Negative pressure wound therapy with instillation for body wall reconstruction using an artificial mesh in a...

A 4-year-old spayed female Dachshund was presented in shock, displaying multiple haematomas and puncture wounds along the left abdominal wall and ventral aspect of the abdomen after being attacked by another dog. A defect of the left lateral body wall was palpated. Surgery revealed a massive body wall defect and concurrent injury of the intestines. Surgical debridement was performed and the injured portion of the jejunum was resected. The abdominal wall was reconstructed using a polypropylene mesh. Negative pressure wound therapy (NPWT) with instillation of 0.04% polyhexanide (-125 mmHg, instillation interval of 2 h, duration 20 min) was started. Microbial culture after reconstruction of the defect and before application of the NPWTi dressing revealed multiresistant Staphylococcus pseudintermedius. The NPWT dressing was changed on days 2, 5 and 7. Microbial cultures obtained at the first two dressing changes were negative. Therapy was well tolerated and the mesh was completely covered by granulation tissue after 10 days, when the wound was surgically closed.

Bite wounds frequently result in massive, contaminated defects with impaired perfusion, and reconstruction using foreign material carries the risk of biofilm formation and infection. Instillation therapy may provide an alternative for bacterial clearance and fast integration of the mesh.