Effects of unfocused extracorporeal shock wave therapy on healing of wounds of the distal portion of the forelimb in horses.
Abstract: To determine effects of extracorporeal shock wave therapy (ESWT) on healing of wounds in the distal portion of the forelimb in horses. Methods: 6 horses. Methods: Five 6.25-cm2 superficial wounds were created over both third metacarpi of 6 horses. Forelimbs were randomly assigned to treatment (ESWT and bandage) or control (bandage only) groups. In treated limbs, each wound was treated with 625 shock wave pulses from an unfocused electrohydraulic shock wave generator. In control limbs, each wound received sham treatment. Wound appearance was recorded weekly as inflamed or healthy and scored for the amount of protruding granulation tissue. Standardized digital photographs were used to determine the area of neoepithelialization and absolute wound area. Biopsy was performed on 1 wound on each limb every week for 6 weeks to evaluate epithelialization, fibroplasia, neovascularization, and inflammation. Immunohistochemical staining for A smooth muscle actin was used to label myofibroblasts. Results: Control wounds were 1.9 times as likely to appear inflamed, compared with treated wounds. Control wounds had significantly higher scores for exuberant granulation tissue. Treatment did not affect wound size or area of neoepithelialization. No significant difference was found for any of the histologic or immunohistochemical variables between groups. Conclusions: Treatment with ESWT did not accelerate healing of equine distal limb wounds, but treated wounds had less exuberant granulation tissue and appeared healthier than controls. Therefore, ESWT may be useful to prevent exuberant granulation tissue formation and chronic inflammation of such wounds, but further studies are necessary before recommending ESWT for clinical application.
Publication Date: 2010-02-02 PubMed ID: 20113232DOI: 10.2460/ajvr.71.2.229Google Scholar: Lookup
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- Controlled Clinical Trial
- Journal Article
Summary
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The research in question investigates the impacts of extracorporeal shock wave therapy (ESWT) on the healing of forelimb wounds in horses, finding that while ESWT does not expedite the healing process, it contributes to healthier-appearing wounds by reducing granulation tissue overgrowth and chronic inflammation.
Methods
- In the study, five 6.25 cm2 superficial wounds were created over the third metacarpi of six horses. These forelimbs were then divided into a treatment group that received ESWT and bandaging, and a control group which only received bandaging.
- 625 shock wave pulses from an unfocused electrohydraulic shock wave generator were used for each wound in the treatment group, while a sham treatment was given to wounds in the control group.
- Each wound was observed weekly to ascertain if it appeared inflamed or healthy and was scored on the basis of the quantity of protruding granulation tissue.
- Digital photography was used to track the area of neoepithelialization and total wound area.
- For a period of six weeks, one wound on each limb was biopsied weekly to gauge epithelialization, fibroplasia, neovascularization, and inflammation. Additionally, myofibroblasts were labeled using immunohistochemical staining for smooth muscle actin.
Results
- The results demonstrated that wounds in the control group had a 1.9 times higher chance of appearing inflamed as compared to treated wounds.
- The scores for exuberant granulation tissue were significantly higher in the control group.
- The treatment did not affect the size of the wound or the area of neoepithelialization.
- There was no notable disparity in histologic or immunohistochemical variables between the treated and control groups.
Conclusions
- While the use of ESWT did not speed up the healing of distal limb wounds in horses, treated wounds displayed less exuberant granulation tissue and generally appeared healthier than control group wounds. Therefore, these findings suggest that ESWT could be used to prevent the formation of exuberant granulation tissue and ongoing inflammation in such wounds.
- However, the authors caution that further studies are needed before ESWT can be recommended for clinical application.
Cite This Article
APA
Silveira A, Koenig JB, Arroyo LG, Trout D, Moens NM, LaMarre J, Brooks A.
(2010).
Effects of unfocused extracorporeal shock wave therapy on healing of wounds of the distal portion of the forelimb in horses.
Am J Vet Res, 71(2), 229-234.
https://doi.org/10.2460/ajvr.71.2.229 Publication
Researcher Affiliations
- Department of Clinical Studies, Ontario Veterinary College, University of Guelph, Guelph, ON N1G 2W1, Canada. silveira@uoguelph.ca
MeSH Terms
- Animals
- Bandages
- Extremities / injuries
- Granulation Tissue
- High-Energy Shock Waves / therapeutic use
- Horses / injuries
- Wound Healing / radiation effects
- Wounds and Injuries / veterinary
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