ring circular fixators by fixing the proximal two rings in the distal radius/ulna and the distal two rings in the metacarpus. Postoperatively, both calves were treated with analgesic and anti-inflammatory drugs and antibiotic, and the pin-bone interfaces and the open wound were cleaned regularly with povidone-iodine solution. In both animals weight bearing was good to excellent in the immediate postoperative period. The fixator was well maintained and tolerated by the animals until the fractures healed after 45 to 60 days. The movement of the carpal joint was slightly affected when the fixator was removed on day 60, but a follow-up examination after one year showed that both calves had normal functional usage of the limbs.     

Effects of 3 biologic dressings on healing of cutaneous wounds on the limbs of horses

Three biologic dressings [split-thickness allogeneic skin (STS)], allogeneic peritoneum (P), and xenogenic porcine small intestinal submucosa (PSIS)] were studied to determine their effects on bacterial proliferation, inflammatory reaction, vascularization, and overall healing and to compare the effects of these dressings with the effects of a nonbiologic dressing, a nonadherent synthetic pad (NASP). A medial wound (3 cm in diameter) and 2 lateral wounds (2 cm in diameter) were created at the junction of the proximal and middle thirds of each metacarpus and metatarsus in 5 horses. Each medial wound and the proximolateral wound received an STS, P, PSIS, or NASP dressing on day 8 after wounding. The other lateral wound received an NASP dressing. Bacterial proliferation, inflammatory reaction (histologic changes), and drhessing vascularization were evaluated 6 d after application of the dressing. Percentages of contraction and epithelialization, as well as healing time, were determined when the wounds had completely epithelialized. The practical applicability of the different dressings to equine wound management was also assessed. No significant difference was detected in the parameters evaluated among the treated wounds or between the treated and control wounds. The biologic dressings had no effect on infection, inflammatory response, or healing time. Vascularization was not identified in any of the biologic dressings. The PSIS and P dressings required numerous applications over the study period. The STS dressings are more practical than PSIS and P dressings owing to ease of application and stability. Thus, these biologic dressings offer no apparent advantage over a nonbiologic dressing for treatment of small granulating wounds.     

Two Regimes of Perioperative Antimicrobial Prophylaxis for Equine Castration: Clinical Findings,Acute-Phase Proteins,and Bacterial Cultures

A perioperative antibiotic for equine castration with second intention healing is controversial because the necessity is unclear and antimicrobial use promotes the selection of resistant bacteria. Information about different regimes for perioperative antimicrobial prophylaxis in equine castration is sparse. Goal of this study was to compare clinical findings, acute-phase proteins, and bacterial cultures in horses undergoing castration, treated with an intravenous single administration of penicillin G sodium (1× Pen group) or a 3-day course of daily intramuscular procaine penicillin (3× Pen group). Forty-eight stallions were castrated under general anesthesia using a closed technique, with second intention healing. Serum amyloid A (SAA) and fibrinogen were measured on days 0, 3, and 8. Body temperature, wound swelling, and drainage were recorded daily over 10 days. Bacterial swabs of the wound were taken on days 0 and 3. Scrotal swelling (P = .032), amount of drainage from the wound (P = .039), and body temperature (P = .013) on day 8 after castration were significantly higher in the 1× Pen group. The concentration of SAA and fibrinogen on day 8 was significantly higher in the 1× Pen group compared with the 3× Pen group (SAA: P = .049; fibrinogen: P = .035). β-Hemolytic Streptococcus spp. were found more frequently cultured in the 1× Pen group than in the 3× Pen group. Clinical and laboratory data indicate lower inflammatory reaction in the early postoperative period after three applications of penicillin compared with a single-administration. Further investigations evaluating the long-term outcome and potential development of antimicrobial resistant bacteria are needed.     

Costs and complications of equine castration: a UK practice-based study comparing 'standing nonsutured' and 'recumbent sutured' techniques

REASONS FOR PERFORMING STUDY: Clinicians are often asked to guide owners and trainers over the relative advantages and disadvantages of equine castration performed in either the standing horse with an open unsutured scrotal wound with healing by second intention, or a recumbent horse under general anaesthesia in aseptic conditions, with sutured scrotal skin allowing primary wound closure. OBJECTIVES: To identify types and frequency of complications following the 2 differing approaches, and to compare the financial cost associated with each procedure, based on practice charges. METHODS: Veterinary expenses of 217 horses castrated by a Newmarket equine veterinary practice over an 18-month period were analysed. Of these, Group 1 (n = 121) were castrated standing and nonsutured by one of 2 ambulatory clinicians and Group 2 (n = 96) castrated in recumbency, in aseptic equine hospital conditions. RESULTS: Group 1 had a complication prevalence of 22% with no mortalities, and Group 2 a significantly lower complication prevalence of 6% (P = 0.001) with a mortality rate of 1%. The financial cost of Group 1, without complications, was approximately one-third of the cost of uncomplicated Group 2. However, the cost of Group 1 with complications increased to approximately two-thirds of the cost of an uncomplicated Group 2 castration. CONCLUSIONS: Even though the complication prevalence for Group 1 castrations leaving an open scrotal wound was significantly higher than for a recumbent horse with a sutured scrotal wound in a hospital, the average cost of Group 1 was still less, even taking into account the additional follow-up costs associated with treating such complications. POTENTIAL RELEVANCE: This report provides a benchmark for the outcome of 2 methods of castration based on a database obtained from particular circumstances within the practice involved. Further studies are required to corroborate and take into account future development in surgical and anaesthetic techniques.     

Differences in cutaneous wound healing between dogs and cats.

Regardless of the species involved, wound healing follows a predictable course of overlapping phases. In spite of these commonalities, significant species differences in cutaneous wound healing have been uncovered in the Equidae and, more recently, between the dog and cat. It has also recently been shown that the subcutaneous tissues play an important supporting role in cutaneous wound healing, which may help to ex-plain healing differences between cats and dogs. These discoveries may improve veterinarians' understanding of problem wound healing in the cat and, hopefully, lead to better strategies for wound management in this sometimes troublesome species.     

Comparison of a liquid and a powder insecticidal dressing to aid healing and prevent flystrike of mulesing wounds in lambs

A proprietary insecticidal mulesing powder containing diazinon and an experimental liquid dressing based on eucalyptus oil, naphthalene, cresylic acid and chlorfenvinphos in a carrier of liquid hydrocarbons and petroleum oil were compared for their ability to promote wound healing and reduce the incidence of fly strike in freshly mulesed lambs. Throughout the trial period of 4 weeks, fly trapping confirmed the presence of Lucilia cuprina in the paddock where the ewes and lambs were grazing At inspection one month after mulesing, no deaths had occurred since mulesing and no lambs showed evidence of cutaneous myiasis, although a number of their dams (with 8 months wool) were struck. At 4 weeks after mulesing, the wounds of the lambs treated with the experimental liquid dressing showed better healing than those treated with the powder dressing. It was concluded that both mulesing preparations were effective in inhibiting flystrike, but the liquid dressing promoted faster wound healing than did the powder.     

Treatment of inherently unstable open or infected fractures by open wound management and external skeletal fixation

OBJECTIVES: To assess the use of external skeletal fixation with open wound management for the treatment of inherently unstable open or infected fractures in dogs. METHODS: A retrospective review of 10 cases. RESULTS: Fracture stabilisation and wound management required only a single anaesthetic, and despite the challenging nature of these injuries, the final outcome was acceptable or good in every case. However, minor complications associated with the fixator pins were quite common, and two dogs developed complications which required additional surgery. CLINICAL SIGNIFICANCE: Open management of wounds, even when bone was exposed, proved to be an effective technique, and external skeletal fixators were usually effective at maintaining stability throughout an inevitably extended fracture healing period.