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Temporary Rectal Stenting for Management of Severe Perineal Wounds in Two Dogs
Owen T Skinner1, Laura C Cuddy1, James G Coisman1
1From the Department of Small Animal Clinical Sciences, College of Veterinary Medicine, University of Florida, Gainesville, Florida (O.T.S., G.W.E.); Joint Base Lewis-McChord Veterinary Center, Tacoma, Washington (J.G.C.); Department of Surgery, Section of Veterinary Clinical Studies, School of Veterinary Medicine, University College Dublin, Dublin, Ireland (L.C.C.); and Oakland Veterinary Referral Services, Bloomfield Hills, Michigan (J.L.C.).
Abstract:
Perineal wounds in dogs present a challenge due to limited local availability of skin for closure and constant exposure to fecal contaminants. This report describes temporary rectal stenting in two dogs following severe perineal wounds. Dog 1 presented with a 4 × 4 cm full-thickness perineal slough secondary to multiple rectal perforations. A 12 mm internal diameter endotracheal tube was placed per-rectum as a temporary stent to minimize fecal contamination. The stent was removed 18 days after placement, and the perineal wound had healed at 32 days post-stent placement, when a minor rectal stricture associated with mild, intermittent tenesmus was detected. Long-term outcome was deemed good. Dog 2 presented with multiple necrotic wounds with myiasis, circumferentially surrounding the anus and extending along the tail. A 14 mm internal diameter endotracheal tube was placed per-rectum. The perineal and tail wounds were managed with surgical debridement and wet-to-dry and honey dressings prior to caudectomy and negative pressure wound therapy (NPWT). Delayed secondary wound closure and stent removal were performed on day six without complication. Long-term outcome was deemed excellent. Temporary rectal stenting may be a useful technique for fecal diversion to facilitate resolution of complex perineal injuries, including rectal perforation.
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