Radical debridement guided by advanced imaging and frequent monitoring is an effective approach for the treatment of odontogenic abscesses and jaw osteomyelitis in rabbits: a review of 200 cases (2018-2023).

OBJECTIVE: To report the prevalence and document the treatment and outcome of odontogenic abscesses and associated jaw osteomyelitis in pet rabbits. ANIMALS: 200 client-owned rabbits. METHODS: Pet rabbits surgically treated using extraoral teeth extraction with marsupialization for abscesses of dental origin and jaw osteomyelitis were included in the study (February 2018 to February 2023). A case must have had pre- and postoperative computed tomographic study and a follow-up period of at least 4 months. RESULTS: In total, 113 male and 87 female rabbits were treated surgically. The mean age at the time of the diagnosis at the authors' clinic was 3 years and 11 months. Male rabbits suffered from odontogenic abscesses significantly more often than females. The mean surgical time varied from 25 to 95 minutes, based on the severity of the pathology and location. The wound healed completely in an average of 39.7 days (range, 14 to 145 days; 95% CI, 36.9 to 42.5 days). Major complications detected in 18.5% (37/200) cases were associated with prolonged healing time mostly due to the formation of a bone sequestrum and gingival suture failure. The disease-free time following abscess resolution was on average 29 months (range, 4 to 60 months). The recurrence of the odontogenic infection was 8% (16/200 cases). CLINICAL RELEVANCE: The radical surgical technique with the extraction of all the infected teeth with the removal of all affected tissue and osteomyelitic bone and regular follow-up wound management is an effective method for the treatment of odontogenic abscesses with jaw osteomyelitis.

Percutaneous ultrasonic debridement of equine tendinopathy and desmopathy: A report of 10 cases.

Background: Tendinopathy and desmopathy are significant causes of morbidity in horses. Aim: To evaluate the use of percutaneous ultrasonic debridement (PUD) as a treatment for chronic tendinopathy and desmopathy in the horse. Methods: Eight adult horses with 10 affected limbs presented for lameness, ranging from 60-700 days postinjury. Diagnostic ultrasound identified the following: suspensory branch desmitis (n = 1), suspensory body desmitis (n = 2), Achilles tendinopathy (n = 1), desmitis of the accessory ligament of the deep digital flexor (DDF) tendon (n = 1), DDF tendinopathy (n = 2), and superficial digital flexor tendinopathy (n = 3). All horses had demonstrated lameness ranging from grade 1 to 4 [American Association of Equine Practitioners (AAEP) scale], with a mean pretreatment grade of 2.7. All horses underwent PUD using the Tenex Health TX® System. Results: Follow-up results were available from 6 to 41 months (mean, 23.2 months). Follow-up ultrasound imaging demonstrated improvement in fiber alignment and architectural change in all cases. All horses had a reduction in lameness from the treated tendon or ligament (AAEP grade 0-1; mean AAEP grade, 0.2) following a single treatment; lameness completely resolved in 8 of 10 treated limbs. No adverse events occurred in any case. No horses in this study developed a recurrence of their original lesion. Conclusion: Horses in this study demonstrated improvement following the PUD procedure. The procedure was well-tolerated and safe. Removal of tendinopathic scar tissue with PUD resulted in a return to function and without recurrence of the original lesion in all horses.

Treatment of canine spontaneous chronic corneal epithelial defects (SCCEDs) with corneal thermal cautery: A retrospective study of 89 cases.

PURPOSE: To evaluate the clinical course and outcome of canine spontaneous chronic corneal epithelial defects (SCCEDs) treated with a combination of cotton-tip epithelial debridement (ED) and corneal thermal cautery (CTC), with or without diamond burr debridement (DBD). METHODS: Retrospective medical record review was used to identify dogs treated for SCCEDs at the Veterinary School of Toulouse between 2001 and 2021. The variables identified included signalment, history, clinical findings, previous treatments, and outcomes. Surgery was performed under manual restraint after topical anesthesia of the cornea. The outcome endpoints included healing, clearing of the cornea and complications. RESULTS: Seventy-seven dogs (89 eyes) from 28 different breeds fulfilled the inclusion criteria. The mean age was 8.78 years. The overall success rate after one procedure was 65.1% with a mean healing time of 15.4 days, but 21 eyes lost to follow-up after the initial treatment, were not included in calculations. There was no significant effect of age, eye, brachycephalic conformation and previous treatments. No significant differences in healing rates were found between groups that received DBD or not. Fifteen eyes (22.7%) underwent a second procedure. Complications (corneal pigmentation, uveitis, corneal bullae, and corneal infection) were observed in 15 cases (22%), with only two cases of complicating melting ulcer. CONCLUSIONS: CTC is a safe and effective treatment for SCCEDs in dogs and can be performed without general anesthesia. Additional DBD does not bring any significant value to CTC in SCCEDs. CTC could be interesting in cases where other procedures are less desirable.

Debridement and primary closure of a mesenteric duodenal perforation in a dog.

A 7-year-old male mixed intact breed dog was presented with a 6-day history of lethargy and anorexia. A linear foreign body was diagnosed and an exploratory laparotomy performed. The foreign body was pushed orad and removed via gastrotomy. Two mesenteric duodenal perforations were found: one at the level of the common bile duct and a second at the duodenal flexure. Both lesions were debrided and primarily closed in a simple interrupted appositional pattern. A gastrostomy tube and closed suction drain were placed routinely. The dog recovered without complications and ate voluntarily the first day postoperatively. The drain and gastrostomy tube were removed without incident at 4 and 15 days, respectively. Five months postoperatively the dog was reported to be clinically normal. Debridement and primary closure may represent an alternative to more extensive surgery with rerouting for duodenal perforations in select cases.

Long-term outcome of dogs treated by surgical debridement of proximal humeral osteochondrosis.

OBJECTIVE: To evaluate long-term clinical outcomes of dogs surgically treated for proximal humeral osteochondrosis (OC). STUDY DESIGN: Cross-sectional study. SAMPLE POPULATION: Twenty dogs (n = 26 shoulders). METHODS: Dogs treated with surgical debridement of proximal humeral OC lesions >12 months prior were enrolled. Orthopedic examination (including limb circumference and shoulder goniometry), kinetic gait analysis, shoulder radiographs, shoulder computed tomography (CT), and shoulder arthroscopy were performed. All owners completed a dog mobility questionnaire. RESULTS: Brachial circumference (P = .003) and maximum shoulder extension (P = .013) were decreased and maximum shoulder flexion (P = .008) was increased (ie less flexion) in the OC limb versus the contralateral limb in unilaterally affected dogs. There were no differences in peak vertical force and vertical impulse between affected and unaffected limbs. Dogs demonstrated a 4.4% decrease in load distributed to the operated limb. Osteoarthritis was present in all shoulders treated for OC lesions. The degree of osteoarthritis in OC-affected shoulders was increased compared to the contralateral limb as evaluated on CT (P = .005) and radiography (P = .0001) in unilaterally affected cases. Moderate-to-severe synovitis was seen in all OC-affected joints. Arthroscopically, all lesions were noted to have patchy, incomplete cartilaginous infilling. Median of aggregate Liverpool Osteoarthritis in Dogs (LOAD) scores was 6. CONCLUSION: All dogs exhibited ipsilateral muscle atrophy and progressive osteoarthritis, with most dogs exhibiting subtle lameness on the subjective gait examination. Despite this, owner-perceived mobility was satisfactory. CLINICAL SIGNIFICANCE: Progression of joint disease over time should be expected; however, the abnormalities detected on examination appear to be of questionable clinical relevance.

Corneal diamond burr debridement for superficial non-healing corneal ulcers in cats.

OBJECTIVE: To describe the clinical outcomes and efficacy of diamond burr debridement (DBD) treatment for corneal ulceration in cats. PROCEDURE(S): Medical records of cats that received DBD at two private practices between 2015 and 2021 were retrospectively reviewed. DBD was performed using a battery-powered, handheld motorized burr and a bandage contact lens was placed in 18/21 eyes. Corneal ulceration was considered resolved if the cornea was fluorescein negative with a stable epithelial surface. Recurrence was defined as return of corneal ulceration. Descriptive statistics and a Fisher's exact test were conducted on the study population. RESULTS: Twenty-one eyes from 20 cats with superficial corneal ulcers refractory to medical treatment underwent DBD. Domestic and Burmese were the most commonly encountered breeds and the median age of affected cats was 8.83 years (range 0.5-20 years). Corneal ulceration was present for a median of 14 days prior to DBD. Healing was achieved in 81% of eyes; with four eyes failing to heal and requiring further intervention. Corneal sequestrum was reported in one case that failed to heal. Of the healed cases, three cases recurred (17.6%) at a mean of 116.3 days (range 79-135 days). Burmese were overrepresented (p < .001) in cases that failed to heal or recurred (6/7 eyes; 85.7%). The median postoperative follow-up time was 93 days (range 6-1613 days). CONCLUSIONS: Diamond burr debridement is a safe, non-invasive treatment for corneal ulceration in cats but, compared with published results, it had a lower success rate than superficial lamellar keratectomy.

Local wound management: A review of modern techniques and products.

Management of wounds is a commonly performed and essential aspect of small animal veterinary medicine. Appropriate wound management is a difficult art to master, due to the inherent complexity of the clinical scenario, as well as the ever-evolving nature of the field with the constant addition of new products and techniques. This article reviews key concepts that may help the practitioner better understand the natural process of wound healing, factors that delay healing and strategies to help improve the local wound environment to make it more conducive to healing during open wound management. The concept of wound bed preparation is defined before common local wound management strategies, such as wound lavage and debridement, are discussed in more detail. Key aspects of the management of biofilms and appropriate use of antimicrobial agents are also reviewed. Finally, the concept of moist wound healing and its impact in modern wound management is explained before a broad variety of types of wound dressings are reviewed, with a particular focus on active dressings.

La prise en charge des plaies est un aspect courant et essentiel de la médecine vétérinaire pour petits animaux. La gestion appropriée des plaies est un art difficile à maîtriser, en raison de la complexité inhérente du scénario clinique, ainsi que de la nature en constante évolution du domaine avec l'ajout constant de nouveaux produits et techniques. Cet article passe en revue les concepts clés qui peuvent aider le praticien à mieux comprendre le processus naturel de cicatrisation des plaies, les facteurs qui retardent la cicatrisation et les stratégies pour aider à améliorer l'environnement local de la plaie afin de le rendre plus propice à la cicatrisation lors de la gestion des plaies ouvertes. Le concept de préparation du lit de la plaie est défini avant que les stratégies locales courantes de gestion des plaies, telles que le lavage et le débridement de la plaie, ne soient discutées plus en détail. Les principaux aspects de la gestion des biofilms et de l'utilisation appropriée des agents antimicrobiens sont également passés en revue. Enfin, le concept de cicatrisation humide et son impact dans la prise en charge moderne des plaies sont expliqués avant de passer en revue une grande variété de types de pansements, avec un accent particulier sur les pansements actifs.

El manejo de heridas es un aspecto esencial y comúnmente realizado de la medicina veterinaria de pequeños animales. El manejo adecuado de heridas es un arte difícil de dominar, debido a la complejidad inherente del escenario clínico, así como a la naturaleza en constante evolución de este campo con la adición constante de nuevos productos y técnicas. Este artículo revisa los conceptos clave que pueden ayudar al médico a comprender mejor el proceso natural de cicatrización de heridas, los factores que retrasan la cicatrización y las estrategias para ayudar a mejorar el entorno local de la herida para que sea más propicio para la cicatrización durante el tratamiento de heridas abiertas. El concepto de preparación del lecho de la herida se define antes de que se analicen con más detalle las estrategias comunes de tratamiento local de la herida, como el lavado y el debridamiento de la herida. También se revisan aspectos clave del manejo de biopelículas y el uso adecuado de agentes antimicrobianos. Finalmente, se explica el concepto de cicatrización húmeda de heridas y su impacto en el tratamiento moderno de heridas antes de revisar una amplia variedad de tipos de apósitos para heridas, con un enfoque particular en los apósitos activos.

Manejo de feridas é um procedimento essencial comumente realizado na medicina veterinária de pequenos animais. Um manejo de feridas adequado é uma arte difícil de se aperfeiçoar, devido à sua complexidade inerente ao cenário clínico, bem como à natureza em constante evolução da área com a adição contínua de novas técnicas e produtos. Este artigo revisa os conceitos mais importantes que podem ajudar o clínico a compreender melhor o processo natural de cicatrização de feridas, fatores que atrasam e estratégias que melhoram o ambiente local da ferida para torná-la mais predisposta à cicatrização durante o manejo de feridas abertas. O conceito de preparação do leito da ferida deve ser definido antes da discussão mais detalhada das estratégias de manejo mais comuns, como lavagem e debridamento. Aspectos chave do manejo de biofilmes e uso apropriado de antimicrobianos também foram revisados. Finalmente, o conceito de cicatrização úmida de feridas e o seu impacto no manejo de feridas moderno é explicado antes da revisão de diversos tipos de curativos oclusivos, com um foco particular nos curativos ativos.

Electroceutical treatment of infected chronic wounds in a dog and a cat.

OBJECTIVES: To describe the use of an innovative printed electroceutical dressing (PED) to treat non-healing, infected chronic wounds in one dog and one cat and report outcomes. ANIMALS: A 4-year-old female spayed Mastiff and a 1-year-old female spayed domestic shorthair cat. STUDY DESIGN: Short case series. METHODS: Both cases had chronic wounds (duration: approximately 1 year for the dog and 6 3/4 months for the cat) that remained open and infected despite various wound management strategies. Both animals were treated with the PED. Observations from the records regarding wound size, antimicrobial susceptibility, and the time to healing were recorded. RESULTS: After 10 days of PED treatment in the dog and 17 days of PED treatment in the cat, the wounds had decreased in size by approximately 4.2 times in the dog and 2.5 times in the cat. Culture of punch biopsies yielded negative results. Wounds were clinically healed at 67 days in the dog and 47 days in the cat. No further treatment of the wounds was required beyond that point. CONCLUSION: Application of a PED led to closure of two chronic wounds and resolution of their persistent infection. CLINICAL SIGNIFICANCE: PEDs may provide a new treatment modality to mitigate infection and promote healing of chronic wounds.

Topical Ethylenediaminetetraacetic acid (EDTA) administration following corneal diamond burr keratotomy for calcareous corneal degeneration in canines.

OBJECTIVE: To evaluate the outcomes of canine patients diagnosed with corneal ulceration associated with presumed calcareous corneal degeneration (CCD) that were treated with diamond burr keratotomy (DBK) and ongoing postoperative topical 3% or 4% Ethylenediaminetetraacetic acid (EDTA). PROCEDURES: Retrospective assessment of CCD cases treated with ongoing topical EDTA following DBK between 2011 and 2020 at Veterinary Ophthalmic Referrals. Descriptive statistics of the study population were assessed, and a survival analysis was performed using R statistical software. RESULTS: A total of 51 eyes from 41 dogs were assessed, with small terrier breeds overrepresented (27/41, 65.9%). Median age of dogs at the time of diagnosis was 14.3 years (range 8-17.2 years). Following DBK, the median time to commencement of topical EDTA was 11 days (range 0-28 days). Cases were followed for a median duration of 216 days (range 42-1379 days). Corneal ulceration recurred in 7/51 (13.7%) eyes at a median duration of 80 days (range 63-156 days). The probability of recurrence of corneal ulceration associated with CCD at 12 months was 15.6% (95% CI: 4.1-25.7%). A second DBK procedure followed by ongoing topical EDTA was performed in 4/7 (57.1%) of the recurred eyes. These retreated eyes had no further recurrence recorded and a median follow-up time of 401 days (range 120-858 days). CONCLUSION: Ongoing topical EDTA following DBK is an effective adjunct treatment method for CCD with reduced rates of recurrence of CCD-associated corneal ulceration when compared to published rates of recurrence when treated with DBK alone.

Use of autologous serum or Vizoovet to improve healing rates of spontaneous chronic corneal epithelial defects after diamond burr debridement in dogs.

PURPOSE: To determine whether the use of autologous serum or Vizoovet® improved healing rates of spontaneous chronic corneal epithelial defects (SCCEDs) after diamond burr debridement (DBD) in dogs. STUDY DESIGN: Two parallel group randomized prospective study with a historical control group. MATERIALS AND METHODS: Canine patients having undergone DBD for treatment of SCCEDs were included. Data for the control group (ofloxacin only) were gathered from patient records. Patients were randomly assigned to treatment groups for post-procedural medical treatments of ofloxacin and autologous serum (group 1) or ofloxacin and Vizoovet®, an all-natural eyed drop containing propolis, aloe vera, and chamomile (group 2). Each dog was examined between 2 and 3 weeks until the cornea was fluorescein stain negative. Data points collected included age, sex, breed, type of medications used, retention of bandage contact lens (BCL), time to healing, and number of DBD performed. RESULTS: A total of 120 dogs, each contributing one eye to the study, underwent DBD for SCCEDs. Mean (± standard deviation) days until healed were 20.1 ± 11.1 days, 16.3 ± 4.5 days, and 16.0 ± 3.7 days for the control group, group 1, and group 2, respectively. There was a marginally significant difference in days until healed between groups (p = .0515). SCCEDs healed significantly faster in group 2 (p = .03) and marginally faster in group 1 (p = .06) compared with the control group. Days until healing between group 1 and 2 were not significantly different (p = .76). CONCLUSIONS: As compared to the control group, use of Vizoovet® as adjunctive medical treatment resulted in shorter corneal healing time after DBD.

Management of severe burn injuries with novel treatment techniques including maggot debridement and applications of acellular fish skin grafts and autologous skin cell suspension in a dog.

CASE DESCRIPTION: A 3-year-old 27-kg female spayed American Bulldog with severe burn injuries caused by a gasoline can explosion was evaluated. CLINICAL FINDINGS: The dog had extensive partial- and full-thickness burns with 50% of total body surface area affected. The burns involved the dorsum extending from the tail to approximately the 10th thoracic vertebra, left pelvic limb (involving 360° burns from the hip region to the tarsus), inguinal area bilaterally, right medial aspect of the thigh, and entire perineal region. Additional burns affected the margins of the pinnae and periocular regions, with severe corneal involvement bilaterally. TREATMENT AND OUTCOME: The dog was hospitalized in the hospital's intensive care unit for 78 days. Case management involved provision of aggressive multimodal analgesia, systemic support, and a combination of novel debridement and reconstructive techniques. Debridement was facilitated by traditional surgical techniques in combination with maggot treatment. Reconstructive surgeries involved 6 staged procedures along with the use of novel treatments including applications of widespread acellular fish (cod) skin graft and autologous skin cell suspension. CLINICAL RELEVANCE: The outcome for the dog of the present report highlighted the successful use of maggot treatment and applications of acellular cod skin and autologous skin cell suspension along with aggressive systemic management and long-term multimodal analgesia with debridement and wound reconstruction for management of severe burn injuries encompassing 50% of an animal's total body surface area.

Diagnosis and outcome of nasal polyposis in 23 dogs treated medically or by endoscopic debridement.

This study describes the clinical, diagnostic, and pathological characteristics of canine nasal polyps and how they responded to medical, endoscopic, and surgical treatments. The database of a multi-center veterinary endoscopy group was searched from 2010 to 2018. All dogs with a histological diagnosis of nasal polyposis that were undergoing endoscopic investigation (N = 23), were included. Clinical signs at presentation were sneezing (91%), nasal discharge (83%), stertor (74%), and frontonasal deformation (17%). Skull radiography on 13 dogs had alterations in 77% of cases, including turbinate lysis (6/13), increased radiopacity of one (4/13) or both (6/13) nasal cavities, and lysis of the nasal vomer bone (3/13). Nasal polyposis had a characteristic endoscopic appearance. There were clinical and diagnostic similarities between this cohort of dogs and dogs with nasal neoplasia, although dogs with nasal polyps were often younger and polypoid tissue was external to the nose. Steroid therapy alone was not effective in treating polyposis in dogs; however, endoscopic debulking with a laser and forceps was more effective.

Diagnostic et issue de la polypose nasale chez 23 chiens traités médicalement ou par débridement endoscopique. Cette étude décrit les caractéristiques cliniques, diagnostiques et pathologiques des polypes nasaux canins et comment ils ont répondu aux traitements médicaux, endoscopiques et chirurgicaux. La base de données d'un groupe multicentres d'endoscopie vétérinaire a été recherchée de 2010 à 2018. Tous les chiens avec un diagnostic histologique de polypose nasale qui faisaient l'objet d'une investigation endoscopique (N = 23), ont été inclus. Les signes cliniques à la présentation étaient des éternuements (91 %), un écoulement nasal (83 %), un stertor (74 %) et une déformation fronto-nasale (17 %). La radiographie du crâne de 13 chiens présentait des altérations dans 77 % des cas, y compris une lyse du cornet (6/13), une radio-opacité accrue d'une (4/13) ou des deux (6/13) cavités nasales et une lyse du vomer nasal (3/13). La polypose nasale avait un aspect endoscopique caractéristique. Il y avait des similitudes cliniques et diagnostiques entre cette cohorte de chiens et celle de chiens atteints de néoplasie nasale, bien que les chiens atteints de polypes nasaux étaient souvent plus jeunes et que le tissu polypoïde était externe au nez. La thérapie stéroïdienne seule n'a pas été efficace dans le traitement de la polypose chez les chiens; cependant, la réduction endoscopique avec un laser et une pince était plus efficace.(Traduit par Dr Serge Messier).

Surgical debridement and primary closure of the oral mucosa for repair of open mandibular pars incisiva fractures in three neonatal calves.

CASE DESCRIPTION: 3 neonatal female calves (ages, < 1 to 4 days) were examined because of mandibular trauma. CLINICAL FINDINGS: Physical examination indicated that each calf had an open fracture of the mandibular pars incisiva (rostral mandibular fracture) with ventral displacement of the incisors at the affected region. Oral radiographs were obtained for 1 calf and revealed that 5 incisors were fractured at the level of the apical dental buds. TREATMENT AND OUTCOME: Each calf was anesthetized. The fracture site and surrounding tissues were surgically debrided and flushed with sterile 0.05% chlorhexidine solution. The laceration in the oral mucosa was closed with absorbable suture in an interrupted horizontal mattress pattern. Additionally, a Penrose drain was placed during primary closure and removed 4 days later in 1 calf. The fractured incisors were removed during primary debridement in another calf. All calves received perioperative antimicrobials and analgesics. One calf developed mild osteomyelitis of the rostral mandible, which resolved with additional surgical debridement and antimicrobial treatment. That calf and another developed mild brachygnathia. At the time of last follow-up (3 to 13 months after hospital discharge), all 3 calves were eating and growing as expected. CLINICAL RELEVANCE: 3 calves with open rostral mandibular fractures were successfully managed by surgical debridement and primary closure of the oral laceration. The procedure was easy to perform, did not require specialized equipment, and was less expensive than other repair methods. This procedure may be an effective and economic on-farm treatment alternative for calves with rostral mandibular fractures.

Early and aggressive surgical debridement and negative pressure wound therapy to treat necrotizing fasciitis in three dogs.

OBJECTIVE: To report the management and outcomes of dogs with necrotizing fasciitis (NF) treated with early, aggressive surgical debridement and negative pressure wound therapy (NPWT). STUDY DESIGN: Short case series. ANIMALS: Three dogs surgically treated for NF. METHODS: Clinical signs in the three dogs included an identified wound, severe pain, fever, and progressive erythema. A tentative diagnosis of NF was based on the presence of suppurative inflammation and intracellular bacteria seen in fine needle aspirates and clinical progression in each case. Each dog was treated with surgical debridement within 6 hours of clinical suspicion for NF. Necrosis affected multiple tissue layers was noted surgical exploration. Systemic supportive care and antibiotherapy were also provided for 3 to 4 weeks postoperatively. RESULTS: Three surgical debridements were required in two dogs, and four surgical debridements were required in one dog. All of the surgical sites were managed with NPWT until final primary closure was possible at 4, 5, and 6 days after initial surgery. Results of histopathology and culture of the surgical sites were consistent with NF as described in each case. All dogs survived to discharge and long-term follow up. CONCLUSION: Management with early surgery, multiple debridements, and the use of NPWT led to resolution of NF in three dogs.

The effect of Lucilia sericata larval excretion/secretion (ES) products on cellular responses in wound healing.

Chronic wounds are still regarded as a serious public health concern, which are on the increase mainly due to the changes in life styles and aging of the human population. There are different types of chronic wounds, each of which requires slightly different treatment strategies. Nevertheless, wound bed preparation is included in treatment of all types of chronic wounds and involves tissue debridement, inflammation, and infection control, as well as moisture balance and epithelial edge advancement. Maggot therapy (MT) is a form of biological debridement which involves the application of live medical grade Lucilia sericata (Meigen, 1826) (Diptera: Calliphoridae) larvae. Whereas it was initially thought to act mainly through debridement, today MT is known to influence all four overlapping physiological phases of wound repair: homeostasis, inflammation, proliferation, and remodelling/maturing. During MT, medical-grade larvae are applied either freely or enclosed in tea-bag like devices (biobag) inside the wounds, which suggests that larva excretion/secretion (ES) products can facilitate the healing processes directly without the need of direct contact with the larvae. This review summarizes the relevant literature on ES-mediated effects on the cellular responses involved in wound healing.

Arthroscopic debridement of short frontal plane proximal phalanx fractures preserves racing performance.

BACKGROUND: Outcomes have been reported for a limited number of short frontal plane fractures of the proximal phalanx following nonsurgical treatment and internal fixation. OBJECTIVES: To describe a new approach, arthroscopic debridement, of short frontal plane fractures of the proximal phalanx in flat-racing Thoroughbreds and post-operative racing outcome. STUDY DESIGN: Retrospective case-control study. METHODS: Medical records of 81 Thoroughbred racehorses treated with arthroscopic debridement for frontal plane fractures of the proximal phalanx were reviewed. Diagnostic images and operative reports were used to characterise lesions and a technique for arthroscopic treatment was described. Post injury racing career length, starts, earnings and race quality are compared with matched controls. RESULTS: Of 81 treated horses, 74 (91%) raced post-operatively. Treated horses had fewer post-operative starts compared with controls (median 12, 95% CI 9-16 vs median 19, 95% CI 15-23; P < .001), but there was no difference in post-operative earnings (median $51 465, 95% CI $39 868-$85 423 vs median $68 017, 95% CI $54 247-$87 870, P = .7) or career length (median 7 quarters, 95% CI 5-8 vs median 9 quarters, 95% CI 8-10, P = .1). MAIN LIMITATIONS: Retrospective studies prevent prospective control of sampling bias and limit selection of matched controls. CONCLUSIONS: Treatment of frontal plane fractures of the proximal phalanx by arthroscopic debridement results in racing performance comparable to uninjured controls with respect to longevity and earnings.

Cotton-tip debridement, scalpel blade debridement, and superficial grid keratotomy for treatment of spontaneous chronic corneal epithelial defects (SCCED): A retrospective evaluation of 308 cases.

PURPOSE: To evaluate the clinical course and outcome of canine SCCEDs treated with a combination of cotton-tip debridement (CTD), scalpel blade debridement (SBD), and superficial grid keratotomy (SGK). METHODS: Medical records of dogs diagnosed with SCCED and treated by the same diplomate (FJO) from 2011 to 2019 were reviewed. Age, breed, sex, affected eye, time of onset before treatment, previous procedures performed, time to healing, need for a second treatment, and complications were reported. RESULTS: A total of 308 eyes (291 dogs) met the inclusion criteria and were included in the study. All dogs received the same treatment (CTD + SBD + SGK) and the same topical medication (tobramycin 0.3% solution and sodium chloride 5% ointment). All eyes healed. Mean age at presentation was 9 years and 6 months (114.4 ± SD 28.0 months), and Boxer was the most common breed (93/308; 30.2%). Mean corneal healing time was 11.5 days (±SD 6.6). Complications occurred in 15/308 (4.9%) eyes. The three main complications observed were infected epithelial ulcer, infected stromal ulcer, and melting corneal ulcer, and 7/15 (46.7%) of the complications were diagnosed in Boston Terrier. Healing occurred after one treatment in 299/308 (97.1%) eyes, and the remaining cases needed a second treatment. CONCLUSIONS: CTD + SBD + SGK is an inexpensive and efficient treatment for SCCED in dogs. Boston Terrier may be at higher risk of developing complications following this procedure.

Clinical characteristics and treatment of spontaneous chronic corneal epithelial defects (SCCEDs) with diamond burr debridement.

OBJECTIVE: To document the characteristics of unilateral, bilateral SCCEDs, and unilateral SCCED with a subsequent SCCED in the contralateral eye that are treated with diamond burr debridement (DBD). PROCEDURE: Medical records of canine SCCEDs who have received DBD between 2010 and 2018 were retrospectively reviewed. Signalment, eye(s) affected, procedures performed, time to detected healing, and complications were statistically analyzed. RESULTS: Two hundred and forty-nine dogs had unilateral SCCEDs (85.0%), 13 dogs (4.4%) had bilateral SCCEDs, and 31 dogs (10.6%) had unilateral SCCED with a subsequent SCCED in the contralateral eye, 26 of which occurred within 24 months following the unilateral SCCED. No significant differences in healing rates after one DBD were found between different presentations of SCCEDs. Boxers are 2.3 times more likely to have subsequent SCCED in their contralateral eye than non-Boxer breeds. Of the 341 SCCEDs (293 dogs) in the total study population, 252 eyes (73.9%) achieved healing after undergoing one DBD. Fifteen cases were lost to subsequent follow-up, and 58 eyes (17.0%) required additional intervention after a DBD. Complications occurred in 16 eyes (4.7%) including 13 cases of keratomalacia and three cases of anterior uveitis. CONCLUSION: Diamond burr debridement is a safe and effective treatment for different presentations of SCCEDs. No significant differences in healing rates after one DBD were found between different presentations of SCCEDs. Particularly in Boxers, a new SCCED may develop in the contralateral eye, typically within 24 months following a presentation of unilateral SCCED.

Prospective evaluation of the influence of sampling method on bacterial culture results and antimicrobial selection in 52 dogs with infected wounds.

OBJECTIVE: To determine the influence of sampling methods on culture results and selection of antimicrobials for treating infected wounds in dogs. DESIGN: Prospective study from January to July 2016. SETTING: Three private multispecialty referral centers. ANIMALS: Fifty-two client-owned dogs with infected wounds. INTERVENTIONS: Each wound was sampled for culture by 3 methods: swabbing prior to preparation (dirty swabs), swabbing after debridement and sterile lavage (clean swabs), and biopsy. Bacterial species and phenotypes were compared. Three clinicians unaware of patient, wound, and sampling information selected antimicrobial drugs based on culture and sensitivity reports. Antimicrobials were divided into class I, II, or III based on established guidelines. The number, highest class of antimicrobial chosen, and inter-investigator agreement were examined. MEASUREMENTS AND MAIN RESULTS: Identical populations of bacteria were isolated for all 3 sampling techniques in only 31% of wounds. Significantly fewer bacterial species were isolated from biopsy samples (1.87 bacterial species per wound ± 1.14) than from clean swab samples (2.29 ± 1.18; P = 0.009) but not dirty swab samples (2.29 ± 1.29; P = 0.06). The recovery frequency for gram-positive bacteria was lower for biopsy compared to either swabbing technique (P = 0.001 for both comparisons). No difference was observed between clean and dirty swabbing techniques for any parameter examined. Sampling technique did not affect the proportion of wounds with anaerobic, gram-negative, or multi-drug resistant bacteria. The number (P = 0.28) and highest class of antimicrobial (P = 0.9) selected per wound did not differ between the 3 sampling techniques (P = 0.28). Clinician agreement was 83-90% depending on sampling technique. CONCLUSION: Although there were some differences in bacteria isolated from biopsy samples compared to swab samples from infected wounds, technique did not influence the number and highest class of antimicrobial selected by clinicians. Wound debridement prior to sampling by swabbing did not alter the number or type of bacteria isolated, nor the number or the highest class of antimicrobial selected by clinicians.