Negative pressure wound therapy for the management of surgical site infections with zoonotic, drug‐resistant pathogens on the upper body of the horse

Abstract

Negative pressure wound therapy (NPWT) is frequently used to assist with the healing of challenging wounds or surgical incisions.NPWT applies sub-atmospheric pressure to a wound through a sealed dressing that draws exudate while applying mechanical pressure to the tissue bed. The negative pressure applied to the surrounding skin and wound bed improves vascularity, removes wound exudate, and reduces interstitial oedema (Stanley, 2017). This modulates the inflammatory and proliferative responses of wound healing, reduces the bacterial burden in the tissue bed, and relieves tension on the surrounding skin edges (Glass & Nanchahal, 2012;Stanley, 2017).Negative pressure wound therapy has been used in human medicine for acute and chronic wounds, infected and noninfected wounds, open incisions or those with primary closure, and reconstructive techniques at risk of dehiscence (Glass & Nanchahal, 2012). NPWT is commonly applied to skin grafts, incisions at high risk for dehiscence, diabetic and pressure ulcers, and to assist with the closure of open abdomens (

Negative-Pressure Wound Therapy (NPWT) in Horses: A Scoping Review

“…After one article was removed because it related to goats, a total of 16 papers underwent the second stage of screening considering the full-paper version of the studies. During full-paper screening, just 14 papers were included for eligibility and a new one was also included after being found as a citation in other papers, for a total of 15 articles [ 3 , 9 , 11 , 12 , 13 , 14 , 15 , 16 , 17 , 18 , 19 , 20 , 21 , 22 , 23 ].…”

“…In other studies, cross-tying was used in cases of distal limb wounds to avoid the excessive movement of the horses impairing the sealing [ 9 ]. Topical reactions, such as cellulitis, edema, and mild erythema, were reported in just two studies [ 3 , 18 ]. Despite the general trend in NPWT providing beneficial effects on wound healing, the same results were not reported when NWPT was compared with standard wound care using calcium alginate dressings on contaminated and non-contaminated wounds that were surgically induced.…”

“…This characteristic is important in the management of cases of polymicrobial multidrug-resistant surgical-site infections and wounds without the concurrent administration of antimicrobials improving responsible antimicrobial stewardship. The advantage of containing septic exudate within a canister is that it limits the exposure to personnel and improves environmental biosecurity, which are important features to consider in a hospital [ 18 ]. NPWT may also seal surgical wounds, assisting primary closure and preventing nosocomial bacterial contamination [ 9 ].…”

“…To conclude, the reported benefits of NPWT in horses were: Limitation of the number of required bandage changes in cases of highly exudative wounds reducing costs and personnel involved [ 18 ]. Increased hospital biosecurity by containing septic exudate.…”

“… Increased hospital biosecurity by containing septic exudate. This is extremely important when dealing with infected wounds and surgical-site infections, especially when polymicrobial, multidrug-resistant bacterial pathogens are present [ 18 ]. Nosocomial infection may be limited, too [ 9 ].…”