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Soft Tissue Surgery

Pitt KA, Stanley BJ.

Michigan State University, East Lansing, MI, USA.

 Vet Surg 2014;43:380–7.

Kelly Bowlt’s review: The aim of this prospective, descriptive study was to report the experience with negative pressure wound therapy (NPWT) in 45 consecutive dogs that were admitted with extensive cutaneous wounds to a veterinary hospital practice, and to determine the feasibility of NPWT. This therapy involves the application of sub-atmospheric pressure to a wound and is used extensively in human wound care. A porous primary dressing (usually consisting of open-cell polyurethane foam) is placed onto the wound bed, the wound is sealed with an impermeable drape, and a continuous-action vacuum is applied through a footpad attached to the foam. Initial studies have shown that NPWT increases blood flow to the wound, removes exudate, and stimulates granulation tissue formation. It has been used in human surgery, notably for orthopaedic trauma, burns, free skin grafts, compromise flaps, incisional dehiscence, cytotoxic sloughs, and open abdomen drainage.

A total of 53 wounds in 45 dogs were studied. They were largely traumatic in origin and were distributed fairly evenly between the trunk, and the proximal and distal aspects of the limbs. The majority of the wounds (34 dogs, 76%) had no granulation tissue and were treated at a mean of 4.2days after wounding, while 11 dogs had granulating wounds that were initially treated at a mean of 87days after wounding. The median length of time for NPWT was 3days, with a mean hospitalisation time of 7.8days. Most wounds (n=33, 62%) were closed surgically after NPWT and healed at 14days. The other 18 wounds healed at a mean of 21days by second intention after hospital discharge. Overall, 96% of the wounds healed; two dogs died before definitive closure could be attempted.

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