Application of negative pressure wound therapy to partially closed median sternotomy in a dog.

Abstract

A 6-year-old Labrador retriever dog with a history of pneumonia was presented because of an acute onset of dull mentation and coughing. Diagnostic imaging and cytology revealed a pneumothorax, pneumomediastinum, and pleural effusion, consistent with pyothorax. The dog underwent exploratory sternotomy for lung lobectomy of the right cranial and middle lung lobes. Persistent pneumothorax and pleural effusion were present after surgery, and the sternotomy site dehisced 6 d postoperatively. A second CT scan revealed persistent consolidation of the left cranial lung lobe and continued pneumothorax and pleural effusion. A left cranial lung lobectomy was done on the 8th day following initial surgery. An incisional infection was determined to be associated with multidrug-resistant Escherichia coli infection. Due to persistent pleural and incisional drainage, a third exploratory sternotomy was required, which revealed dehiscence of the surgical site and an unstable sternal repair with fractured sternebrae. The sternotomy site was left partially closed and negative pressure wound therapy (NPWT) was applied. No complications with NPWT were encountered, and the incision healed appropriately. Key clinical message: This is the first documented description of the use of NPWT in a dog to successfully manage a partially closed sternotomy and resolve a multidrug-resistant infection of the sternotomy site.