Banshee

Banshee’s Negative Pressure Wound Therapy

A dog with only a day or two to live was saved by vets at Rowe Referrals using negative pressure wound therapy, NPWT.

Eight-year-old Staffie crossbreed Banshee was left with progressively worsening necrotising fasciitis after suffering wounds in an attack by a cat.

After treatment at Rowe Referrals, Banshee was able to return home to her Worcester owners where she has made a healthy recovery.

Vet Dr. Elisa Best, highly experienced in NPWT, says the case is just the latest heartening success story at Rowe Referrals and hopes to see its wider use within the veterinary profession.

Banshee had been left with puncture wounds after the attack and was treated at her local vet practice.

However, a swelling then appeared under her neck and started to bruise. She was increasingly lethargic, and her bloods showed thrombocytopenia.

Banshee was firstly referred elsewhere, where an ultrasound scan led to concerns about an area of necrotising fasciitis getting progressively larger.

“The vets who did the initial consultation contacted us because they knew we were able to perform negative pressure wound therapy and of the benefit in cases such as Banshee,” said Dr. Best.

“In just one day since we’d seen the images sent to us, it had already progressed substantially. The tissue death was all the way down the dog’s neck, she was clinically very ill, and there were concerns if she would survive.

“But the moment I saw her, I was hopeful we could fix it.”

Banshee was anaesthetised and the necrotic tissue debrided. The resulting defect was very large and stretched from the intermandibular region to the sternum.

The wounds were flushed with saline and then soaked in Prontosan® solution.

NPWT was then applied using a 3M® KCI® VAC® machine at -125mmHG.

Banshee was hospitalised for treatment and supportive care.

She developed severe oedema around her face and muzzle, suspected to be due to vasculitis. The NPWT was left in place for three days, after which she was anaesthetised, and the dressing removed.

The necrotising fasciitis had not progressed and apart from a small amount of necrotic tissue at the very proximal end, the wound looked healthy and had started to develop granulation tissue.

The wound was soaked again using Prontosan® and partially closed and the NPWT reapplied.

“The location made it very difficult to keep a seal for the NPWT,” said Dr. Best. “The nursing team here put in a huge amount of effort, frequently having to patch it up and keep it working effectively.

“I have a massive interest in NPWT, as does one of our nurses.

“Although it is used extensively in human medicine, it’s much less used in veterinary, which I think is a real shame. There is quite a knowledge gap and it’s not as well recognised as it should be.

“It is such a good modality for difficult wounds. We have two machines which we use as much as we can as it increases wound healing significantly.

“It stopped the problem in its tracks with Banshee and we were able to move on to conventional dressings and the owners brought in regularly for us to change them.”

The dressing changes and open wound management continued until final closure.