• 1.

    Theoret C. Physiology of wound healing. In: Theoret C, Schumacher J, eds. Equine wound management. 3rd ed. Hoboken, NJ: John Wiley & Sons Inc, 2016;113.

    • Crossref
    • Search Google Scholar
    • Export Citation
  • 2.

    Dart AJ, Sole-Guitart A, Stashak TS, et al. Selected factors that negatively impact healing. In: Theoret C, Schumacher J, eds. Equine wound management. 3rd ed. Hoboken, NJ: John Wiley & Sons Inc, 2016;3046.

    • Crossref
    • Search Google Scholar
    • Export Citation
  • 3.

    Westgate SJ, Percival SL, Knottenbelt DC, et al. Microbiology of equine wounds and evidence of bacterial biofilms. Vet Microbiol 2011;150:152159.

    • Crossref
    • Search Google Scholar
    • Export Citation
  • 4.

    Jacobsen S. Update on wound dressings. In: Theoret C, Schumacher J, eds. Equine wound management. 3rd ed. Hoboken, NJ: John Wiley & Sons Inc, 2016;104131.

    • Crossref
    • Search Google Scholar
    • Export Citation
  • 5.

    Bischofberger AS, Dart CM, Perkins NR, et al. A preliminary study on the effect of manuka honey on second-intention healing of contaminated wounds on the distal aspect of the forelimbs of horses. Vet Surg 2011;40:898902.

    • Search Google Scholar
    • Export Citation
  • 6.

    Bischofberger AS, Dart CM, Perkins NR, et al. The effect of short− and long-term treatment with manuka honey on second intention healing of contaminated and noncontaminated wounds on the distal aspect of the forelimbs in horses. Vet Surg 2013;42:154160.

    • Crossref
    • Search Google Scholar
    • Export Citation
  • 7.

    Kelleher ME, Kilcoyne I, Dechant JE, et al. A preliminary study of silver sodium zirconium phosphate polyurethane foam wound dressing on wounds of the distal aspect of the forelimb in horses. Vet Surg 2015;44:359365.

    • Crossref
    • Search Google Scholar
    • Export Citation
  • 8.

    Adams AP, Santschi EM, Mellencamp MA. Antibacterial properties of a silver chloride-coated nylon wound dressing. Vet Surg 1999;28:219225.

  • 9.

    Harmon CCG, Hawkins JF, Li J, et al. Effects of topical application of silver sulfadiazine cream, triple antimicrobial ointment, or hyperosmolar nanoemulsion on wound healing, bacterial load, and exuberant granulation tissue formation in bandaged full-thickness equine skin wounds. Am J Vet Res 2017;78:638646.

    • Crossref
    • Search Google Scholar
    • Export Citation
  • 10.

    Lipp C, Kirker K, Agostinho A, et al. Testing wound dressings using an in vitro wound model. J Wound Care 2010;19:220226.

  • 11.

    Carnwath R, Graham EM, Reynolds K, et al. The antimicrobial activity of honey against common equine wound bacterial isolates. Vet J 2014;199:110114.

    • Crossref
    • Search Google Scholar
    • Export Citation
  • 12.

    Cooper R, Molan P. The use of honey as an antiseptic in managing Pseudomonas infection. J Wound Care 1999;8:161164.

  • 13.

    Cooper RA, Molan PC, Harding KG. Antibacterial activity of honey against strains of Staphylococcus aureus from infected wounds. J R Soc Med 1999;92:283285.

    • Crossref
    • Search Google Scholar
    • Export Citation
  • 14.

    Kwakman PHS, de Boer L, Ruyter-Spira CP, et al. Medical-grade honey enriched with antimicrobial peptides has enhanced activity against antibiotic-resistant pathogens. Eur J Clin Microbiol Infect Dis 2011;30:251257.

    • Crossref
    • Search Google Scholar
    • Export Citation
  • 15.

    Stojadinovic O, Tomic-Canic M. Human ex vivo wound healing model. Methods Mol Biol 2013;1037:255264.

  • 16.

    Xu W, Hong SJ, Jia S, et al. Application of a partial-thickness human ex vivo skin culture model in cutaneous wound healing study. Lab Invest 2012;92:584599.

    • Crossref
    • Search Google Scholar
    • Export Citation
  • 17.

    Schaudinn C, Dittmann C, Jurisch J, et al. Development, standardization and testing of a bacterial wound infection model based on ex vivo human skin. PLoS One 2017;12:e0186946.

    • Crossref
    • Search Google Scholar
    • Export Citation
  • 18.

    Stone R II, Wall JT, Natesan S, et al. PEG-plasma hydrogels increase epithelialization using a human ex vivo skin model. Int J Mol Sci 2018;19:3156.

  • 19.

    Alves DR, Booth SP, Scavone P, et al. Development of a high-throughput ex-vivo burn wound model using porcine skin, and its application to evaluate new approaches to control wound infection. Front Cell Infect Microbiol 2018;8:196.

    • Crossref
    • Search Google Scholar
    • Export Citation
  • 20.

    Van Hecke LL, Haspeslagh M, Hermans K, et al. Comparison of antibacterial effects among three foams used with negative pressure wound therapy in an ex vivo equine perfused wound model. Am J Vet Res 2016;77:13251331.

    • Crossref
    • Search Google Scholar
    • Export Citation
  • 21.

    Antweiler RC, Taylor HE. Evaluation of statistical treatments of left-censored environmental data using coincident uncensored data sets: I. Summary statistics. Environ Sci Technol 2008;42:37323738.

    • Crossref
    • Search Google Scholar
    • Export Citation
  • 22.

    Rigo C, Ferroni L, Tocco I, et al. Active silver nanoparticles for wound healing. Int J Mol Sci 2013;14:48174840.

  • 23.

    Tian J, Wong KKY, Ho C-M, et al. Topical delivery of silver nanoparticles promotes wound healing. ChemMedChem 2007;2:129136.

  • 24.

    Tsang AS, Dart AJ, Sole-Guitart A, et al. Comparison of the effects of topical application of UMF20 and UMF5 manuka honey with a generic multifloral honey on wound healing variables in an uncontaminated surgical equine distal limb wound model. Aust Vet J 2017;95:333337.

    • Crossref
    • Search Google Scholar
    • Export Citation
  • 25.

    Berry DB II, Sullins KE. Effects of topical application of antimicrobials and bandaging on healing and granulation tissue formation in wounds of the distal aspect of the limbs in horses. Am J Vet Res 2003;64:8892.

    • Crossref
    • Search Google Scholar
    • Export Citation
  • 26.

    Eberlein T, Haemmerle G, Signer M, et al. Comparison of PHMB-containing dressing and silver dressings in patients with critically colonised or locally infected wounds. J Wound Care 2012;21:12, 1416, 1820.

    • Crossref
    • Search Google Scholar
    • Export Citation
  • 27.

    Mertz PM, Oliveira-Gandia MF, Davis SC. The evaluation of a cadexomer iodine wound dressing on methicillin resistant staphylococcus aureus (MRSA) in acute wounds. Dermatol Surg 1999;25:8993.

    • Crossref
    • Search Google Scholar
    • Export Citation
  • 28.

    Leaper DJ, Durani P. Topical antimicrobial therapy of chronic wounds healing by secondary intention using iodine products. Int Wound J 2008;5:361368.

    • Crossref
    • Search Google Scholar
    • Export Citation
  • 29.

    Atiyeh BS, Dibo SA, Hayek SN. Wound cleansing, topical antiseptics and wound healing. Int Wound J 2009;6:420430.

  • 30.

    Bigliardi PL, Alsagoff SAL, El-Kafrawi HY, et al. Povidone iodine in wound healing: a review of current concepts and practices. Int J Surg 2017;44:260268.

    • Crossref
    • Search Google Scholar
    • Export Citation
  • 31.

    Wang L, Qin W, Zhou Y, et al. Transforming growth factor β plays an important role in enhancing wound healing by topical application of Povidone-iodine. Sci Rep 2017;20:991.

    • Crossref
    • Search Google Scholar
    • Export Citation
  • 32.

    Cooper RA. Iodine revisited. Int Wound J 2007;4:124137.

  • 33.

    Moffatt CJ, Stanton J, Murray S. A randomised trial to compare the performance of Oxyzyme and Iodozyme with standard care in the treatment of patients with venous and mixed venous/arterial ulceration. Wound Med 2014;6:110.

    • Crossref
    • Search Google Scholar
    • Export Citation
  • 34.

    Akiyama H, Oono T, Saito M, et al. Assessment of cadexomer iodine against Staphylococcus aureus biofilm in vivo and in vitro using confocal laser scanning microscopy. J Dermatol 2004;31:529534.

    • Crossref
    • Search Google Scholar
    • Export Citation
  • 35.

    Lamme EN, Gustafsson TO, Middelkoop E. Cadexomer iodine ointment shows stimulation of epidermal regeneration in experimental full-thickness wounds. Arch Dermatol Res 1998;290:1824.

    • Crossref
    • Search Google Scholar
    • Export Citation
  • 36.

    Nagoba BS, Selkar SP, Wadher BJ, et al. Acetic acid treatment of pseudomonal wound infections—a review. J Infect Public Health 2013;6:410415.

  • 37.

    Demirci S, Dogan A, Aydın S, et al. Boron promotes streptozotocin-induced diabetic wound healing: roles in cell proliferation and migration, growth factor expression, and inflammation. Mol Cell Biochem 2016;417:119133.

    • Crossref
    • Search Google Scholar
    • Export Citation
  • 38.

    Nzietchueng RM, Dousset B, Franck P, et al. Mechanisms implicated in the effects of boron on wound healing. J Trace Elem Med Biol 2002;16:239244.

    • Crossref
    • Search Google Scholar
    • Export Citation
  • 39.

    Güzel Y, Golge UH, Goksel F, et al. The efficacy of boric acid used to treat experimental osteomyelitis caused by methicillin-resistant Staphylococcus aureus: an in vivo study. Biol Trace Elem Res 2016;173:384389.

    • Crossref
    • Search Google Scholar
    • Export Citation
  • 40.

    Tepedelen BE, Soya E, Korkmaz M. Boric acid reduces the formation of DNA double strand breaks and accelerates wound healing process. Biol Trace Elem Res 2016;174:309318.

    • Crossref
    • Search Google Scholar
    • Export Citation
  • 41.

    Woods EJ, Cochrane CA, Percival SL. Prevalence of silver resistance genes in bacteria isolated from human and horse wounds. Vet Microbiol 2009;138:325329.

    • Crossref
    • Search Google Scholar
    • Export Citation
  • 42.

    Majtan J. Honey: an immunomodulator in wound healing. Wound Repair Regen 2014;22:187192.

  • 43.

    Carter DA, Blair SE, Cokcetin NN, et al. Therapeutic manuka honey: no longer so alternative. Front Microbiol 2016;7:569.

  • 44.

    Oryan A, Alemzadeh E, Moshiri A. Biological properties and therapeutic activities of honey in wound healing: a narrative review and meta-analysis. J Tissue Viability 2016;25:98118.

    • Crossref
    • Search Google Scholar
    • Export Citation
  • 45.

    Hendrickson DA. Management of superficial wounds. In: Auer JA, Stick JA, Kummerle JM, et al., eds. Equine surgery. 5th ed. St Louis: Elsevier Saunders, 2019;303317.

    • Search Google Scholar
    • Export Citation
  • 46.

    To E, Dyck R, Gerber S, et al. The effectiveness of topical polyhexamethylene biguanide (PHMB) agents for the treatment of chronic wounds: a systematic review. Surg Technol Int 2016;29:4551.

    • Search Google Scholar
    • Export Citation
  • 47.

    Sibbald RG, Coutts P, Woo KY. Reduction of bacterial burden and pain in chronic wounds using a new polyhexamethylene biguanide antimicrobial foam dressing-clinical trial results. Adv Skin Wound Care 2011;24:7884.

    • Crossref
    • Search Google Scholar
    • Export Citation
  • 48.

    Chindera K, Mahato M, Sharma AK, et al. The antimicrobial polymer PHMB enters cells and selectively condenses bacterial chromosomes. Sci Rep 2016;6:23121.

  • 49.

    Assadian O, Assadian A, Stadler M, et al. Bacterial growth kinetic without the influence of the immune system using vacuum-assisted closure dressing with and without negative pressure in an in vitro wound model. Int Wound J 2010;7:283289.

    • Crossref
    • Search Google Scholar
    • Export Citation

Advertisement

Effects of various wound dressings on microbial growth in perfused equine musculocutaneous flaps

Eva De Clercq MVetMed1, Stien Den Hondt MVetMed1, Cindy De Baere1, and Ann M. Martens DVM, PhD1
View More View Less
  • 1 Department of Surgery and Anaesthesiology of Domestic Animals, Faculty of Veterinary Medicine Ghent University, B-9820 Merelbeke, Belgium.

Abstract

OBJECTIVE

To compare the effect of multiple wound dressings on microbial growth in a perfused equine wound model.

SAMPLE

Abdominal musculocutaneous flaps from 16 equine cadavers.

PROCEDURES

8 full-thickness skin wound covered were created in each flap. Tissues were perfused with saline (0.9% NaCl) solution. Wounds were inoculated with methicillin-resistant Staphylococcus aureus (MRSA) or Pseudomonas aeruginosa (106 CFUs), incubated, and covered with a dressing containing activated charcoal, boric acid, cadexomer iodine, calcium alginate, manuka honey, nanoparticle silver, or polyhexamethylene biguanide or with a control (nonadherent gauze) dressing. Muscle biopsy specimens were obtained at baseline (immediately prior to dressing application) and 6, 12, 18, and 24 hours later for mean bacterial load (MBL) determination. The MBLs at each subsequent time point were compared with that at baseline within dressing types, and MBLs at each time point were compared among dressing types.

RESULTS

MBLs in MRSA-inoculated wounds covered with cadexomer iodine dressings were significantly decreased from baseline at the 6− and 12-hour time points. For P aeruginosa–inoculated wounds, MBLs were significantly increased from baseline in all wounds at various times except for wounds with cadexomer iodine dressings. The MBLs of wounds with cadexomer iodine dressings were lower than all others, although not always significantly different from those for wounds with boric acid, manuka honey, nanoparticle silver, and polyhexamethylene biguanide dressings.

CONCLUSIONS AND CLINICAL RELEVANCE

In this nonviable perfused wound model, growth of MRSA and P aeruginosa was most effectively reduced or inhibited by cadexomer iodine dressings. These results and the effect of the dressings on wound healing should be confirmed with in vivo studies.

Abstract

OBJECTIVE

To compare the effect of multiple wound dressings on microbial growth in a perfused equine wound model.

SAMPLE

Abdominal musculocutaneous flaps from 16 equine cadavers.

PROCEDURES

8 full-thickness skin wound covered were created in each flap. Tissues were perfused with saline (0.9% NaCl) solution. Wounds were inoculated with methicillin-resistant Staphylococcus aureus (MRSA) or Pseudomonas aeruginosa (106 CFUs), incubated, and covered with a dressing containing activated charcoal, boric acid, cadexomer iodine, calcium alginate, manuka honey, nanoparticle silver, or polyhexamethylene biguanide or with a control (nonadherent gauze) dressing. Muscle biopsy specimens were obtained at baseline (immediately prior to dressing application) and 6, 12, 18, and 24 hours later for mean bacterial load (MBL) determination. The MBLs at each subsequent time point were compared with that at baseline within dressing types, and MBLs at each time point were compared among dressing types.

RESULTS

MBLs in MRSA-inoculated wounds covered with cadexomer iodine dressings were significantly decreased from baseline at the 6− and 12-hour time points. For P aeruginosa–inoculated wounds, MBLs were significantly increased from baseline in all wounds at various times except for wounds with cadexomer iodine dressings. The MBLs of wounds with cadexomer iodine dressings were lower than all others, although not always significantly different from those for wounds with boric acid, manuka honey, nanoparticle silver, and polyhexamethylene biguanide dressings.

CONCLUSIONS AND CLINICAL RELEVANCE

In this nonviable perfused wound model, growth of MRSA and P aeruginosa was most effectively reduced or inhibited by cadexomer iodine dressings. These results and the effect of the dressings on wound healing should be confirmed with in vivo studies.

Contributor Notes

Address correspondence to Dr. De Clercq (eclercq1@gmail.com).