while open wounds require a combination of tissue contraction, connective tissue deposition, and epithelialization to a lesser extent. Chronic ulcers heal by secondary intention similar to open wounds.

Although there are numerous indications and potential indications for HBOT, there are 14 accepted indications by Undersea and Hyperbaric Medical Society, and the FDA. Indications related to wounds and ulcers include clostridial myonecrosis, crush injury, radiation-induced soft tissue and bone necrosis, necrotizing soft tissue infections, diabetic ulcers Wagner III or higher, refractory osteomyelitis, and thermal burns.

At present, only platelet-derived growth factor BB (PDGF-BB) is currently approved by the FDA for treatment of diabetic foot ulcers. Application of recombinant human PDGF-BB in a gel suspension to these wounds increases the incidence of total healing and decreases healing time.

Bioengineered skin substitutes have evolved from keratinocyte monolayers to dermal equivalents to split-thickness products with a pseudo-epidermis, and most recently, to products containing both epidermal and dermal components that resemble the three-dimensional structure and function of normal skin (see Table 9-11). Indicated for use with standard compression therapy in the treatment of venous insufficiency ulcers and for the treatment of neuropathic diabetic foot ulcers, these bilayered skin equivalents also are being used in a variety of wound care settings.

Ponies with gastric cannulas fed 45 mL corn oil PO once daily by dose syringe had significantly lower gastric acid output and increased prostaglandin concentration in their gastric juice compared to the non oil dosed animals

Feeding of sweet feed should be avoided as a large quantity of VFAs could be produced if greater than 1 to 2 kg of sweet feed is fed per meal. Grains like barley and oats can be substituted to decrease fermentation to VFAs. The diet should not exceed 2 g/kg bodyweight of starch intake per day or more than 1 g/kg bodyweight of starch per meal.24 Concentrate meals should not be fed less than 6 hours apart.

feed supplement consisting of salts of organic acids in combination with B‐vitamins might be beneficial in the management of ESGD98 and a preparation containing sea buckthorn berries appeared to have protective effects against the development of EGGD in a fasting model of disease

23% of horses experiencing worsening of their EGGD grade in a series of recent studies, despite omeprazole treatment at doses ranging from 1–4 mg/kg PO once daily.

a recent study reported a 67.5% healing rate for EGGD of the pyloric antrum using omeprazole (GastroGard1) at 4 mg/kg PO once daily and sucralfate at 12 mg/kg PO twice daily.91 Further studies investigating the role of sucralfate and the potential for interactions between it and omeprazole, as reported in human medicine, are required.

although such bacteria are present in ESGD their role appears to be secondary as the response to acid suppression alone is good

The factors that contribute to breakdown of this protective layer are yet to be elucidated in the horse, but in humans Helicobacter pylori and NSAIDs are the predominant causes of gastric ulceration.