Second intention wound healing progressed slowly and with an indolent behaviour. Microscopically there was marked overlapping of the inflammatory and proliferative phases over a long time period.

BackgroundCompared with mammals, wound healing in reptiles is characterized by reduced wound contraction and longer healing times. The aim of this study is to describe the clinical and histopathological effects of topical insulin on second-intention healing of experimentally induced wounds in skin without dermal bony plates of Trachemys scripta elegans exposed to daily variations in ambient temperature and in an aquatic environment. Forty-four healthy adult females were assigned to two groups: Group 1 (n = 24) was used to assess clinical features such as wound contraction; Group 2 (n = 20) was used for histological evaluation and morphometric analysis. Topical porcine insulin (5 IU/ml diluted in glycerol) was applied daily 1 week. For each control time (2, 7, 14, 21 and 28 days post-wounding), re-epithelisation and wound remodelling were evaluated histologically and the number of main inflammatory cells (heterophils, macrophages, lymphocytes and fibroblasts) was scored.ResultsMean wound contraction was higher in the insulin-treated group at each time point and differences were significant at day 28 (P < 0.0001). Histologically, these clinical findings were associated with better re-epithelisation, inflammatory response, collagen synthesis and remodelling of the wounds. Morphometrically, insulin-treated wounds had significantly higher mean counts of heterophils (day 7), macrophages (days 2, 7 and 14) and fibroblasts (days 14 and 21), whereas lymphocyte counts were significantly lower at day 21. These results demonstrate that topical insulin modifies the inflammatory response of turtle skin up-regulating inflammatory cells at early stages and promoting wound healing.ConclusionsTopical insulin is a potentially useful therapy in skin wounds of Trachemys scripta and should be evaluated in non-experimental wounds of turtles and other reptiles.

Background Ozone is an antimicrobial agent that in experimental and case-control studies has been found to exert a positive effect on wound healing. Wild and pet chelonians frequently present insidious wounds exhibiting secondary infections and/or delayed healing. Objectives Evaluate the effects of topical ozonated sunflower oil on second-intention healing of acute experimental skin wounds in red-eared sliders ( Trachemys scripta elegans ). Methods Randomised within-subject controlled study; Group 1 (n = 24) was used to assess clinical healing features; Group 2 (n = 12) was used for histological evaluation in which two sets of wounds were biopsied at 2, 7, 14, 21, 28 and 42 days over the course of the cicatrisation process. A single 6 mm diameter wound was made on each rear limb and topical ozonated (950 peroxide value) and non-ozonated sunflower oil were applied daily for one week on treated and contralateral control wounds, respectively. Results Mean wound size was significantly lower in the ozone-treated group at day 28 ( p < 0.0001) with differences of clinical relevance (74.04% vs. 93.05% reduction of initial wound size). Histologically, the acute inflammatory reaction was enhanced in treated wounds, with significantly higher numbers of heterophils ( p = 0.0016), lymphocytes ( p < 0.001) and fibroblasts ( p < 0.001). Conclusions Daily topical application of ozonated sunflower oil over the course of one week improved the healing of acute, full-thickness skin wounds in chelonians. This clinical outcome was histologically correlated with an enhanced acute inflammatory reaction, as well as the production and remodelling of collagen fibres.