Negative pressure wound therapy, silver coated foam dressing and conventional bandages in open wound treatment in dogs. A retrospective comparison of 50 paired cases

Clinical effect analysis of using medical glue versus conventional suturing to treat dog bite in children's maxillofacial region after negative pressure sealing drainage: A randomized trial

BACKGROUND

To compare the clinical effectiveness of applying medical glue versus conventional suturing after primary suturing and continuous vacuum sealing drainage (VSD) technology in the treatment of facial wounds caused by dog bites in children's maxillofacial region, with respect to operation time, wound infection rate, treatment effect, and patient satisfaction.

METHODS

From May 2020 to July 2022, 68 children with a dog bite in the maxillofacial region were randomly divided into medical glue and conventional suturing groups. The patients in both groups were treated with conventional debridement, tetanus and/or rabies immunization, and antibiotic therapy. The medical glue group was treated with VSD after the first-stage of the loose suture of the wound. After 5 days, the suture was removed, and the wound was tightly bonded with medical glue again. The conventional suturing group was treated with VSD after the first-stage of loose suture of the wound. The primary outcomes were the operation time and satisfaction of the 2 groups, and the secondary outcomes was the wound infection rate.

RESULTS

The operation time of the medical glue group was significantly lower than that of the conventional suturing group. However, there was no significant difference between the 2 groups in the wound infection rate. Still, the patient satisfaction was significantly better in the medical glue group than the conventional suturing group with statistically significant difference (P < .05).

CONCLUSION

In conclusion, applying medical glue after using negative pressure sealing drainage in treating maxillofacial dog bites can reduce surgeons work intensity, lessen children's pain, and improve the clinical treatment effect.

Local wound management: A review of modern techniques and products

Management of wounds is a commonly performed and essential aspect of small animal veterinary medicine. Appropriate wound management is a difficult art to master, due to the inherent complexity of the clinical scenario, as well as the ever-evolving nature of the field with the constant addition of new products and techniques. This article reviews key concepts that may help the practitioner better understand the natural process of wound healing, factors that delay healing and strategies to help improve the local wound environment to make it more conducive to healing during open wound management. The concept of wound bed preparation is defined before common local wound management strategies, such as wound lavage and debridement, are discussed in more detail. Key aspects of the management of biofilms and appropriate use of antimicrobial agents are also reviewed. Finally, the concept of moist wound healing and its impact in modern wound management is explained before a broad variety of types of wound dressings are reviewed, with a particular focus on active dressings.

Wound healing in animals: a review of physiology and clinical evaluation

Wound healing is a complicated process consisting of overlapping phases directed and regulated by many mediators of healing produced locally at the wound. The end goal of wound healing is the production of tissue at the site of injury which has a similar structure and provides protection to the body. Any alterations in the normal healing process can lead to delayed healing or additional tissue damage. Factors that contribute to aberrant wound healing can be species-specific and include both intrinsic (systemic) factors and extrinsic (environmental) factors. Management of wounds and recognition of alterations can be optimised by adoption of a structured framework for wound assessment, such as the TIME principle (acronym referring to the following categories: tissue, inflammation or infection, moisture, and edge of wound or epithelial advancement). This review article provides an overview of the phases of wound healing, variation of healing among different species, factors reported to delay healing, and an introduction to the TIME principle as a structured approach to clinical evaluation of wounds.

A Randomized Controlled Trial to Assess the Cost-effectiveness of a Novel, Simple Modification to the Negative Pressure Wound Therapy System

Background:

Negative pressure wound therapy (NPWT) has shown remarkable adaptation in wound management worldwide. Numerous studies have provided evidence that demonstrates both the medical and financial advantages of NPWT. In this study, the VAC Therapy System, one of the leading commercially used NPWT systems, has been utilized to treat patients with either acute or chronic wounds requiring surgical intervention, with the aim of demonstrating the efficacy of using a modified version of the VAC system while reducing the total associated cost.

Method:

The patients were divided into two randomly selected groups using randomization generator software. A modification was made by replacing the disposable canister provided by Kinetic Concepts Inc., with an alternative reusable canister (Baxter, Inc.); one group was assigned to use the conventional VAC Therapy System, and the other was assigned to use the modified version. Our study aimed to investigate whether this modification would lower the cost of the VAC Therapy System while still achieving the desired outcome.

Results:

The VAC Therapy System contributed to improving the wound bed score in both groups, which supports previous findings on the effectiveness of NPWT while reflecting that the modification did not negatively impact the functionality and the integrity of the VAC Therapy System. Furthermore, the average daily consumables cost was markedly reduced in the modified group compared with the standard group, which reduced the overall cost of treatment.

Conclusion:

It is possible to use the VAC Therapy System to its full advantage, while minimizing the financial burden of using it.

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.

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.

Wound Care

Wound care requires an understanding of normal wound healing, causes of delays of wound healing, and the management of wounds. Every wound must be treated as an individual with regard to cause, chronicity, location, and level of microbial contamination, as well as patient factors that affect wound healing. Knowledge of wound care products available and when negative pressure wound therapy and drain placement is appropriate can improve outcomes with wound healing. Inappropriate product use can cause delays in healing. As a wound healing progresses, management of a wound and the bandage material used must evolve.