Wilmink J M, Stolk P W, van Weeren P R, Barneveld A
Department of General and Large Animal Surgery, Faculty of Veterinary Medicine, Utrecht, The Netherlands.
Equine Vet J. 1999 Jan;31(1):53-60. doi: 10.1111/j.2042-3306.1999.tb03791.x.
Second-intention healing of deep wounds was studied in 5 horses and 5 ponies. Standardised wounds were created on the distal limbs and hind quarters. Wounds on the metatarsi extended onto the metatarsal bone; the depth of the wounds in the femoral biceps muscle was 18 mm. The wound margins were marked by tattoos. Photographs were taken at weekly intervals to determine the wound area. The relative contribution of contraction and epithelialisation to wound closure was quantified by means of the tattoos. Swelling of the limbs was measured; and regularity and aspect of the granulation tissue were semi-quantitatively scored. Second-intention wound healing occurred significantly faster in ponies than in horses, and muscle wounds healed significantly faster than metatarsal wounds. These marked differences reflected the greater contribution of contraction to wound healing. Moreover, demarcation was seen earlier and a healthy granulation bed developed more rapidly in ponies, whereas in horses the granulation tissue remained irregular and purulent for longer. Healing of the metatarsal wounds of horses differed markedly from that of all other wounds: these wounds increased to almost twice their original size in the first 2 weeks, exuberant granulation tissue was persistent, epithelialisation started later, and contraction played a minor role in wound closure. Limb swelling was greater in horses than in ponies. Periosteal new bone formation was more extensive, and was active over a longer period in the metatarsal bones of horses than of ponies. From this study it is concluded that second-intention healing of deep wounds occurs faster in ponies than in horses. This difference can be largely attributed to a more pronounced and faster wound contraction in ponies than in horses. Therefore, attempts to improve second-intention wound healing in clinical practice should be directed at stimulation of wound contraction.
对5匹马和5匹矮种马的深部伤口二期愈合情况进行了研究。在远端肢体和后躯创建标准化伤口。跗骨上的伤口延伸至跗骨;股二头肌伤口深度为18毫米。用纹身标记伤口边缘。每周拍照以确定伤口面积。通过纹身对收缩和上皮形成对伤口闭合的相对贡献进行量化。测量肢体肿胀情况;对肉芽组织的规则性和外观进行半定量评分。矮种马的二期伤口愈合明显快于马,肌肉伤口愈合明显快于跗骨伤口。这些显著差异反映出收缩对伤口愈合的贡献更大。此外,矮种马的分界出现得更早,健康的肉芽床形成得更快,而马的肉芽组织在更长时间内保持不规则且有脓性。马的跗骨伤口愈合与所有其他伤口明显不同:这些伤口在最初2周内增大到几乎是原来大小的两倍,过度增生的肉芽组织持续存在,上皮形成开始较晚,收缩在伤口闭合中起的作用较小。马的肢体肿胀比矮种马更严重。骨膜新骨形成在马的跗骨中比在矮种马中更广泛,且活跃时间更长。从这项研究得出结论,深部伤口的二期愈合在矮种马中比在马中发生得更快。这种差异很大程度上可归因于矮种马比马的伤口收缩更明显、更快。因此,在临床实践中试图改善二期伤口愈合应着眼于刺激伤口收缩。