Negative pressure wound therapy augmented full-thickness free skin grafting in the cat: outcome in 10 grafts transferred to six cats

Combined Oxygen-Ozone Therapy for Mesh Skin Graft in a Cat with a Hindlimb Extensive Wound

This case report describes a new therapeutic approach for a domestic shorthaired female cat, who has an extensive posttraumatic wound in the right hind limb. After patient stabilization, general anesthesia was started and the wound was cleaned and debrided of devitalized tissues, followed by the application of ozone therapy and bandage. Eight sessions of ozone therapy were performed for 17 days until the application of the skin graft. Three more sessions of ozone therapy were performed every 3 days postoperatively. The bagging method and the perilesional infiltration method were used. The ozone therapy ensured an accelerated recovery of the patient without any complications. According to our knowledge, this is the first case report with the use of ozone therapy to support a free skin graft in a cat. The new therapeutic approach could be used to accelerate healing of the wounds with a significant lack of substance, by supporting pre- and post-operative skin grafts.

Filling the vacuum: Role of negative pressure wound therapy in open wound management in cats

Practical relevance:

Open wounds and their treatment present a common challenge in veterinary practice. Approaching 15 years ago negative pressure wound therapy (NPWT) started to be incorporated into clinical veterinary medicine, and its availability is becoming more widespread in Europe and the USA. Use of this therapy has the potential to significantly increase the healing rate of open wounds as well as free skin grafts in small animals, and it has been occasionally described for the management of feline wounds.

Aim:

This review describes the mechanisms of action of, and indications for, NPWT, and offers recommendations for NPWT specific to feline patients.

Evidence base:

The information presented is based on the current evidence and the author’s clinical experience of the technique gained over the past 12 years. Comparative studies of different treatment options are lacking and, since wound healing in cats and dogs differs, cat-specific studies are especially needed. Well-designed wound healing studies comparing different advanced techniques will improve open wound healing in cats in the future, and potentially allow better understanding of the role of NPWT in this setting.

Seed skin grafts for reconstruction of distal limb defects in 15 dogs

OBJECTIVES

To report the surgical technique of seed skin grafting and clinical application for reconstruction of wounds on the distal limb of client-owned dogs.

MATERIALS AND METHODS

Medical records from The Animal Hospital at Murdoch University were retrospectively reviewed for dogs requiring reconstruction using seed grafting for distal limb skin defects between January 2009 and May 2020.

RESULTS

Fifteen dogs were included. Grafting was performed on distal limb wounds at or below the carpus or tarsus, following trauma (n = 12) or neoplasia excision (n = 3). Complete epithelialisation with minimal contracture was recorded at a median of 4 weeks (range 3 to 8 weeks) after implantation. Median follow-up was 37 months (range 3 to 55 months) after grafting. Postoperative complications included epidermal inclusion cyst in two dogs. Good functional outcome with acceptable cosmesis despite sparse hair growth was achieved in all cases.

CLINICAL SIGNIFICANCE

Seed grafting is a simple technique that can be used reliably to reconstruct wounds on the distal limb in dogs where other reconstructive techniques are not suitable. Complete epithelialisation with sparse hair growth, good long-term functional outcome and minimal complications can be expected.

Indications, complications, and outcomes associated with subdermal plexus skin flap procedures in dogs and cats: 92 cases (2000-2017)

OBJECTIVE

To describe indications, complications, and outcomes associated with subdermal plexus skin flap (SPSF) procedures in dogs and cats.

ANIMALS

53 dogs and 20 cats that received SPSFs for reconstruction of skin defects from 2000 to 2017.

PROCEDURES

Medical record data were collected and summarized regarding patient signalment, indication for the SPSF procedure, type and location of SPSF, complications, and outcome.

RESULTS

92 SPSF procedures (64 in dogs and 28 in cats) were included. Indications for the procedures included tumor excision (n = 37 [40%]), acute wound (14 [15%]) or chronic wound (28 [30%]) reconstruction, surgical scar revision (7 [8%]), and other reasons (6 [7%]). Types of SPSFs included advancement (31 [34%]), axillary fold (20 [22%]), inguinal fold (20 [22%]), rotation (16 [17%]), transposition (3 [3%]), and distant direct (2 [2%]). Complications were noted for 47 (51%) procedures at a mean ± SD of 6.9 ± 4.0 days after surgery and were classified as minor (34 [37%]) or major (13 [14%]). Outcome was considered excellent for 44 (48%) procedures, good for 33 (36%), fair for 13 (14%), and poor for 2 (2%).

CONCLUSIONS AND CLINICAL RELEVANCE

Results suggested that approximately half of SPSF procedures in dogs and cats can be expected to be followed by a complication, occurring at a mean of 1 week after surgery, and yet with appropriate management of these complications, a good to excellent outcome was possible. Owners should be counseled about the likely need for additional visits and costs associated with treatment of postoperative complications.

Technological Advances in Wound Treatment of Exotic Pets

Although most research about the use of technological advances for wound healing was performed in laboratory animals but oriented to human medicine, recent technological advances allowed its application not only to small animals but also to exotic pets. This article reviews the literature available about some of these techniques (negative wound pressure therapy, photobiomodulation [laser therapy], electrical stimulation therapy, therapeutic ultrasonography, hyperbaric oxygen therapy), and other advances in wound management (skin expanders, xenografts, and bioengineered autologous skin substitutes) in exotic pet species.

Feasibility of a disposable canister-free negative-pressure wound therapy (NPWT) device for treating open wounds in horses

BACKGROUND

Wounds are among the most common medical conditions affecting horses and have a major economic impact on the horse industry. Wound healing in horses is distinct to that documented in other species, and often results in delayed healing and extensive scarring, with compromised functional and aesthetic outcomes. To date, there is no conventional method objectively proven to accelerate healing or to successfully prevent complications associated with second intention healing. Several effects of Negative Pressure Wound Therapy (NPWT) may be particularly useful to the management of wounds in horses. However, cumbersome designs of classic NPWT devices render them unsuitable for equine practice. A new lightweight, portable and disposable unit of NPWT (PICO®), should facilitate the use of this modality by equine practitioners. The aim of this study was to evaluate the feasibility of using this canister-free system to treat experimental open wounds in horses.

RESULTS

No difficulties were encountered with the application or maintenance of the PICO® system during the ex vivo experiment or during the preliminary in vivo experiment conducted on intact skin. All horses readily tolerated the PICO® but difficulties with adhesion and seal prevented the completion of the experimental wound study despite the use of many adjunctive adhesives.

CONCLUSION

The current PICO® dressing design is not suitable to be used as a dressing for open wounds in horses though the device is well tolerated by equine patients. A dressing with a wider adhesive edge, a superior adhesive and a more flexible pad would likely be better adapted to enable its future use in equine practice.

Vakuumassistierte Wundbehandlung (Negative Pressure Wound Therapy, NPWT) in der Kleintiermedizin

Die Behandlung offener Wunden gehört zu den alltäglichen Herausforderungen in der Tiermedizin. In den letzten Jahren hat sich mit der vakuumassistierten Wundbehandlung (Negative Pressure Wound Therapy, NPWT) eine neue Therapieform entwickelt. Durch ihren Einsatz lassen sich die Heilung offener Wunden und die Einheilungsrate freier Hauttransplantate beim Kleintier signifikant verbessern. In diesem Überblick werden Wirkweise, Indikationen sowie Komplikationen der Negative Pressure Wound Therapy dargestellt.

Retrospective comparison of negative pressure wound therapy and silver-coated foam dressings in open-wound treatment in cats

Objectives The objective of this study was to evaluate negative pressure wound therapy (NPWT) for the treatment of complicated wounds in cats. Methods Twenty cats undergoing open-wound treatment in two clinics were classed according to treatment method: NPWT (group A, n = 10) and polyurethane foam dressing (group B, n = 10). Pairs of patients from each group were matched based on wound conformation, localisation and underlying cause. Cats from both groups were compared in terms of duration of previous treatment, time to closure and complications. Results Signalment, duration of previous treatment, antibiotic and antiseptic treatment, and bacterial status were comparable between groups. Total time to wound closure was significantly shorter ( P = 0.046, strong effect size; Cohen d = 0.8) in group A (25.8 days, range 11.0-57.0 days) compared with group B (39.5 days, range 28.0-75.0 days). NPWT-treated wounds suffered fewer complications and became septic less frequently during treatment compared with wounds treated with a foam dressing. The progression of fat tissue necrosis was particularly well controlled under NPWT, resulting in fewer deaths due to this condition in this group. However, although a strong effect of NPWT on the progression of infection, fever and sepsis was detected (Cramer-V 0.5), this difference was not significant. Conclusions and relevance This study demonstrated that time to healing was considerably shorter, and complication rate lower, in NPWT-treated animals compared with foam dressing-treated cats. In particular, the effective management of infection by NPWT emphasises the value of NPWT in the treatment of cats suffering from infected wounds.

[Features of skin graft in pediatric plastic surgery]

Skin graft is a skin tissue fragment transferred from a donor site to a receiving site with a spontaneous revascularization. Basic process of plastic surgery, skin graft known in children, specific, warnings and refinements. It finds its indication in many pediatric cases: integumental diseases (neavus, hamartoma), acute burns and scars, traumatic loss of substance or surgically induced, congenital malformations of the hands and feet, etc. Specific skin graft techniques in children are developed: donor sites, sampling technique and procedure, early postoperative care. Especially in children, the scalp is a perfect site for split skin graft and technique is actively developed. Refinements and special cases are discussed: use of dermal matrices, allografts, xenografts, negative pressure therapy, prior skin expansion of the donor site. Results of skin graft in children are exposed: taking of graft, growth and shrinkage, pigmentation. Skin graft sometimes allows to stay the complex movement and get the best final benefit, permanent or at least temporary, in a growing being.