RESIDENT surgeon at Lisadell Equine Clinic, Simon Hennessy delivered an update on Wound Management Therapies to the recent 18th Irish Equine Veterinary Conference.

Wound stages include acute, inflammatory, remodelling and haemostatis.

In the horse, Simon Hennessy described the inflammatory phase as being quite poor and weak, chronic infection can set in, resulting in this phase ongoing.

“So what stage of wound healing are we at? What can we do to aid the situation? We (at Lisadell) use the Versajet system - hydro-surgical debridement - it aids the inflammatory phase, vastly reduces healing time. It was designed from the system used to treat human burns. It aims to minimise the damage to tissue, it is quite effective at removing contamination,” explained Hennessy.

Using levels 1 through 10, this system takes away bacteria without damaging the cells and is very effective, allowing wounds to be okay for primary closure.

Cases referred to on the screen including that of a five-year-old thoroughbred gelding with a bad tongue laceration and another of a 14-year-old hunter with a severely contaminated leg wound with exposed tendons.

HELPFUL WORMS

Simon Hennessy’s presentation also included cases where larval debridement (worms eating dead flesh) was successfully used. Again this comes from human medicine, larvae of the common green bottle fly basically eat necrotic tissue, held in place with breathable bandages.

One case of a young thoroughbred foal caught in a fence was greatly aided using this treatment. Within six days, the worms had cleaned up the wounds allowing the granulating tissue bed to improve.

Larval treatment can also used in cases of chronic, non-draining wound sites such as fistulous withers, cleaned up in a 16-year-old horse, the conference was informed.

“Maggots are excellent for chronic wounds with multi-resistent bacteria. Manuka honey, (grade 15+) has a low pH and the high sugar shrink the bacterial cell walls. Don’t use it on its own but include it in the management of wounds as a good topical therapy,” advised Hennessy.

WOUND THERAPIES

Negative pressure wound therapy was cited as a great tool, coming from human medicine.

Foam is cut to the shape of the wound, covered with adhesive pressure and a tube connected to a system which improves wound healing by improving blood flow to the area and getting rid of the bacteria.

Other updates Hennessy delivered in his presentation included Stem Cells and PRP Gel, skin grafts and skin flaps, as well as the use of skin expanders in wound management in horses.