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.     

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.     

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.     

Comparison of equine amnion and a nonadherent wound dressing material for bandaging pinch-grafted wounds in ponies

OBJECTIVE: To evaluate healing of pinch-grafted wounds on the distal aspect of the limbs of ponies bandaged with equine amnion or a standard nonadherent wound dressing material. ANIMALS: 6 ponies. PROCEDURE: A 2.5x2.5-cm full-thickness section of skin was removed from the dorsal aspect of each limb at the midpoint of the metacarpus or metatarsus. Six days later, wounds were grafted with partial-thickness pinch grafts. Half the wounds were bandaged with amnion, and the other half were bandaged with a nonadherent dressing. Bandages were changed every 3 days until wound healing was complete. At each bandage change, numbers of grafts lost were recorded, and wounds were measured. RESULTS: Percentage of grafts lost from wounds bandaged with amnion was not significantly different from percentage lost from wounds bandaged with the nonadherent dressing. Median healing time for wounds bandaged with amnion (30 days) was significantly less than median healing time for wounds bandaged with the nonadherent dressing (39 days). All wounds were healed by day 45. CONCLUSIONS AND CLINICAL RELEVANCE: Results suggest that amnion can be used for bandaging pinch-grafted wounds on the distal aspect of the limbs of ponies.     

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.     

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.     

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 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 periodontal dressings on fibroblasts and gingival wound healing in dogs

In the present study the effects of different commercially available periodontal dressings (Peripac, Barricaid, Fittydent, Reso-Pack and Myzotect-tincture) on fibroblast (V-79-379A) proliferation and survival were tested in vitro. Barricaid, Fittydent and Reso-Pack periodontal dressings have only small inhibitory effects on cell proliferation (83.3 +/- 9%, 71.6 +/- 8.7% and 87.3 +/- 4.5% of control after 48 h, respectively) in comparison with the great inhibitory effect of Myzotect-tincture (2.9 +/- 0.1%) and Peripac (33.7 +/- 11.4%) (p < 0.001). Barricaid was the only dressing where 41% of cells survived after exposure, while the other four dressings killed all the cells in 6 days. In addition, the healing of artificially created gingival wounds covered by Barricaid and Reso-Pack was followed for 7 days in 12 Beagle dogs. Histological evaluation of gingival tissue demonstrated that wounds covered by Reso-Pack showed the best epithelisation and vascularity and the least inflammatory reaction in first 4 days. Later the observed parameters were similar with those of wounds covered by Barricaid or without pack. The present results indicate that Peripac periodontal dressing and Myzotect-tincture showed the highest cytotoxicity to fibroblasts in vitro. From the histological observations in Beagle dogs Reso-Pack has been found to be the most suitable dressing, followed by Barricaid.     

Effects of amnion and live yeast cell derivative on second-intention healing in horses

Equine amnion and live yeast cell derivative were evaluated as a biological dressing and as a topical wound medicament respectively, in the treatment of granulating wounds of the distal portion of the limbs of horses. Wounds measuring 2.5 x 2.5 cm were created on the dorsomedial aspect of the metacarpal and metatarsal region of all 4 limbs of 9 horses. Each wound was assigned randomly to 1 of 3 treatment groups: group C, treated with a nonadherent bandage as a control; group A, treated with amnion beneath a nonadherent bandage; and group L, treated with live yeast cell derivative beneath a nonadherent bandage. Rates of contraction and epithelialization were not significantly different among groups. Percentage of epithelialization for group A was significantly greater throughout the study than for the other groups. Number of days to complete healing was significantly less in group A and significantly greater in group L than in group C. Incidence and severity of exuberant granulation tissue were significantly less in group A than in the other 2 groups. Group L had more frequent and severe cases of exuberant granulation tissue than the other 2 groups.     

Evaluation of dressings to aid healing of mulesing wounds on sheep

Five proprietary and one experimental dressing were compared with no treatment in their ability to aid healing of mulesing wounds in over 1900 young lambs. Healing was judged as the completeness of shrinkage of the mulesing cuts and the condition of scabs on the new skin surface. When assessed at 21 d it was found that treatment with Heriots Crown Wound Powder or Coopers Mulesing Powder offered a significant advantage over leaving the wounds untreated. Neither aqueous organophosphate washes, Defiance nor Defiance containing 0.08% chlorfenvinphos offered any healing advantage over controls. However, washing the wounds with an aqueous organophosphate solution aided healing more than the Defiance-based dressings. It was considered that the powders or the washes encouraged quick scab formation either by creating a dry covering (powders) or by washing away blood and allowing fast drying of the wound. The Defiance-type dressings slowed healing by keeping the wound moist for up to 10 d, but healing was not significantly different to the untreated group by 21 d.     

Effects of Negative Pressure Wound Therapy on Healing of Open Wounds in Dogs

Objective: To compare the effect of negative pressure wound therapy (NPWT) with standard‐of‐care management on healing of acute open wounds in dogs. Study Design: Prospective, controlled, experimental study. Animals: Adult dogs (n=10). Methods: Full‐thickness 4 cm × 2 cm wounds were surgically created on each antebrachium and in each dog were randomized to receive either NPWT or standard wound dressings (CON) for 21 days. Dressing changes and wound evaluations were made at 8 time points. First appearance of granulation tissue, smoothness of granulation tissue, exuberance, percent epithelialization, and percent contraction were compared. Biopsies for histopathology were taken, and histologic scores determined, at 5 time points, and aerobic bacterial wound cultures performed at 2 time points. Results: Granulation tissue appeared significantly earlier, and was smoother and less exuberant in NPWT wounds compared with CON wounds. Percent contraction in NPWT wounds was less than CON wounds after Day 7. Percent epithelialization in NPWT wounds was less than CON wounds on Days 11, 16, 18, and 21. Histologic scores for acute inflammation were higher in NPWT on Day 3, and lower on Day 7, than CON wounds. Bacterial load was higher in NPWT on Day 7. Conclusion: NPWT accelerated appearance of smooth, nonexuberant granulation tissue; however, prolonged use of NPWT impaired wound contraction and epithelialization.     

Effect of bandaging on second intention healing of wounds of the distal limb in horses

Objective   To evaluate the effect of a non-occlusive dressing incorporated in a 3-layer bandage on second intention healing of wounds of the distal portion of the limb.
Study Design   Untreated wounds in 33 adult horses used in four studies using the same wound-healing model conducted over 5 years.
Methods   Standardised, full-thickness wounds were made in the skin overlying the dorsomedial aspect of the mid-metacarpus; 17 horses were bandaged with a non-occlusive dressing covered by gauze-coated cotton wool that was compressed with adhesive tape; 16 horses were left unbandaged. Wounds were photographed weekly for 9 weeks and the images were analysed electronically.
Results   There were significant effects associated with bandage (P < 0.0001), week (P < 0.001), and bandage by week interaction (P < 0.0001). There was no difference in wound area at the first time-point after wound creation (P = 0.38). After week 1, there was a difference between bandaged and unbandaged wounds in wound area at each measurement until the end of the study. Bandaged wounds showed greater and more prolonged retraction. Unbandaged wounds retracted for 2 weeks before beginning to contract, whereas bandaged wounds continued to retract for 3 weeks. In bandaged wounds excess granulation tissue required regular trimming, but not in unbandaged wounds. There was no difference between groups in the total days to healing or the overall rate of healing.
Conclusions   These results should be treated with caution until validated with contemporaneous, controlled studies. Covering a wound with a non-occlusive dressing in a 3-layer bandage led to greater wound retraction, modulated the rate of wound contraction and promoted excessive granulation tissue. If excessive granulation tissue is excised regularly, bandaging has no effect on total time to healing.     

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.     

Effect of a silicone-containing dressing on exuberant granulation tissue formation and wound repair in horses

OBJECTIVE: To determine the effect of a silicone dressing on the rate and quality of repair of limb wounds and compare microvascular occlusion and apoptosis in wounds treated with the silicone dressing and those treated with a conventional dressing in horses. ANIMALS: 5 horses. PROCEDURE: Horses received two 6.25-cm2 wounds on each metacarpus. Ten wounds were treated with a silicone dressing; the other 10 were treated with a control dressing. Quality of repair and wound size were evaluated at each bandage change. Time to healing and the number of excisions of exuberant granulation tissue were recorded. Biopsy specimens taken from healed wounds were evaluated semiquantitatively via histologic examination, p53 immunohistochemical analysis, terminal deoxynucleotidyl transferase-mediated dUTP-biotin nick end labeling (TUNEL) to quantify apoptosis, and electron microscopic examination to measure microvessel luminal diameters. RESULTS: The silicone dressing surpassed the conventional dressing in preventing formation of exuberant granulation tissue and improving tissue quality. Microvessels were occluded significantly more often in wounds dressed with the silicone gel, which also diminished the expression of mutant p53, an indirect inhibitor of apoptosis, although greater apoptosis was not confirmed quantitatively by use of TUNEL. CONCLUSIONS AND CLINICAL RELEVANCE: Because the silicone dressing inhibited the formation of exuberant granulation tissue, it may be integrated in a management strategy designed to improve the repair of limb wounds in horses.     

Evaluation of LHP? (1% hydrogen peroxide) cream versus petrolatum and untreated controls in open wounds in healthy horses: a randomized,blinded control study

Background

Treatment and protection of wounds in horses can be challenging; protecting bandages may be difficult to apply on the proximal extremities and the body. Unprotected wounds carry an increased risk of bacterial contamination and subsequent infection which can lead to delayed wound healing. Topical treatment with antimicrobials is one possibility to prevent bacterial colonization or infection, but the frequent use of antimicrobials ultimately leads to development of bacterial resistance which is an increasing concern in both human and veterinary medicine.

Methods

Standardized wounds were created in 10 Standardbred mares. Three wounds were made in each horse. Two wounds were randomly treated with LHP^® or petrolatum and the third wound served as untreated control. All wounds were assessed daily until complete epithelization. Protocol data were recorded on day 2, 6, 11, 16, 21 and 28. Data included clinical scores for inflammation and healing, photoplanimetry for calculating wound areas and swab cytology to assess bacterial colonization and inflammation. Bacterial cultures were obtained on day 2, 6 and 16.

Results

Mean time to complete healing for LHP^® treated wounds was 32 days (95%CI = 26.9-37.7). Mean time to complete healing for petrolatum and untreated control wounds were 41.6 days (95%CI = 36.2-47.0) and 44.0 days (95%CI = 38.6-49.4) respectively. Wound healing occurred significantly faster in LHP^® wounds compared to both petrolatum (p = 0.0004) and untreated controls (p < 0.0001). There was no significant difference in time for healing between petrolatum and untreated controls. Total scores for bacteria and neutrophils were significantly (p < 0.0001) lower for LHP^® treated wounds compared to petrolatum from day 16 and onwards. Staphylococcus aureus and Streptococcus zooepidemicus were only found in cultures from petrolatum treated wounds and untreated controls.

Conclusions

Treatment with LHP^® reduced bacterial colonization and was associated with earlier complete wound healing. LHP^® cream appears to be safe and effective for topical wound treatment or wound protection.     

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.     

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.     

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.     

In vitro efficacy of a polyhexamethylene biguanide-impregnated gauze dressing against bacteria found in veterinary patients

OBJECTIVE: To evaluate the in vitro efficacy of polyhexamethylene biguanide (PHMB)-impregnated gauze dressing in limiting the growth of bacteria both within and underneath the dressing. STUDY DESIGN: In vitro study. METHODS: Squares of PHMB-impregnated and control gauze were placed on agar plates inoculated with 1 of 11 bacterial species, including 8 multi-resistant organisms. Growth under the gauze was assessed qualitatively after 24-hour incubation. Repeated use of sponges was used to evaluate residual inhibitory activity against Micrococcus lutea and Staphylococcus schleiferi ss. schleiferi. In a second procedure, PHMB-impregnated and control gauze squares were placed in sterile plastic wells and inoculated with 1 of 5 bacterial species, including Pseudomonas spp. and Klebsiella spp. Inhibition of bacterial growth within and underneath the dressing after 24-hour incubation was evaluated by quantifying the numbers of bacteria on the well floor and within each square. RESULTS: PHMB-impregnated gauze provided greater inhibition of growth of 4/4 Gram-positive species and 2/6 Gram-negative species on inoculated plates compared with control gauze. Residual inhibitory activity of PHMB-impregnated gauze was significantly greater against M. lutea on all days and against S. schleiferi ss. schleiferi on days 1 and 4 compared with control. No bacteria were recovered from inoculated PHMB-impregnated gauze squares placed in sterile wells or from the well floor underneath. More than 9 x 10(5) colony-forming units (CFU) were recovered from inoculated control samples placed in sterile wells and more than 8.4 x 10(4) CFU were recovered from control well floors. CONCLUSION: PHMB-impregnated gauze dressing, when placed on inoculated agar plates, reduces growth of underlying bacteria, particularly Gram-positive species. Wet-inoculated PHMB-impregnated dressing prevents growth of Gram-positive and Gram-negative bacteria both within and underneath the dressing. CLINICAL RELEVANCE: PHMB-impregnated dressings may be useful for reducing contamination of underlying wounds by bacterial pathogens.