Boot camp: Training and dressing regimens for modeling plantar wounds in the swine

Abstract

Foot ulceration annually affects millions of patients and accounts for billions of dollars in medical expenses in the US alone. Many previous studies have investigated co-morbidities associated with impaired healing, such as microbial infection, compromised circulation, and diabetes. By comparison, little is known about how wound healing proceeds in plantar skin, despite its many unique specializations related to its load-bearing function. One of the main challenges in modeling plantar wounds is the difficulty in maintaining wound dressings, as animals generally have a low tolerance to wearing bandages on their feet. With assistance from the MGH Center for Comparative Medicine, we developed a positive reinforcement-based behavioral training regimen that successfully induced tolerance for plantar dressings in swine, which is a critical first step towards enabling in vivo study of the wound healing process in this highly specialized skin area. This training program will be described in detail in this manuscript.

The case for considering volar skin in a “separate status” for wound healing

“…With the body of evidence showing that the viable portions of volar skin are every bit as unique as its stratum corneum, it appears that more comprehensive investigations of the wound healing process specifically in volar skin are warranted. Our research group has recently begun such investigations ( 63 ), in hopes of shedding new light on the pathophysiology of foot ulcers.…”

Breakthrough treatments for accelerated wound healing

“…Various species have been used to model cutaneous wound healing and tissue repair responses, among which the most popular are the pig, rabbit, mouse, and rat ( 113 ). The type of injury (e.g., burn, incisional, and chronic), location of injury (e.g., plantar) ( 114 ), and patient factors influencing healing (e.g., immunocompetency, nutrition status, and diabetes) may influence the choice of animal model ( 115 ). Pig wound healing models have anatomical and physiological similarities that most closely recapitulate those of human skin.…”