The Best Protocol to Treat Equine Skin Wounds by Second Intention Healing: A Scoping Review of the Literature

Equine skin wound treatment continues to be a challenge for veterinarians. Despite being a frequent practice, it remains difficult to choose an evidence-based treatment protocol. This study aimed to comprehensively explore the literature and provide a scoping review of therapeutic strategies for equine skin wounds and identify knowledge gaps and opportunities for future research. This review was conducted using specific criteria to select literature that described methods to manage second intention wound healing. After removing duplicates and screening papers for suitability, 81 manuscripts were included for data extraction. Of these, 59 articles were experimental studies, 10 were case reports, 9 were case series, and 3 were clinical studies. The most frequent wound location was the distal limbs. Macroscopic assessment was the main tool used to evaluate treatment effectiveness. All of the case reports, case series, and clinical studies reported positive outcomes with regard to the treatment used, while only 36% of the experimental studies found significant healing improvement in treated wounds compared to control groups. It was found that there are many treatments that have exhibited controversial results, and there exists a lack of evidence for the adoption of specific treatment protocols.

In vitro elution of amikacin from four hydrogel preparations: A pilot study

OBJECTIVE

To determine in vitro elution of amikacin from poloxamer 407 NF, 1% carboxymethylcellulose (CMC), 3% CMC, 5% CMC, and control (sterile water).

STUDY DESIGN

Descriptive in vitro.

SAMPLE POPULATION

Triplicate samples from each experimental group.

METHODS

Amikacin solution was prepared in poloxamer 407 NF, 1% CMC, 3% CMC, 5% CMC, or sterile water. Then, 1 ml of phosphate-buffered saline (PBS) was added to each of three aliquots per base and the samples were incubated at 37°C. PBS was removed and replaced at 1, 4, 8, 12, 24, 48, 72, 96, 120, 144, 168, 192, 216, and 240 hours and amikacin concentration was measured.

RESULTS

The highest median concentration of amikacin in the eluent of poloxamer 407 NF, 3% CMC, and 5% CMC was observed at 48 hours: 3300, 3030, and 2190 μg/ml, respectively. The highest median concentration of amikacin in the eluent of 1% CMC and sterile water were observed at 1 hour: 13300 and 15600 μg/ml, respectively. Median eluent concentration of amikacin exceeded 2000 μg/ml (the reported minimum inhibitory concentration [MIC] of certain biofilm-producing methicillin-resistant Staphylococcus pseudintermedius) from 24 to 96 hours for poloxamer 407 NF, 24-72 hours for 3% CMC, 48-72 hours for 5% CMC, 1-4 hours for 1% CMC, and 1-4 hours for sterile water.

CONCLUSION

Amikacin elution from tested substances reached or exceeded target MIC during the 240 hours tested.

CLINICAL SIGNIFICANCE

Hydrogel-amikacin solutions may be useful topical treatment options for some infected wounds. In vivo safety and efficacy should be evaluated.