The Effect of Intravenous Regional Perfusion of the Distal Limb With Amikacin Sulfate on Wounds Healing by Second Intention in Horses.
Authors: Edwards-Milewski Margaux L, Morello Samantha L, Zhao Qianqian, Mattan-Bell Cynthia
Journal: Veterinary surgery : VS
Summary
# Editorial Summary Intravenous regional limb perfusion (IVRLP) with amikacin is commonly used to deliver high antibiotic concentrations to distal limb wounds in horses, yet little evidence exists regarding its effects on the healing process itself. This experimental study compared gross and histological healing outcomes in seven horses, each with two identical full-thickness wounds (2.5 × 2.5 cm) created on the dorsal metacarpus; one limb received IVRLP treatment with amikacin sulfate on days 2, 3, and 4 post-wounding whilst the contralateral limb served as untreated control. Over the 62-day observation period, treated and untreated wounds showed no significant differences in size, contraction rate, or total healing time, though histological examination revealed increased mononuclear cell infiltration in perfused wounds without affecting oedema, haemorrhage, fibrovascular proliferation, or exuberant granulation tissue formation. These findings suggest that three days of amikacin IVRLP does not impair second-intention healing in distal limb wounds, providing reassurance for practitioners using this technique therapeutically, though the clinical significance of elevated inflammatory cell counts warrants further investigation in naturally occurring contaminated wounds.
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Practical Takeaways
- •IVRLP with amikacin is safe to use on distal limb wounds without impairing second intention healing, making it a viable option for managing contaminated or infected wounds
- •Practitioners can confidently apply regional perfusion therapy without concern for delayed healing or granulation tissue complications
- •The increased inflammatory cell response suggests therapeutic benefit while maintaining normal healing kinetics
Key Findings
- •IVRLP with amikacin sulfate for 3 consecutive days did not negatively affect second intention wound healing in equine distal limbs
- •No statistically significant differences in wound size, contraction rate, or total healing time between treated and control wounds
- •Greater mononuclear cell infiltration observed in IVRLP-treated wounds without clinical significance
- •All wounds healed without exuberant granulation tissue formation in both treatment groups