What is biological and regenerative therapy?
a branch of research dealing with the process of replacing, engineering, or regenerating cells, tissues, or organs to restore normal function
What do most therapies in veterinary medicine aim to do?
reduce inflammation, promote, neovascularization, or modulate/promote an anabolic local environment during healing
What does IRAP stand for?
autologous conditioned serum
What is autologous conditioned serum?
-Anti-inflammatory cytokine “interleukin-1 receptor antagonist protein” (the ‘IRAP’ protein binds to IL-1 receptors to block cellular signaling of inflammation
How do you acquire IRAP?
1. collect whole blood from an animal
2. expose blood to select surfaces to stimlate monocytes to secrete IL1
3. Keep at body temperature for 24 hours
4. Centrifuge and aspirate serum off
5. ACS serum then injected into joint
What are the different broad sub-types of regenative therapies?
autologous conditioned serum, platelet rich plasma, autologous protein solution, and stem cells
What is platelet rich plasma therapy?
a blood-derived therapy focusing on enriching plasma substrate from whole blood with growth factors released from platelets
What are the two types of platelet rich plasma?
centrifuged-based or filtration-based
What is PRP used for?
soft tissue injuries (horses) or osteoarthritis (dogs)
What is autologous protein solution?
a combination of PRP and IRAP
What is autologous protein solution also called?
What are the types of stem cells?
embryologic and adult
What is autologous stem cell treatment?
when cells are collected from the same patient to be treated
What is allogenic stem cell treatment?
cells collected from a donor animal and given to a patient of the same species
Where are bone marrow stem cells collected from?
the sternum, tuber coxae, and the humerus (dogs)
Where are adipose stem cells retrieved from?
fat at the base of the tail head or inguinal region
What are conditions in which regenerative therapy can be used to treat primary injury/disease or augment healing post-surgery?
in musculoskeletal disease - joint disease/osteoarthritis or tendon and ligament injury
What are the four different wound closure technique categories?
primary closure, delayed primary closure, secondary closure, and second intention healing
When does primary closure occur?
it is immediate closure of viable tissue within 6 hours of injury
What type of wounds do you do primary closure on?
clean and clean-contaminated wounds
When does delayed primary closure occur?
3-5 days after wound occurs but before the appearance of granulation tissue
What is secondary closure also known as?
third intention healing
When does secondary closure occur?
over 5 days after injury, after granulation tissue appears
What type of wounds is secondary closure done on?
contaminated or dirty wounds
What must you do before performing secondary closure?
debride the granulation tissue and skin edges before closing
What is second-intention healing?
when the wound is allowed to heal by granulation, contraction, and epithelialization
What are main differences in equine wound management?
the wounds are often very contaminated, there is a less intense inflammatory response, and wounds on the limbs have delayed healing, they develop exuberant granulation tissue
Do horses or ponies heal faster?
How is exuberant granulation tissue managed/treated?
minimize inflammation and motion, excise granulation tissue (repeat every 2 weeks in horses), topical treatment
If excising granulation tissue, where should you start?
from the bottom of the wound because the granulation tissue will bleed a lot