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InFocus

Recent papers published on dealing with wounds

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.

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