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CC BY 4.0 · VCOT Open 2019; 02(02): e1-e8
DOI: 10.1055/s-0039-1693007
Original Article
Georg Thieme Verlag KG Stuttgart · New York

Evaluation of Systemic Effects of Negative Pressure Wound Therapy in Open Wound Treatment in Dogs

Rebecca Albert
1   Clinic for Small Animal Surgery and Reproduction, Ludwig-Maximilians University, Munich, Germany
,
Sven Reese
2   Department for Basic Veterinary Sciences, Ludwig-Maximilians University, Munich, Germany
,
Mirja C. Nolff
1   Clinic for Small Animal Surgery and Reproduction, Ludwig-Maximilians University, Munich, Germany
,
Andrea Meyer-Lindenberg
1   Clinic for Small Animal Surgery and Reproduction, Ludwig-Maximilians University, Munich, Germany
› Author Affiliations
Further Information

Publication History

30 July 2018

02 May 2019

Publication Date:
17 July 2019 (online)

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Abstract

Objectives The aim of this study was to evaluate the systemic effect of negative pressure wound therapy (NPWT) on the treatment of complicated wounds in dogs.

Materials and Methods Dogs undergoing open wound treatment were randomly assigned to one of two groups: NPWT (n = 11) or polyurethane foam dressing (n = 11). Rectal temperature, heart rate as well as haematocrit, thrombocytes, leucocyte count, band neutrophils, C-reactive protein (CrP), total protein and albumin were recorded daily from the beginning of therapy (day 0) until day 5, as well as on day 10. The effect of treatment on systemic parameters was evaluated as well as the prognostic power of the individual parameters with regard to successful wound closure.

Results A more profound systemic decrease was found in total protein under NPWT. This difference was non-significant. Patients with non-successful closure displayed a non-significant trend towards lower initial leukocyte and thrombocyte counts and significantly higher CrP values on days 4, 5 and 10 (p < 0.05) compared with successfully treated patients. Receiver operating characteristic analysis revealed an optimal cutoff value of 70.2 mg/L at day 4 (sensitivity 80; specificity of 85.7).

Conclusion There might be an increased loss of protein in NPWT-treated patients, which does not affect albumin levels, otherwise no systemic effects were detected compared with the control treatment. The parameter with the best sensitivity and specificity to detect serious complications (no wound closure achieved) was CrP at day 4.

Keywords

negative pressure wound therapy - polyurethane foam - C-reactive protein - prognostic values for wound closure

Author Contribution

Rebecca Albert and Mirja C. Nolff contributed to conception of study, study design, acquisition of data and data analysis and interpretation. Sven Reese contributed to data analysis and interpretation. Andrea Meyer-Lindenberg contributed to conception of study and study design. Rebecca Albert and Mirja C. Nolff and Andrea Meyer-Lindenberg drafted, revised and approved the submitted manuscript.


Supplementary Material

 

  • References

  • 1 Pavletic MM. Wound management principles and techniques. Vet Q 1997; 19 (Suppl. 01) 22-24
    CrossrefPubMedGoogle Scholar
  • 2 Gurtner GC, Werner S, Barrandon Y, Longaker MT. Wound repair and regeneration. Nature 2008; 453 (7193): 314-321
    PubMedGoogle Scholar
  • 3 Wilmink JM, van Weeren PR. Second-intention repair in the horse and pony and management of exuberant granulation tissue. Vet Clin North Am Equine Pract 2005; 21 (01) 15-32
    CrossrefPubMedGoogle Scholar
  • 4 Wilmink JM, Nederbragt H, van Weeren PR, Stolk PW, Barneveld A. Differences in wound contraction between horses and ponies: the in vitro contraction capacity of fibroblasts. Equine Vet J 2001; 33 (05) 499-505
    PubMedGoogle Scholar
  • 5 Bohling MW, Henderson RA, Swaim SF, Kincaid SA, Wright JC. Comparison of the role of the subcutaneous tissues in cutaneous wound healing in the dog and cat. Vet Surg 2006; 35 (01) 3-14
    CrossrefPubMedGoogle Scholar
  • 6 Bohling MW, Henderson RA, Swaim SF, Kincaid SA, Wright JC. Cutaneous wound healing in the cat: a macroscopic description and comparison with cutaneous wound healing in the dog. Vet Surg 2004; 33 (06) 579-587
    CrossrefPubMedGoogle Scholar
  • 7 Volk SW, Bohling MW. Comparative wound healing--are the small animal veterinarian's clinical patients an improved translational model for human wound healing research?. Wound Repair Regen 2013; 21 (03) 372-381
    CrossrefPubMedGoogle Scholar
  • 8 Glass GE, Murphy GF, Esmaeili A, Lai LM, Nanchahal J. Systematic review of molecular mechanism of action of negative-pressure wound therapy. Br J Surg 2014; 101 (13) 1627-1636
    CrossrefPubMedGoogle Scholar
  • 9 Nuutila K, Siltanen A, Peura M. , et al. Gene expression profiling of negative-pressure-treated skin graft donor site wounds. Burns 2013; 39 (04) 687-693
    CrossrefPubMedGoogle Scholar
  • 10 Dzieciuchowicz Ł, Kruszyna Ł, Krasiński Z, Espinosa G. Monitoring of systemic inflammatory response in diabetic patients with deep foot infection treated with negative pressure wound therapy. Foot Ankle Int 2012; 33 (10) 832
    CrossrefPubMedGoogle Scholar
  • 11 Nolff MC, Fehr M, Reese S, Meyer-Lindenberg AE. Retrospective comparison of negative pressure wound therapy and silver-coated foam dressings in open-wound treatment in cats. J Feline Med Surg 2017; 19 (06) 624-630
    CrossrefPubMedGoogle Scholar
  • 12 Nolff MC, Fehr M, Bolling A. , et al. Negative pressure wound therapy, silver coated foam dressing and conventional bandages in open wound treatment in dogs. A retrospective comparison of 50 paired cases. Vet Comp Orthop Traumatol 2015; 28 (01) 30-38
    Article in Thieme ConnectPubMedGoogle Scholar
  • 13 Weed T, Ratliff C, Drake DB. Quantifying bacterial bioburden during negative pressure wound therapy: does the wound VAC enhance bacterial clearance?. Ann Plast Surg 2004; 52 (03) 276-279 , discussion 279–280
    CrossrefPubMedGoogle Scholar
  • 14 Stanley BJ, Pitt KA, Weder CD, Fritz MC, Hauptman JG, Steficek BA. Effects of negative pressure wound therapy on healing of free full-thickness skin grafts in dogs. Vet Surg 2013; 42 (05) 511-522
    CrossrefPubMedGoogle Scholar
  • 15 Hourigan LA, Hourigan L, Linfoot JA. , et al. Loss of protein, immunoglobulins, and electrolytes in exudates from negative pressure wound therapy. Nutr Clin Pract 2010; 25 (05) 510-516
    CrossrefPubMedGoogle Scholar
  • 16 Eming SA, Krieg T, Davidson JM. Inflammation in wound repair: molecular and cellular mechanisms. J Invest Dermatol 2007; 127 (03) 514-525
    CrossrefPubMedGoogle Scholar
  • 17 Pitzer GB, Patel KG. Proper care of early wounds to optimize healing and prevent complications. Facial Plast Surg Clin North Am 2011; 19 (03) 491-504
    CrossrefPubMedGoogle Scholar
  • 18 Grose R, Werner S. Wound-healing studies in transgenic and knockout mice. Mol Biotechnol 2004; 28 (02) 147-166
    CrossrefPubMedGoogle Scholar
  • 19 Golebiewska EM, Poole AW. Platelet secretion: from haemostasis to wound healing and beyond. Blood Rev 2015; 29 (03) 153-162
    CrossrefPubMedGoogle Scholar
  • 20 Jenne CN, Urrutia R, Kubes P. Platelets: bridging hemostasis, inflammation, and immunity. Int J Lab Hematol 2013; 35 (03) 254-261
    CrossrefPubMedGoogle Scholar
  • 21 McNicol A, Israels SJ. Beyond hemostasis: the role of platelets in inflammation, malignancy and infection. Cardiovasc Hematol Disord Drug Targets 2008; 8 (02) 99-117
    CrossrefPubMedGoogle Scholar
  • 22 Yeaman MR. Platelets: at the nexus of antimicrobial defence. Nat Rev Microbiol 2014; 12 (06) 426-437
    CrossrefPubMedGoogle Scholar
  • 23 Black S, Kushner I, Samols D. C-reactive protein. J Biol Chem 2004; 279 (47) 48487-48490
    CrossrefPubMedGoogle Scholar
  • 24 Kjelgaard-Hansen M, Strom H, Mikkelsen LF, Eriksen T, Jensen AL, Luntang-Jensen M. Canine serum C-reactive protein as a quantitative marker of the inflammatory stimulus of aseptic elective soft tissue surgery. Vet Clin Pathol 2013; 42 (03) 342-345
    CrossrefPubMedGoogle Scholar
  • 25 Kjelgaard-Hansen M, Jacobsen S. Assay validation and diagnostic applications of major acute-phase protein testing in companion animals. Clin Lab Med 2011; 31 (01) 51-70
    CrossrefPubMedGoogle Scholar
  • 26 Christensen MB, Eriksen T, Kjelgaard-Hansen M. C-reactive protein: quantitative marker of surgical trauma and post-surgical complications in dogs: a systematic review. Acta Vet Scand 2015; 57: 71
    CrossrefPubMedGoogle Scholar
  • 27 Christensen MB, Langhorn R, Goddard A. , et al. Comparison of serum amyloid A and C-reactive protein as diagnostic markers of systemic inflammation in dogs. The Canadian veterinary journal. Can Vet J 2014; 55 (02) 161-168
    PubMedGoogle Scholar
  • 28 Cerón JJ, Martinez-Subiela S, Ohno K, Caldin M. A seven-point plan for acute phase protein interpretation in companion animals. Vet J 2008; 177 (01) 6-7
    CrossrefPubMedGoogle Scholar
  • 29 Karlsson I, Wernersson S, Ambrosen A. , et al. Increased concentrations of C-reactive protein but not high-mobility group box 1 in dogs with naturally occurring sepsis. Vet Immunol Immunopathol 2013; 156 (1-2): 64-72
    CrossrefPubMedGoogle Scholar
  • 30 Gebhardt C, Hirschberger J, Rau S. , et al. Use of C-reactive protein to predict outcome in dogs with systemic inflammatory response syndrome or sepsis. J Vet Emerg Crit Care (San Antonio) 2009; 19 (05) 450-458
    CrossrefPubMedGoogle Scholar
  • 31 Mathon DH, Palierne S, Meynaud-Collard P. , et al. Laparoscopic-assisted colopexy and sterilization in male dogs: short-term results and physiologic consequences. Vet Surg 2011; 40 (04) 500-508
    CrossrefPubMedGoogle Scholar
  • 32 Nevill B, Leisewitz A, Goddard A, Thompson P. An evaluation of changes over time in serum creatine kinase activity and C-reactive protein concentration in dogs undergoing hemilaminectomy or ovariohysterectomy. J S Afr Vet Assoc 2010; 81 (01) 22-26
    PubMedGoogle Scholar