Dressings, Bandages, and Splints for Wound Management in Dogs and Cats

A Prospective, Blinded, Open-Label Clinical Trial to Assess the Ability of Fluorescent Light Energy to Enhance Wound Healing after Mastectomy in Female Dogs

Mammary gland tumors represent the most frequently diagnosed malignant neoplasm in intact female dogs, and surgical removal represents the current gold standard treatment. To promote wound healing and prevent possible bacterial contamination, perioperative antimicrobials are commonly used in clinical practice, even though there are no publications establishing guidelines for the use of such drugs in canine mastectomy. The aim of the present study was to evaluate the ameliorative effect of fluorescent light energy on the quality of the healing process after mastectomy surgery in female dogs, in the absence of perioperative antimicrobial administration. Nine female dogs received a multiple-gland mastectomy due to gland tumors and received FLE application immediately after surgery and then five days after. The surgical incisions were evaluated by a blind investigator over time using the Modified Hollander Cosmesis and Modified Draize Wound Healing Score systems. Statistical analysis revealed a significant ameliorative effect of FLE in the control of step-off borders, contour irregularities, and excessive distortion. In addition, erythema, edema, and serous discharge were lower for those wounds managed with FLE. These results underscore the advantageous impact of FLE on the healing of post-mastectomy wounds in female dogs, offering the dual benefits of reducing potential infection risks and lessening the home care burden for pet owners.

Use of a semitendinosus myocutaneous flap for the coverage of hindlimb full-thickness skin defects in cats

BACKGROUND

The management of feline hindlimb full-thickness skin defects is challenging. On the other hand, the use of a semitendinosus (ST) myocutaneous flap for their coverage has not been reported.

OBJECTIVES

To describe the ST flap and compare it with second intention healing for managing hindlimb full-thickness skin defects.

METHODS

In 12 purpose-bred laboratory domestic short-haired cats, two wounds were made on each tibia. The wounds in group A (n = 12) were covered with ST flaps, and those in group B (n = 12) were left to heal by second intention. In both groups, clinical assessment scoring and planimetry were performed between one-30 d postoperatively. Computed tomography-angiography (CTA) was performed on days zero, 10, and 30, and histological examinations were performed on days zero and 14 and at 6 and 12 mon postoperatively.

RESULTS

Statistically significant differences in the clinical assessment scores were observed between groups A and B on days 14 (p = 0.046) and 21 (p = 0.016). On the other hand, the time for complete healing was similar in the two groups. CTA revealed significant differences in the muscle width (day 0 compared to days 10 and 30 [p = 0.001, p = 0.026, respectively], and days 10 to 30 [p = 0.022]), ST muscle density, and the caliber of the distal caudal femoral artery and vein (day 0 compared to day 10 [p < 0.001], and days 10 to 30 [p < 0.001]). Histologically significant differences in inflammation, degeneration, edema, neovascularization, and fibrosis were observed on day 14 compared to zero and 6 mon, but no differences were found between the time interval of 6 and 12 mon.

CONCLUSIONS

An ST flap can be used effectively to manage hindlimb full-thickness skin defects.

Clinical Benefits of Using a Smartphone Application to Assess the Wound Healing Process in a Feline Patient - A Case Report

The aim of this paper was to determine whether digital imagery can be employed in veterinary medicine to measure and analyze wound healing dynamics. A smartphone application (ImitoMeasure) was used to capture, measure, and analyze the metatarsal wound images in a cat patient. The smartphone app was used to evaluate the wound area, width, length, and circumference at the time of topical treatments. Further analysis of the measurements taken by the ImitoMeasure app revealed significant correlations among all analyzed parameters. The day of treatment was inversely correlated with all the parameters of the wound, showing the healing progress over time. Also, the width was the most influential parameter (P ≤ .05) when assessing wound area. Thus, the app provided a noncontact, easy to use, and accurate smart wound measurement solution. Additionally, this case report describes the treatment of a cat with a severe chronic metatarsal wound and extensive soft tissue loss using a commercially available silver calcium alginate dressing (Askina Calgitrol Ag, B. Braun). The dressing was changed every 2 days, in the first week of treatment, and then every 3 days until the cat was discharged, 21 days later. Granulation tissue formed rapidly, from the fourth day of treatment and continued to expand in the entire wound bed; epithelization process started since the 16th day of treatment and mature scar tissue could be observed 21 days postinjury.

A Textile Pile Debridement Material Consisting of Polyester Fibers for in Vitro Removal of Biofilm

Biofilms formed on skin wound lead to inflammation and a delay of healing. In the present work, a novel textile pile debridement material was prepared and treated by plasma. Samples before and after plasma treatment were characterized by a series of methods, including scanning electron microscopy (SEM), atomic force microscopy (AFM), X-ray photoelectron spectroscopy (XPS), and water uptake capacity. Besides, mechanical, coagulation, and in vitro biofilm removal performances of the textile pile debridement material were evaluated, with a medical gauze as a control. The results demonstrate that the plasma treatment produced corrosions and oxygen-containing polar groups on the fiber surface, offering an enhanced water uptake capacity of the textile pile debridement material. In addition, compressive tests certify the mechanical performances of the textile pile debridement material in both dry and wet conditions. The results from a kinetic clotting time test suggest a favorable ability to promote blood coagulation. Furthermore, the results of an MTT cell viability assay, SEM, and confocal laser scanning microscopy (CLSM) illustrate that the textile pile debridement material demonstrates a more superior in vitro biofilm removal performance than medical gauze. All of these characterizations suggest that the textile pile debridement material can offer a feasible application for clinical wound debridement.

The Effect of a Hydrocolloid Dressing on Second Intention Wound Healing in Cats

The objective of the present study was to evaluate the effect of a hydrocolloid dressing on second intention wound healing in cats. Two full-thickness skin wounds, measuring 2 × 2 cm, were created on both sides of the dorsal midline of 10 cats; bilaterally, one randomly selected wound was bandaged with a hydrocolloid dressing and the second one (control) with a semiocclusive pad. Subjective clinical evaluation of granulation tissue formation, of the quantity and nature of wound exudate, and planimetry were performed on the right-side wounds, and histological examination on the left. No significant differences in subjective clinical evaluation or in planimetry were observed between the hydrocolloid-treated wounds and controls. Most wounds had serous or absence of exudate (41.25% and 25%, respectively), whereas purulent exudate was observed in 7.5% of wounds. Edema was significantly increased in the hydrocolloid-treated wounds compared with controls on day 7 but no significant differences in the other histological variables were observed.

Initial Management of Traumatic Wounds

When traumatic wounds are quickly and accurately treated, morbidity and costs can be significantly decreased. Several factors, such as time delay between injury and treatment, the degree of contamination, extension and depth of the wound, and the mechanism of injury, influence the treatment and prognosis and stress the importance of a patient-specific approach. Although all traumatic wounds are contaminated, antibiotic therapy is seldom required if correct wound management is installed.

Retrospective comparison of negative pressure wound therapy and silver-coated foam dressings in open-wound treatment in cats

Objectives The objective of this study was to evaluate negative pressure wound therapy (NPWT) for the treatment of complicated wounds in cats. Methods Twenty cats undergoing open-wound treatment in two clinics were classed according to treatment method: NPWT (group A, n = 10) and polyurethane foam dressing (group B, n = 10). Pairs of patients from each group were matched based on wound conformation, localisation and underlying cause. Cats from both groups were compared in terms of duration of previous treatment, time to closure and complications. Results Signalment, duration of previous treatment, antibiotic and antiseptic treatment, and bacterial status were comparable between groups. Total time to wound closure was significantly shorter ( P = 0.046, strong effect size; Cohen d = 0.8) in group A (25.8 days, range 11.0-57.0 days) compared with group B (39.5 days, range 28.0-75.0 days). NPWT-treated wounds suffered fewer complications and became septic less frequently during treatment compared with wounds treated with a foam dressing. The progression of fat tissue necrosis was particularly well controlled under NPWT, resulting in fewer deaths due to this condition in this group. However, although a strong effect of NPWT on the progression of infection, fever and sepsis was detected (Cramer-V 0.5), this difference was not significant. Conclusions and relevance This study demonstrated that time to healing was considerably shorter, and complication rate lower, in NPWT-treated animals compared with foam dressing-treated cats. In particular, the effective management of infection by NPWT emphasises the value of NPWT in the treatment of cats suffering from infected wounds.

Management of a facial partial thickness chemical burn in a dog caused by bleach

OBJECTIVE

To describe the management and successful outcome of a late-recognition partial thickness bleach burn to the face and corneas of a dog.

CASE SUMMARY

A 1-year-old male neutered Fox Terrier mix breed dog was evaluated for sloughing facial epithelium 5 days after coming into contact with an 8.25% household bleach cleaning solution. Severe erythema, edema, and crusting were noted around the muzzle and margins of both eyes, with moderate to severe alopecia in these areas. A partially detached, partial thickness eschar was present on the muzzle, while a firmly attached eschar was present in the region of both frontal sinuses. These injuries were consistent with a focal, superficial, and partial thickness chemical burn. Multiple ocular abnormalities, the most concerning of which was corneal ulceration, were also present. The patient's wounds were managed conservatively with limited surgical debridement of the affected epithelium 11 and 22 days after the initial exposure. Topical ocular medications, corneal debridement, and a superficial keratectomy were also used. All lesions resolved completely by 84 days postexposure, with no residual effects on the patient's quality of life.

NEW INFORMATION

Chemical burns caused by contact with alkaline agents such as bleach (sodium hypochlorite) result in extensive necrosis of the skin and underlying structures. This is the first report of management alkaline facial burns in a dog. If inadequate or delayed hydrotherapy following exposure has resulted in superficial partial thickness burns, conservative management can be successful when traditional treatments, especially bandaging, are not feasible.

Principles of Wound Management and Wound Healing in Exotic Pets

The care of wounds in exotic animal species can be a challenging endeavor. Special considerations must be made in regard to the animal's temperament and behavior, unique anatomy and small size, and tendency toward secondary stress-related health problems. It is important to assess the entire patient with adequate systemic evaluation and consideration of proper nutrition and husbandry, which could ultimately affect wound healing. This article summarizes the general phases of wound healing, factors that affect healing, and principles of wound management. Emphasis is placed on novel methods of treating wounds and species differences in wound management and healing.

Effects of two occlusive, hydrocolloid dressings on healing of full-thickness skin wounds in cats

OBJECTIVES

To determine the effects of two occlusive, hydrocolloid dressings on second intention wound healing in cats.

METHODS

Three 2×2 cm full-thickness skin wounds were created on each side of the trunk of 10 cats. Two bilateral wounds were bandaged using different hydrocolloid dressings, namely Hydrocoll and DuoDerm while a semi-occlusive pad (Melolin) was applied to the third bilateral wound (control group). Wound planimetry, subjective evaluation of wound healing, and qualitative bacterial cultures were performed on the right-sided wounds, whereas left-sided wounds were subjected to histological examination.

RESULTS

Subjective evaluation revealed accelerated (p <0.01) granulation tissue formation in hydrocolloid-treated wounds. The amount of wound exudate was initially greater (p <0.01) in these wounds. Seventeen out of 120 evaluated wounds (14.2%) produced purulent exudate, 11 of which showed Staphylococcus aureus growth. Fewer control wounds (3/17) emitted purulent exudate, but all of them yielded moderate bacterial growth as compared to hydrocolloid-treated wounds (8/17) which had a low incidence of bacterial growth. The only significant difference in histological variables was increased cellular infiltration noted on day 7 in Hydrocoll-treated wounds compared to controls. No significant differences in planimetry variables were found between groups.

CLINICAL SIGNIFICANCE

Despite the initially increased amount of wound exudate and the low growth of Staphylococcus aureus, hydrocolloid dressings accelerate granulation tissue formation and can hence be suggested for second intention wound healing in cats.

Negative pressure wound therapy, silver coated foam dressing and conventional bandages in open wound treatment in dogs. A retrospective comparison of 50 paired cases

OBJECTIVES

To evaluate negative pressure wound therapy (NPWT) for treatment of complicated wounds in dogs.

STUDY TYPE

Retrospective multicentre study.

MATERIALS AND METHODS

Dogs (n = 50) undergoing open wound treatment were classified according to treatment method used: bandage (Group A, n = 7), NPWT (Group B, n = 18), and foam dressing (Group C, n = 25). Pairs of patients matched based on wound conformation, localization, and underlying cause were compared between Group A and C (n = 7 pairs) and between groups B and C (n = 18 pairs) in terms of duration of previous treatment, time to closure, and complications.

RESULTS

Signalment, antibiotic medications, antiseptic treatment, and bacterial status of wounds were comparable between groups. The duration of previous treatment was significantly higher in patients assigned to Group B (p = 0.04) compared to Group C, while no significant difference was found between groups A and B. Total time to wound closure was significantly shorter in Group C compared to Group A (p = 0.02) and in Group B compared to Group C (p = 0.003). Wounds treated with NPWT suffered significantly less complications (p = 0.008) and were significantly less septic during treatment (p = 0.016) than wounds treated with a foam dressing.

CONCLUSION

This study shows that time to healing was halved in NPWT treated patients compared to foam dressing treated patients, which in turn healed faster than patients treated with conventional bandage, underlining the value of NPWT therapy for the treatment of complicated wounds.

Use of a custom orthotic boot for management of distal extremity and pad wounds in three dogs

OBJECTIVE

To describe use of a custom orthotic boot for management of distal extremity and pad wounds in dogs.

STUDY DESIGN

Clinical report.

ANIMALS

Dogs (n = 3).

METHODS

A custom orthotic boot made of lightweight copolymer plastic was used to immobilize the distal extremity and protect full-thickness wounds involving the medial or lateral aspect of the metatarsus including a portion of the metatarsal pad in 3 dogs. Boots were made in a bivalve design with closed-cell foam padding and adjustable straps that allowed for easy application. They were molded with the tarsocrural joint in slight hyperextension and the metatarsophalangeal joints in a neutral position so that the wounds and metatarsal pads were "off weighted" when the dogs were standing. In addition, a "window" was cut out directly over the wounds to minimize direct contact between the boot and the wound.

RESULTS

Wounds healed by contraction and epithelialization in 21, 21, and 45 days. The only complication encountered was mild skin irritation at the top of the boot in 2 dogs that was managed with additional closed-cell foam padding.

CONCLUSION

A custom orthotic boot was effective at immobilizing the distal extremity and reducing contact between the wound and the boot which allowed for complete healing by contraction and epithelialization.

Severe burn injury, burn shock, and smoke inhalation injury in small animals. Part 2: diagnosis, therapy, complications, and prognosis

OBJECTIVE

To review the evaluation and treatment of patients suffering from severe burn injury (SBI), burn shock, and smoke inhalation injury. Potential complications and prognosis associated with SBI are also discussed.

DIAGNOSIS

Diagnosis of burn injury and burn shock is based on patient history and clinical presentation. Superficial burn wounds may not be readily apparent for the first 48 h whereas more severe wounds will be evident at presentation. Patients are diagnosed with local or SBI by estimating total body surface area involved using the 'Rule of Nines' or the Lund-Browder chart adapted from the human literature.

THERAPY

Patients suffering from SBI require immediate and aggressive fluid therapy. Burn wounds require prompt cooling to prevent progressive tissue damage. Due to significant pain associated with burn wounds and therapeutic procedures, multimodal analgesia is recommended. Daily wound management including hydrotherapy, topical medications, and early wound excision and grafting is necessary with SBI.

COMPLICATIONS

There are numerous complications associated with SBI. The most common complications include infections, hypothermia, intra-abdominal hypertension, and abdominal compartment syndrome.

PROGNOSIS

The prognosis of SBI in domestic animals is unknown. Based on information derived from human literature, patients with SBI and concomitant smoke inhalation likely have a worse prognosis than those with SBI or smoke inhalation alone.

Use of commercially available foam pipe insulation as a protective device for wounds over the elbow joint area in five dogs

CASE DESCRIPTION

4 large-breed dogs were referred because of nonhealing skin wounds involving the elbow joint area of several weeks to months in duration. One additional large-breed dog was evaluated because of a draining abscess with overlying skin necrosis.

CLINICAL FINDINGS

Previous attempts at closing each wound over the elbow joint area had been unsuccessful. At the time of hospital admission, open wounds had variable degrees of bacterial contamination and infection.

TREATMENT AND OUTCOME

Open wounds over the elbow joint area were closed by use of bipedicle advancement flaps or direct suture apposition of opposing sides of the wound. Lengths of pipe insulation were applied to the forelimb in a fashion to prevent contact pressure to the olecranon for a prolonged period (4 to 13 weeks) after surgery. All wounds healed completely. Release incisions (donor areas) healed by second intention within 3 weeks after surgery. One dog developed periostitis of the olecranon, which responded to antimicrobial administration. A second dog developed a skin bacterial infection below the surgical area that was markedly resistant to antimicrobials.

CLINICAL RELEVANCE

The layered application of commercially available foam pipe insulation provided a simple and economical protective device after closure of problematic skin wounds involving the elbow joint area. Prolonged protection of the olecranon area helped to assure healing was complete and skin coverage was sufficiently stable to reduce the risk of reinjury after removal of the device. Each patient was able to use the involved forelimb during the treatment period. Paired bipedicle advancement flaps (release incisions) were particularly useful for closing small to moderate defects overlying the olecranon in which simple apposition was not feasible.