Use of potentiated antibiotics in wound management

SERIAL CHEMICAL RESTRAINT FOR TREATMENT OF DECUBITUS ULCERS IN TWO NEONATAL WHITE RHINOCEROSES (CERATOTHERIUM SIMUM)

Two neonatal white rhinoceroses (Ceratotherium simum) at two zoological institutions were medically managed for wounds characterized by extensive multifocal necrosis of the skin and subcutaneous tissue, associated with decubitus ulcers throughout the body. Wounds resulted from prolonged recumbency due to inability to stand in one case and causes unconfirmed in the other. Both calves were born in cement stalls during winter. Using either butorphanol (i.v. or i.m.) alone or in combination with detomidine (i.m.), serial chemical restraint was conducted over a 6-wk period to facilitate wound care. Anesthesia was well tolerated in both calves, and lesions responded well to medical treatment.

Use of antimicrobials in wound management

Antimicrobial medication should be considered an adjunct to the general care of wounds rather than a substitute for lavage, drainage, or other physical care intended to promote healing. Judicious use is based on results of diagnostic procedures and the professional judgment of the attending veterinarian. Organisms that contaminate or infect wounds of horses are similar to those that can affect human patients, such that personal hygiene and protection are important when caring for these equine patients, because attendants can easily be exposed to them. Although those organisms are considered to be ubiquitous, the inoculum that may be present on or in an infected wound may be substantially greater than that encountered during other daily activities of the veterinarian. Proper disposal of the bandage materials and personal protective clothing is important. Bacterial resistance is one of many "survival tactics" of bacteria and has been an important clinical consideration for physicians and veterinarians since antimicrobial drugs were discovered. Controversies and insufficient understanding of bacterial resistance abound, however. The entirety of the subject is beyond the scope of this article, but it is important to the veterinary profession and for the formulation of wound management in horses. We and our animal patients live in a world populated by microbial organisms of various types. Resistance among bacteria is likely to continue to be a clinical consideration in the future as it has been during the past 60 to 70 years. As veterinarians, we must recognize the zoonotic nature of resistance and implement biosecurity procedures to protect ourselves, other people in contact with those pathogens, and our patients. We must also recognize the merits of judicious targeted use of antimicrobial drugs and apply appropriate principles during the course of professional care for the well-being of our animal patients.