Case reports – veterinary

Puncture wound on the knee of a horse

A puncture wound on the knee of a horse was treated for 3-4 months with every available type of antibiotics. However, it failed to heal. The horse was referred to Dr. Knapp, who first tried surgical debridement. However, the stitches broke and the wound did not heal. Next, SertaSil was applied once daily without dressing. The wound healed without further complications.

Simon Knapp: “I really like SertaSil. It vascularises the wound, it keeps the wound clean and we have not seen any signs of hypergranulation.”

Responsible: Simon Knapp, vet & clinical director, Scott Dunn's Equine Clinic, Wokingham.

The first picture is from March 27, 2013 and shows the wound just after start of application. The second picture is from April 18, just after application of SertaSil had stopped.

Infected twice dehisced surgical wound

- 9 year 10 month old female neutered Labrador retriever had a dermal lump on her lateral right stifle. Cytology of needle aspirate indicated a mast cell tumour. No thoracic metastases were identified. No abnormal finding in liver and spleen. Mild liver enzyme elevation. The mass was surgically excised with 20mm lateral margins. Histology revealed a grade II Mast Cell Tumour with clear margins.

- 7 days post op, the middle portion of the wound dehisced so she started amoxicillin/clavulanic acid antibiotics.

- 9 days post op, the wound had dehisced totally so the wound was debrided and resutured with stents to relieve tension. A swab was taken for culture and sensitivity – E. coli and β-haemolytic Streptococcus were isolated.

- 20 days post op, the wound dehisced again and there was no skin for repeat surgery.

- 23 days post op SertaSil was started and applied once daily for 4 consecutive days. All applications except the first one was done by the owner at home.

- Then, the wound was left in peace to heal without further treatment or interference. It was fully epithelialized (closed) 16 days after first SertaSil application.

Responsible treating veterinary surgeon’s statement:
I am truly astounded as to the progress of the wound and extremely grateful to you for allowing me to use the product.

Responsible: Heidi Heath, vet, Midforest Vets.

 

The first picture (Day 0) shows the wound before start of application. The second picture is taken Day 4 and the final Day 14.

Abscess on the withers of a horse

A protective rug had caused an abscess on the withers of a horse. It had been on-going for a long time and the abscess had become deep, infected and "nasty". Surgical debridement was performed (photo left) and was immediately followed by daily applications of SertaSil. The abscess healed nicely in 3 weeks without any signs of hypergranulation or other complications.

Owner: “The abscess seemed to have gone quite deep so a lot of tissue was removed but you could really see the healing process, despite it taking a long time.”

Responsible: Simon Knapp, vet & clinical director, Scott Dunn's Equine Clinic, Wokingham.

The first picture shows the wound after debridement and before start of application. The second picture is taken after application of SertaSil has stopped.

Wire wound with extensive soft tissue damage in horse

A horse had a severe wire wound with extensive soft tissue damage to the foot. The wound had been treated with manuka honey for several weeks. It granulated well and decreased in size. However, healing slowed down and finally stopped contracting in spite of continued use of honey, leaving an area near the hoof still open. SertaSil was applied to the area. Within 24 hours the wound had shrunk very significantly and healing progressed well.

Responsible: Nancy Homewood, vet, Hook Norton Veterinary Group, Banbury.

 

The first picture shows the wound just after start of application. The second picture is taken 48 hours later.

Ulcerative non-healing leg wound in a horse

The horse had suffered a laceration on the lower hind leg. The owner had treated him for 3 weeks with different products, including “Purple Spray” (0.5 % Gentian Violet), but the wound did not heal. The owner contacted the clinic and SertaSil treatment was initiated. Wound cleansing and initiation of a normal healing process was achieved after 2-3 applications of SertaSil.

Responsible: Simon Knapp, vet & clinical director, Scott Dunn's Equine Clinic, Wokingham.

 

The pictures below show progression of healing. There were no signs of hypergranulation or other complication during the application period.

Non-healing hock wound in foal

A kick had caused a superficial wound to the lateral aspect of a foal's hock. The wound would not heal and over a 3 week period topical honey, a 50:50 fuciderm/intrasite mix and a course of oral TMPS (antibiotic) were tried, but without inducing healing. SertaSil application was started on May 27, 2013. The wound was hosed daily in the morning and in the afternoon, and, after drying the wound, SertaSil was applied. The wound immediately started to heal and has continued to progress without complications. During the entire period, the foal has remained on the field and been allowed to move freely at all times.

Responsible: Samantha Cutts, vet, Hook Norton Veterinary Group, Banbury.

The pictures show progression of healing. The first picture is May 31, 2013, 4 days after start of application of SertaSil. The next June 2 and the following two pictures are from June 17 before and after the vet cleaned the wound and the last picture is from July 5. There were no signs of hypergranulation or other complication during the application period.

  

Necrotic tail wound in dog

A tail injury developed into a chronic, necrotic wound exposing the tail bone in a Lurcher dog. The wound was debrided, dressed with Intracyte (hydro-gel) and covered with a syringe vial to stop the dog from knocking the wound. After 4 weeks of treatment the wound remained un-healed. No debridement or rinsing was undertaken. SertaSil was applied once and the wound was left undressed, but covered with a hard syringe vial to avoid knocking it. After two weeks, and without any further treatment, the wound had healed, covering the bone and the hair was starting to grow back again on the tip of the tail.

Nancy Homewood: “So far seem to be seeing much reduced healing time and quick action using SertaSil. Ease of application and it also is very handy to apply to wounds that cannot be dressed.”

Responsible: Nancy Homewood, vet, Hook Norton Veterinary Group, Banbury.

The first picture shows the tail wound with the bone protruding. The second picture shows the healing tail after a single application of SertaSil.

Infected necrotic paw wound in a dog following laceration

The dog enters the clinic with a paw that had been lacerated several days earlier. The wound is swollen, red and exudating, showing no evidence of granulation tissue. The wound edges are frayed and appear chewed by the dog. The wound is cleaned, SertaSil applied and dressed. Four days later, the wound shows normal healing with formation of granulation tissue. Use of SertaSil is continued and the wound continues to show good healing. Wound closure is achieved in 15 days after start of treatment.

Responsible: Alf Laebro, vet & partner; and Signe L. Dideriksen, vet, Centrum Small Animal Hospital, Denmark.

Detailed description:

A 5 years and 1 month old bitch (Rottweiler mix) enters the clinic limping without touching the ground on the left hind leg. She has some days previously torn her pad and the wound opening is approx. 12 cm2 (3x4 cm). The wound is swollen, red and exudating showing no evidence of granulation tissue. The wound edges are frayed and appear chewed by the dog. Apart from the limp, the bitch seems healthy and happy.

The wound is cleaned with chlorhexidine, air dried, SertaSil is applied and the wound is dressed with a shock resistant and waterproof bandage using Allevyn, Soffban, Vetrap and Tensoplast. An 8 days Amoxicillin treatment is initiated.

The owner is advised to avoid exercise and getting the dressing wet when the dog is outdoors.

The dressing is changed 4 days later. According to the owner, the dog has done very well, and despite having played and chased balls, the wound looks really good. It has pulled together along the edges where granulation tissue is also emerging. The centre of the wound is yellow due to concentration of lymphatic cells. The wound is cleaned with chlorhexidine, air dried, covered with SertaSil and dressed with a shock resistant and waterproof bandage similar to the previous and supplemented with a paw sock.

At the follow-up 2 days later, the dog walks correctly on all four legs without any sign of lameness. The wound looks good. It is virtually no longer exudating, it is beginning to close from the edges toward the centre and is now covered with granulation tissue except for a small yellow spot of lymphoid cells in the centre. The wound is washed, covered with SertaSil and dressed as last time.

At the follow-up 4 days later, the wound again looks good. 4/5 of the wound is now covered by a thin layer of white epithelium, while 1/5 (approx. 1 cm in diameter) is still open, covered with moist surface granulation tissue. Acidity is recognized between the toes because of the dressing, so the hair is cut, the interdigital space is cleaned with chlorhexidine, dried and Fuciderm (fusidic acid + betamethasone) is applied. The original wound is washed, covered with SertaSil and dressed as before.

At the follow-up 2 days later, the remaining part of the wound is also covered with a thin layer of epithelium. There is obvious contraction from the edges and epithelial tissue along the periphery has matured and become stronger and more resilient. Use of SertaSil is discontinued and the paw is simply dressed as previously.

2 days later at the follow-up, the epithelium has matured and become thicker and denser. The paw is cleaned with chlorhexidine and the owner is advised that the dog must wear a paw sock when outdoors but not indoors in order to allow access of air to the toes.

The owner is telephoned 6 days later. Everything is in perfect order. The dog is not wearing a sock and has shown no interest in the injury for the last 5 days. The wound is completely healed and the only trace left is a light discoloration partly due scar tissue.

The wound had closed in 15 days.

Infected lick granuloma in dog

After 2 days of application

A 7 year old Dalmatian had a history of recurring, itchy skin problems. It was on chronic steroid treatment to manage the condition, but developed an 6 cm long lick granuloma on leg with secondary infection. SertaSil was applied to the wound daily. Within a week, the dog was defiantly more comfortable and not licking the wound. The granuloma epithelialised and healed in 2 weeks without use of systemic antibiotics.

Lucy McDonagh, owner: "Describing SertaSil as 'amazing' is not very articulated, but it simply was! At the time Ben's wound was large and 'angry', bright red and full of fluid. It was almost visible to the naked eye from the first application, that fluid was being drawn away from the wound, the redness and the swelling went down."

William Oldham, vet: "I would use SertaSil for lick granulomas again as the client's experience and clinical outcome far exceeded my expectations."

Responsible: William Oldham, vet, Hawthorn Lodge Veterinary Practice, Banbury.

Heavily infected post surgical paw wound in a dog following removal of skin tumour

The dog had a small benign skin tumour on the toe surgically removed. 7 days after surgery all stitches have broken open, the wound is heavily infected and red and must heal by second intention. Four days later after two applications of SertaSil, the wound is no longer infected, but is healing with clear presence of granulation tissue, healthy wound edges and has reduced in size from 2 to 1½ cm in diameter. Application of SertaSil continues and the wound is fully closed 30 days after first treatment. This is achieved in spite of the fact that the dog had bitten off the dressing one weekend and chewed the wound and that three pressure ulcers had formed on the paw, all three infected and one of them with a 1 cm deep pocket formation. These also received SertaSil and progressed fast and steadily to complete healing.

Responsible: Alf Laebro, vet & partner; and Signe L. Dideriksen, vet, Centrum Small Animal Hospital, Denmark.

Detailed description:

A 6 years and 3 months old boxer bitch has had a small benign skin tumour surgically removed caudally on the 5th toe of the hind paw dexter.

2 days after surgery the dressing is changed and everything is normal. 5 days later, however, all stitches have broken open. The wound is heavily infected and red, and must heal by second intention. The wound is cleaned with chlorhexidine, rinsed with saline, SertaSil is applied and the wound is dressed with Allevyn, Soffban (padding), VetRap and Tensoplast. Furthermore, the owner is informed of the risk that further complications eventually can result in the amputation of the toe.

The next day, the infection and the redness are reduced. The wound is cleaned with chlorhexidine, covered with SertaSil and dressed as the previous day.

At the follow-up 3 days later, no infection is observed, the presence of granulation tissue is evident, the wound edges look healthy, and the wound size is reduced from 2 cm to 1 ½ cm in diameter.

3 days later at the follow up, the wound still displays a well granulating centre and evident epithelialization around the edges. Again, the wound is cleaned with chlorhexidine, covered with SertaSil and dressed as before.

7 days later, the wound diameter is reduced to 1 cm. The use of SertaSil is continued, and the wound is dressed as before.

16 days later, after dressing change with SertaSil every second or third day, the wound is completely healed despite the fact that the dog had bitten off the dressing one weekend and chewed the wound.

The entire process was complicated by the fact that three pressure ulcers had formed on the paw during this course, all three infected and one of them with a 1 cm deep pocket formation. All three pressure ulcers were cleaned with chlorhexidine and SertaSil was used similarly to the original, broken open surgical wound. All three pressure ulcers showed granulation after 2 days, corresponding to one application of SertaSil. At each dressing change, SertaSil was applied, and the wounds progressed fast and steadily to complete healing.

Moist eczema (pyotraumatic dermatitis) in a dog - I

A dog had a 9 cm2 hot spot on the head. The dog was to appear in an exhibition and therefore the area was not shaved, but only loose hairs removed. The area was cleansed and SertaSil applied. At check-up eight hours later, healing was clearly in progress showing contraction of the wound edges. The wound was left untouched. 12 and 24 hours later SertaSil was applied to any moist areas after which the wound was left undisturbed. Over the next week, the crust-like surface gradually fell off revealing new skin. After a week, the wound was completely healed.

Responsible: Alf Laebro, vet & partner; and Signe L. Dideriksen, vet, Centrum Small Animal Hospital, Denmark.

Detailed description:

A 9 years and 10 months old Labrador bitch had a hot spot of approximately 9 cm2 (3x3cm) affecting the top of the head reaching to the upper onset of the outer ear. The dog showed clear signs of pain but was otherwise healthy.

The dog was short haired and due for showing of working skills shortly. All loose hairs in the affected area were removed but the area was not shaved. The area was cleansed with hydrogen peroxide, dried with a sterile gauze pad and SertaSil was applied evenly over the entire wound including the wound edges.

After approximately 5 minutes the dog’s breathing calmed down and the dog settled down, indicating a reduction of pain.

At check-up eight hours later, healing was clearly in progress showing contraction of the wound edges. The wound was left untouched. 12 hours later SertaSil was applied to the no longer white or dry areas. This procedure was repeated 12 hours later. From then on the wound was left untouched. Over the next week, the crust-like surface gradually fell off revealing fresh epithelium.

After a week, the wound was completely healed.

Some days later the same procedure was used on a different dog (11 year old Labrador bitch, 6 cm2 moist eczema on left flank). Procedures and healing processes were identical.

Moist eczema (pyotraumatic dermatitis) in a dog - II

A Labrador had a 6 cm2 moist eczema lesion on the cheek. The area was shaved, cleaned, dried, sprinkled with SertaSil and left uncovered. 4 hours later, maceration and spreading had stopped. 12 hours later, edges were showing clear signs of healing and the wound was dry. SertaSil was re-applied and left un-dressed. After additional 12 hours, SertaSil was added in a few places where it had fallen off. The wound was checked every 12 hours, but no further action was required. During the following days the crust started falling off in small pieces/flakes leaving completely healed skin underneath.

Responsible: Alf Laebro, vet & partner; and Signe L. Dideriksen, vet, Centrum Small Animal Hospital, Denmark.

Detailed description:

A 10 and a half years old Labrador Retriever bitch presented a 6 cm2 (2x3cm) lesion of moist eczema on the right cheek. The area was shaved well beyond the margins of the lesion, washed with hydrogen peroxide, dried, sprinkled with SertaSil and left uncovered. 4 hours later, the maceration and spreading had stopped, and, as the area was still dry, the wound was left alone except for a couple of small dots of the wound, which were no longer white from powder; these were sprinkled with a little extra SertaSil.

12 hours after first application of SertaSil, the edges were showing clear signs of healing and the wound was dry and covered with a thin, soft, bendable sort of crust. Under the “crust” no bacterial growth was taking place. Again, the wound was covered with SertaSil and left un-dressed.

After additional 12 hours, healing was clearly in progress. A little SertaSil was added in a few places where the wound was not white from SertaSil powder or covered with the thin, bendable “crust”.

The wound was checked every 12 hours, but no further action was required. During the following days the crust started falling off in small pieces/flakes leaving completely healed skin underneath, eventually leaving a fully closed wound where only the hair was yet to grow back.

Abscess in cat

A cat had developed an abscess. The abscess was opened surgically, cleaned and SertaSil was applied. The owner continued daily applications of SertaSil at home. Responsible nurse:
Faye Porter:"SertaSil cleared up the abscess very effectively."

Responsible: Faye Porter, head nurse, Blythwood Veterinary Group, Hatch End, London

Infected necrotic post surgical tail wound in a dog following removal of skin atheroma

A dog had a 1.4 cm dia. atheroma surgically removed from tail. 10 days later stitches were removed, but the OP site was lightly infected. The owners were instructed to wash with chlorhexidine shampoo and dress the wound daily.

5 days later, the OP wound showed light superficial necrosis. It was cleaned, covered with SertaSil and dressed. The dog had also chewed the tip of the tail and it was warm, oedematous and developing wounds. It was cleaned, but not covered with SertaSil. Baytril (Enrofloxacin) treatment was initiated and Acepromazin was prescribed for 3 nights to avoid further biting.

2 days later, the OP wound had decreased in size and showed obvious improvement. The tip of the tail was still thickened and revealed a distinct festering smell. Both wounds were cleaned, covered with SertaSil and dressed.

4 days later both the tip and the OP-wound showed clear improvement. The wounds were cleaned and covered with SertaSil. The owner was instructed to apply SertaSil on both wounds every other day for a week. At follow-up one week later, both wounds were completely healed.

Responsible: Alf Laebro, vet & partner; and Signe L. Dideriksen, vet, Centrum Small Animal Hospital, Denmark.

Detailed description:

A 3 years and 8 months old Alsatian male dog has had an atheroma of approx. 1.4 cm in diameter surgically removed from the middle of the tail dexter ventrally.

Upon removal of the stitches 10 days after surgery, the OP site was lightly infected. Owners were instructed to wash with chlorhexidine shampoo and dress the wound daily; they were also advised for the dog to wear a cone or otherwise to prevent the dog from licking / biting the area.

At the control visit 5 days later, the wound showed good healing at the bottom of the wound bed but it was accompanied by a light superficial necrosis. The dog had bitten and chewed the tip of the tail considerably, and it was now thickened and displaying wounds in the skin. The tip of the tail seemed warm and oedematous. The OP wound was rinsed with chlorhexidine, SertaSil was applied and the wound dressed with gauze compress, VetRap and Tensoplast. The tip of the tail was also washed with chlorhexidine but SertaSil was not used. A 7 day treatment with Baytril (Enrofloxacin) was initiated and Acepromazin for 3 nights was prescribed. The owner was informed of the risk that the tail could need amputation.

At the control visit 2 days later, the OP wound had decreased in size and showed obvious improvement. The tip of the tail was still thickened and revealed a distinct festering smell. Both wounds were cleaned with chlorhexidine, covered with SertaSil and dressed with Melolin, elastic gauze and VetRap. It was only possible to carry out checks and dressing changes 4 days later, where both the tip of the tail and the OP-wound showed very evident improvement.

Again, the wounds were rinsed with chlorhexidine and SertaSil was applied. The owner brought some SertaSil home and was instructed to use it every other day for a week. At the follow-up visit one week later, everything was completely healed without the need for further treatment.

Infected run pad in dog

A 9 year old Newfoundlander had an approx. 2 cm long infected wound under the run pad - presumably from a cut while walking. SertaSil was applied twice daily without applying a dressing. The wound healed in approx. 7 days without the use of antibiotics or other treatments.

Responsible: William Oldham, vet, Hawthorn Lodge Veterinary Practice, Banbury.

The first picture shows the cut in the paw and the second picture the healing paw after use of SertaSil.

Skin wound in an elephant

An adult female African elephant in a UK zoo developed a skin wound just below the elbow on the lateral aspect of the left forelimb. The origin of the wound is unknown, but it developed from a minor abscess in the dermis over which the epidermis broke down. The resulting ulcerated area became infected with a moderate purulent exudate. The elephant allowed daily application of SertaSil without difficulty.

Responsible vet: "The wound has healed without complication and in a relatively short period of time. Such lesions in elephants can be very persistent and my impression is that SertaSil has effected a swift resolution."

Responsible vet: "This has been very encouraging."

Responsible:John C. M. Lewis, vet, International Zoo Veterinary Group.

The pictures are from May 11, 2013 at start of application (left) and May 27, 2013 after several applications of SertaSil.

Non-healing paw wound

Enzo, the Doberman, was so unfortunate that he had to have his claw removed surgically after damaging it. However, the wound would not heal and a new claw would not start forming. First, antibiotics and honey were used, but without success. Next, SertaSil was applied 6 times - the number of applications were higher than necessary because Enzo thought it tasted great!! (it is non-toxic) The wound proceeded towards healing and the formation of a new claw.

Enzo also had a non-healing wound on the tip of the tail. This was also resolved with a few applications of SertaSil.