Ch. 9-10: Wound Healing & ST Infection Flashcards
Nolff VCOT 2018 PQ
Comparison of NPWT and Silver-coated foam dressings in open wound treatment in dogs: a prospective controlled clinical trial
- how many days to closure for each group?
- how many day difference between # of days for closure bw groups? PQ
- Diff in wound planimetry?
- Diff in wound infn progression?
- Conclusion re: NPWT?
Group A – NPWT treatment VS group B – silver foam dressing
Total time to closure was S shorter in NPWT g (14 d) compared with silver foam group (28 d) = ** 14 day difference between two groups **
Wound planimetry on days 3, 6, and 9 showed S greater reduction in total wound area for group A at all-time points
Wounds in Group A showed less progression of local infection than wounds in group B
Conc: NPWT-treated wounds showed faster closure (14 days!), improved macro-deformation and less local signs of infection.
Repellin Vet Sx 2021
The effects of a proprietary Manuka honey and essential oil hydrogel on the healing of acute full-thickness wounds in dogs
- differences in groups re: culture, wound contx, history?
- conclusion?
HoneyCure (HOC) vs standard of care (CON) dressings
No differences in timing of initial granulation tissue between groups or time to complete epithelialization
Wound contraction and histological scores did not differ between groups
Cultures positive in 17.5% of wounds; no difference between groups
conclusion: study did not provide evidence to support the application of HoneyCure® in small, acute wounds in healthy dogs. However, application may be beneficial in the early proliferative stage of wound healing and in wounds that would benefit from early, robust epithelialization.
Latimer Vet Sx 2018
Effects of hyperbaric oxygen therapy on uncomplicated incisional and open wound healing in dogs
- difference between HBO and controls?
- adverse events?
- conclusion re HBO?
HBOT once daily (1.7 atmospheres absolute 30 min on day 1, 2 ATA 40 min day 2-7)
No difference detected between HBO and control uncomplicated open and incisional wounds at any time for contraction, epithelialization, subjective wound scores, histopath scores, or bacterial loads
All HBO dogs tolerated hyperbaric oxygen treatments with no adverse effects
Conclusion: HBOT protocol tested here was safe but did not enhance the healing of uncomplicated acute wounds and incisions of dogs.
Kalnins JVIM 2022
Antimicrobials in dog-to-dog bite wounds : A retrospective study of 1526 dog bite events ( 1999-2019 )
- MC 2 abx prescribed?
- under dosing % for each?
- recommendations?
Most common isolates previously reported = Staphylococcus pseudintermedius, Enterococcus spp., Escherichia coli and Pasteurella multocida
Study → 1526 DBW in Australia
ABX prescribed in 88% with 73% being Clavamox, and secondly first-gen cephalosporins (18%)
Underdosing occurred in 13% of cases for AMX and 26% for cephalosporins
culture & susceptibility is still recommended to optimize antimicrobial stewardship
Hamil Vet Sx 2020 PQ
Pretreatment aerobic bacterial swab cultures to predict infection in acute open traumatic wounds:
A prospective clinical study of 64 dogs**
PQ culturing acute wounds
- all dogs had abx at presentation but what % then got post-op infn?
- correlation bw initial wound culture and dev of infn?
- correlation vs bacteria on initial wound swab and subsequent culture?
- main take aways re: acute would cultures, prediction for subsequent infn, and selection of abx?
Fewer bacteria were cultured from postlavage than from prelavage swabs in 86% acute wounds.
All primary clinicians prescribed β-lactam antibiotics to the dogs at initial presentation.
All bacteria cultured from postlavage/debridement cultures at initial presentation were susceptible to the prophylactic antimicrobial prescribed.
Postoperative infection was subsequently diagnosed in 22% dogs; 13/14 of these dogs had positive culture results.
No correlation was detected between the results of initial wound cultures and the subsequent development of wound infection. Bacterial species present in the initial wound swab did not correlate with those subsequently cultured from infected tissues.
Conclusion: Results of pretreatment wound cultures from open traumatic wounds in dogs were not predictive of bacterial species subsequently recovered from infected wounds.
The bacterial burden present in pretreatment wounds was not predictive of whether wounds would ultimately become infected after surgical management.
Clinical significance: Routine bacterial culturing of acute wounds is not likely to help predict subsequent wound infection, nor is it likely to accurately guide early selection of antimicrobials to treat wounds that become infected.
Dazio JVIM 2021
Acquisition and carriage of multidrug-resistant organisms in dogs and cats presented to small animal practices and clinics in Switzerland
- admission prevalence of MDRO?
- rate of MDRO acquisition?
- 2 MC bacteria?
- 2 RF for MDRO carriage?
- conclusion re: hospital?
Estimated admission prevalence of MDRO was 15% (18% of dogs and 10% of cats)
Overall rate of MDRO acquisition was 30% (20% for cats, 30% for dogs)
E.coli (17%) and Klebseiella pneumoniae (13%) were most common
Risk factors for MDRO carriage in dogs and cats: hospitalization at clinic 1 (OR 5) and days of hospitalization (OR 4 for 3-4 days, OR 6 for >5 days)
Conclusion: Vet hospital play a important role in selection and transmission of MDRO amoung vet patients
Stokes JAVMA 2021 PQ
Comparison of bacteriologic culture results for skin wound swabs and skin wound biopsy specimens
- what procedure did they do for each wound / what was compared?
- % of positive cultures?
- % with identical culture results?
- techniques in agreement in regards to what?
- if swab was negative, what happened with tissue?
- % that would have treated differently when looking at both technique results?
- Conclusion re: swab technique? meaning of a negative swab? clinical significance of disagreement bw techniques?
each wound underwent routine preparation prior to collection of 2 specimens, 1 by superficial swab (Levine) technique and 1 by tissue biopsy - both cultured
overall, 85% tissue and 75% swab had positive cultures
20% had identical culture results between sampling techniques (Swab and tissue cultures)
Despite results not being identical in many, techniques were in agreement for most common bacteria cultured
All wounds for which swab cultures yielded no growth also had no growth on biopsy
in 13% of cases, the observers would have treated the patient differently on the basis of the results of the 2 cultures
Conclusion: swab culture collected by the Levine technique is an appropriate noninvasive alternative to tissue bx culture
A negative result obtained from culture of a swab is likely to be reliable.
Disagreement between the results of swab and tissue biopsy specimen cultures is likely of low clinical importance
Thieman-Mankin JAVMA 2020
Randomized, controlled clinical trial to assess the effect of antimicrobial-impregnated suture on the incidence of surgical site infections in dogs and cats
- what suture used?
- incidence of SSI in each group?
- What factors were different bw groups?
- what 3 factors on MVA were associated with increased SSI rates?
evaluated prophylactic efficacy of triclosan-coated (TC) suture in preventing SSIs
Incidence of SSI was 6% in the non-TC suture group and 6% in the TC suture group (and overall incidence 6%) - no difference
- NO DIFFERENCE IN ANYTHING
- No significant difference was found in the incidence of SSI between groups.
- No significant difference was detected in the incidence of incisional problems (eg, redness, dehiscence, and seroma formation) between groups
On multivariable analysis, factors associated w/ increased SSI rates, included:
- Incision length > 10 cm
- Surgery performed by the soft tissue surgery department
- Anesthesia duration of > 240 minutes
Rajeev JAVMA 2022
Surgical treatment of deep neck infections in 19 dogs
Retrospective evaluation of 19 dogs undergoing surgical treatment of deep neck infections
- PE finding that was in all dogs? what about fever?
- HIstopath results what was MC?
- What ratio correlated with decreased duration of CS prior to presentation and increased length hospitalization?
- uni or polymicrobial infn common?
- which 5 bacteria MC with septic FB reactions?
All dogs had cervical swelling, <50% had fever
Histopathology most commonly revealed pyogranulomatous inflammation (14/15)
Increasing neutrophil-to-lymphocyte ratio was moderately correlated to a decreased duration of clinical signs before presentation and an increased length of hospitalization
Bacterial culture was submitted for all dogs, and polymicrobial infections were common (8/19).
Broad-spectrum empirical antimicrobials were commonly prescribed.
Change in antimicrobial treatment based on culture was uncommon (3/19).
Mixed bacterial populations are most commonly isolated from canine septic foreign body reactions and abscesses: Streptococcus spp, Staphylococcus spp, Pasteurella multocida, Escherichia coli, and Actinomyces spp
Papich JAVMA 2023
Antimicrobial agents in small animal dermatology for treating staphylococcal infections
- Consider MRSP resistant to what regardless of culture?
- if suspecting MRSP, culture to confirm which 5 class of abx should be used?
Methicillin-resistant staphylococci should be considered resistant to all other β-lactams, including cephalosporins and amoxicillin-clavulanate (eg, Clavamox), regardless of the MIC susceptibility test result.
If MRSP are the suspected cause of infection, a culture & susceptibility test should be used to confirm whether tetracyclines, chloramphenicol, trimethoprim-sulfonamides, aminoglycosides, or fluoroquinolones are appropriate choices.
Hottmann VSURG 2023
In vitro elution of amikacin from four hydrogel preparations: A pilot study
- amikacin vs MIC?
- what did they suggest?
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.
Dannemiller VSURG 2020 PQ
In vitro evaluation and in vivo use of a novel surgical stent to minimize suture pressure necrosis
- novel device / technique? PQ
- diff in SA or pressure between 3 novels?
- difference in novel vs traditional vs control re: SA and pressure?
- amount of pressure necrosis in novel group?
- conclusion re technique and novel technique?
Three novel silicone stents, a traditional stent, and a control were tested to distribute pressure when incorporated into tension-relieving sutures
No difference was found in surface area or pressure among the three silicone stents
Silicone stents yielded an avg 2.5 cm2 more surface area and 850 kPa less pressure compared with the control as well as 1.5 cm2 more surface area and 110 kPa less pressure compared with the traditional stent.
Incision site and silicone stent assessment performed postoperatively revealed no obvious pressure necrosis.
Conclusion: **Stents improved distribution of suture pressure, and novel silicone stents were more effective compared with traditional stents. Novel silicone stents appear to have preliminary clinical success in vivo (a dolphin)
evidence that stents effectively help distribute suture pressure, and their incorporation might minimize the risk of suture pressure necrosis.
Novel silicone stents should be integrated into tension-relieving suture patterns when closing wounds and incisions, particularly in [~aquatic animals~] .. lol.
