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BEVA primary care clinical guidelines: Wound Management in the Horse

Freeman, S.L.; Ashton, N.M.; Elce, Y.A.; Hammond, A.; Hollis, A.R.; Quinn, G.

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Authors

SARAH FREEMAN sarah.freeman@nottingham.ac.uk
Professor of Veterinary Surgery

N.M. Ashton

Y.A. Elce

A. Hammond

A.R. Hollis

G. Quinn



Abstract

Methods: Research questions were proposed by a panel of veterinarians, and developed into PICO format. Evidence in the veterinary literature was evaluated using the GRADE evidence-to-decision framework. Searches for human evidence summaries were conducted in the NICE, Cochrane and JBI databases. Final recommendations were based on both veterinary and human evidence. Results and recommendations: The research questions were categorised into three areas: A. Wound lavage and topical treatments; B. Wound debridement and closure; C. Therapeutics for wound healing. Three hundred and six veterinary publications were identified across thirteen different topics. Fourteen papers were assessed using the GRADE criteria. Twenty-five human evidence summaries were reviewed. The results were developed into recommendations: A. Wound lavage and topical treatments: (i) Tap water should be considered instead of saline for lavage; (ii) Povidone iodine lavage should be considered for contaminated wounds; (iii) Topical silver sulfadiazine may not be suitable for acute wounds; (iv) Optimal lavage pressures are around 13 psi. B. Wound debridement and closure: (i) Debridement pads should be considered for wound preparation; (ii) Larvae debridement should be considered in selected cases; (iii) Hydrosurgery should be considered in acute contaminated wounds. C. Therapeutics for wound healing: (i) Honey may reduce duration of some phases of wound healing. There was insufficient evidence to draw conclusions on the use of chemical debridement, therapeutic ultrasound, laser therapy, wound closure with staples compared to sutures, or identify optimal concentrations of antiseptic lavage solutions. Main limitations: Low quality evidence in veterinary literature; majority of recommendations were based on human evidence. Conclusions: These findings should be used to inform decision-making in equine primary care practice.

Citation

Freeman, S., Ashton, N., Elce, Y., Hammond, A., Hollis, A., & Quinn, G. (2020). BEVA primary care clinical guidelines: Wound Management in the Horse. Equine Veterinary Journal, 53(1), 18-29. https://doi.org/10.1111/evj.13289

Journal Article Type Article
Acceptance Date May 10, 2020
Online Publication Date Jul 17, 2020
Publication Date Dec 20, 2020
Deposit Date Jun 24, 2020
Publicly Available Date Mar 29, 2024
Journal Equine Veterinary Journal
Print ISSN 0425-1644
Electronic ISSN 2042-3306
Publisher Wiley
Peer Reviewed Peer Reviewed
Volume 53
Issue 1
Pages 18-29
DOI https://doi.org/10.1111/evj.13289
Keywords Equine; General Medicine
Public URL https://nottingham-repository.worktribe.com/output/4706033
Publisher URL https://beva.onlinelibrary.wiley.com/doi/abs/10.1111/evj.13289

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