At the North American Veterinary Conference (January 2016), Katie Seabaugh, DVM, MS, DACVS, DACVSMR, of the University of Georgia, focused on management of chronic wounds. When a wound won’t heal, she advised using imaging techniques to look for a sequestrum or foreign body. Bacterial (and fungal, when appropriate) culture adds information to direct treatment.
Once managed with surgical debridement and appropriate antimicrobial therapy, the wound should be dressed and bandaged. She discouraged the use of aerosol sprays for chronic wounds and instead suggested less commonly considered—but highly useful—alternatives for wound dressings:
Calcium alginate (Curasorb) encourages granulation tissue while retaining moisture. It is especially helpful in areas with significant tissue loss, such as over the cannon bone.
Equine amnion decreases formation of granulation tissue and accelerates epithelialization.
Antimicrobial gauze (Kerlix) can be used for infected wounds or wounds involving synovial structures.
Hypertonic saline (Curasalt) used in the initial 1-3 days achieves non-selective debridement of a highly necrotic and contaminated wound.
Platelet-rich plasma (PRP) might provide growth factors for healing.
Non-adherent dressing (Telfa) enables removal of the bandage with minimal interference with healing progression.
Foam dressing (Kendall) is applicable to wounds with moderate exudate. This non-adherent material absorbs fluid and prevents tissue maceration while maintaining appropriate moisture. It decreases granulation formation and encourages epithelialization.
In all cases, the objective is to stimulate and enable the body’s natural defenses to heal a chronic wound.
