As concerns over antibiotic resistance grow, equine veterinarians look for ways to treat wounds without reaching for these powerful drugs. At the 2019 British Equine Veterinary Association Congress, held Sept. 11-14 in Birmingham, U.K., Dean Hendrickson, DVM, Dipl. ACVS, described ways to do just this, ranging from debridement to stem cell therapy.

Debridement

The best way to deal with bacteria is to get rid of them, said Hendrickson, a professor in the Clinical Sciences Department at Colorado State University’s Veterinary Teaching Hospital, in Fort Collins.

“We have a tendency in veterinary medicine to want to kill the bacteria in situ, but I’m going to encourage you to remove them and throw them away and don’t let the patient have to deal with them at all,” he advised the audience.

Veterinarians can remove bacteria through debridement (removing the affected tissue), of which there are several types:

Autolytic debridement. This process uses the body’s own enzymes and moisture to liquefy and remove necrotic (dead) tissue. Hendrickson said it’s the most selective way to remove bacteria and dead cells while leaving healthy cells.

“All you’re doing is leaving the healthy wound exudate (liquid the body produces in response to tissue damage) in contact with the wound bed to accomplish this,” he said. “The normal white blood cells and proteolytic enzymes that occur in wound exudate are your best friends with regard to removing small doses of bacteria and small amounts of necrotic tissue.”

To achieve autolytic debridement, you must keep the wound environment moist (but not soupy), which you can do using dressings. If the wound has a lot of necrotic tissue, however, then you’ll need to use a more aggressive form of debridement, said Hendrickson.

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