BackgroundRegenerative and anti-inflammatory effects on tendinopathies have been attributed to blood-derived biologicals. To date the evidence for the efficacy of autologous platelet-rich plasma (PRP) treatment of naturally occurring equine tendinopathies is limited. The purpose of this placebo-controlled clinical trial was to describe the effect of a single treatment of equine superficial digital flexor tendon (SDFT) disease with PRP on clinical and ultrasonographic parameters. Twenty horses with naturally occurring tendinopathies of forelimb SDFTs were randomly assigned to the PRP-treated group (n = 10) or control group (n = 10) after clinical and ultrasonographic examination. The SDFTs received an intralesional treatment with autologous PRP or were injected with saline, respectively (day 0). All horses participated in a standardized exercise programme and were re-examined clinically, with B-mode ultrasonography (5 times at regular intervals) and ultrasound tissue characterization (week 12 and 24 after treatment) until week 24. Long-term performance was estimated via telephone inquiry.ResultsCompared to day 0, lameness decreased significantly by week 8 after treatment with PRP and by week 12 in the control group. Ultrasonographically there was no difference in the summarized cross sectional area between the groups at any time point. Ultrasound tissue characterization showed that echo types representing disorganized matrix decreased significantly throughout the observation period in the PRP-treated group. Echo type II, representing discontinuous fascicles, not yet aligned into lines of stress was significantly higher 24 weeks after PRP treatment. Eighty percent of the PRP treated horses reached their previous or a higher level of performance after 12 months compared to 50 % in the CG. After 24 months these proportions were 60 % and 50 %, respectively.ConclusionsA single intralesional treatment with PRP up to 8 weeks after onset of clinical signs of tendinopathy contributes to an earlier reduction of lameness compared to saline treatment and to an advanced organization of repair tissue as the fibrillar matrix is getting organized into fascicles while remodelling continues. Long term, PRP treatment has the potential to increase the number of horses reaching their previous level of performance. Earlier treatment of tendinopathy with PRP should be considered to enhance these effects.
In a randomized, prospective, clinical trial the applicability of a vacuum therapy system was evaluated at the ventral abdomen in 50 horses with laparotomy due to acute abdominal pain. The effects on the incidence of wound healing complications after ventral median laparotomy in horses with acute abdominal pain is described. The horses were allocated to the treatment or control group after laparotomy and equipped with a wound dressing and a vacuum (125 mmHg) or with the wound dressing alone. Relevant parameters were collected preoperatively, intraoperatively, six consecutive days postoperatively, and three and eight weeks after surgery. Pre-, intra-and postoperative parameters were not significantly different between the groups. Nine horses (36 %) in the treatment group and four horses (16 %) in the control group developed a wound healing complication. This difference was not statistically significant and neither were the differences in oedema formation and the occurrence of dehiscence. No significant differences concerning exudation, oedema or dehiscence were found between the groups three and eight weeks after surgery. Overall, the vacuum system used in this study is an easy to apply system for general use at the ventral abdomen of the horse, with good toleration by the patients. The results indicate that the use of vacuum therapy for primary closed wounds after median laparotomy has no beneficial effect on wound healing.
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